$Unique_ID{BRK02161}
$Pretitle{}
$Title{TOLAZAMIDE}
$Subject{tolazamide (various manufacturers)
Tolinase (Upjohn)}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


TOLAZAMIDE
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BRAND NAMES (Manufacturers):
     tolazamide (various manufacturers)
     Tolinase (Upjohn)
TYPE OF DRUG:
     Oral antidiabetic
INGREDIENT:
     tolazamide
DOSAGE FORM:
     Tablets (100 mg, 250 mg, and 500 mg)
STORAGE:
     This medication should be stored at room temperature in a tightly closed
       container.  Discard any outdated medication.

USES

     Tolazamide is used for the treatment of diabetes mellitus (sugar
diabetes) that appears in adulthood and cannot be managed by control of diet
alone.  This type of diabetes is known as non-insulin-dependent diabetes (also
called maturity-onset or Type II diabetes).  Tolazamide lowers the blood sugar
level by increasing the release of insulin from the pancreas.

TREATMENT

     In order for this medication to work correctly, it must be taken as
directed by your doctor.  It is best to take this medicine at the same time
each day in order to maintain a constant blood sugar level.  It is, therefore,
important to try not to miss any doses of tolazamide.  If you do miss a dose,
take it as soon as possible, unless it is almost time for the next dose.  In
that case, do not take the missed dose at all; just return to your regular
dosing schedule.  Do not double the next dose.  Tell your doctor if you feel
any side effects from missing a dose of this drug.

SIDE EFFECTS

     Minor.

     Diarrhea, headache, heartburn, loss of appetite, nausea, stomach
discomfort, stomach pain, or vomiting.  These side effects usually disappear
as your body adjusts to the drug.
     Tolazamide may increase your sensitivity to sunlight.  You should,
therefore, avoid prolonged exposure to sunlight and sunlamps.  Wear protective
clothing and sunglasses, and use an effective sunscreen.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
dark urine, fatigue, itching of the skin, light-colored stools, sore throat
and fever, unusual bleeding or bruising, or yellowing of the eyes or skin.

INTERACTIONS

     Tolazamide interacts with several other types of drugs:
     1. Chloramphenicol, guanethidine, fenfluramine, sulfinpyrazone, insulin,
monoamine oxidase (MAO) inhibitors, oxyphenbutazone, oxytetracycline,
phenylbutazone, probenecid, aspirin or other salicylates, and sulfonamide
antibiotics, when combined with tolazamide, can lower blood sugar levels--
sometimes to dangerously low levels.  At least 14 days should separate the use
of this drug and the use of an MAO inhibitor.
     2. Thyroid hormones, dextrothyroxine, epinephrine, phenytoin, thiazide
diuretics (water pills), and cortisone-like medications (such as
dexamethasone, hydrocortisone, and prednisone), combined with tolazamide, can
actually increase blood sugar levels--just what you are trying to avoid.
     3. Rifampin can decrease the blood concentrations of tolazamide, which
can lead to a decrease in its effectiveness.
     4. Oral antidiabetic medications can increase the effects of warfarin,
which can lead to bleeding complications.
     5. Beta-blocking medications (acebutolol, atenolol, betaxolol, carteolol,
esmolol, labetalol, metoprolol, nadolol, penbutolol, pindolol, propranolol,
timolol) combined with tolazamide can result in either high or low blood sugar
levels.  Beta blockers can also mask the symptoms of low blood sugar, which
can be dangerous.
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any of those listed above.

WARNINGS

     * It is important to tell your doctor if you have ever had unusual or
allergic reactions to tolazamide or to any other sulfa medication (sulfonamide
antibiotics, diuretics {water pills}, other oral antidiabetics).
     * It is also important to tell your doctor if you now have or if you have
ever had kidney disease, liver disease, severe infections, or thyroid disease.
     * Avoid drinking alcoholic beverages while taking this medication (unless
otherwise directed by your doctor).  Some patients who take this medicine
suffer nausea, vomiting, dizziness, stomach pain, pounding headache, sweating,
and redness of the face and skin when they drink alcohol.  Also, large amounts
of alcohol can lower your blood sugar concentration to a dangerously low
level.
     * Follow the special diet that your doctor gave you.  This is an
important part of controlling your blood sugar and is necessary in order for
this medicine to work properly.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medicine.
     * Test for sugar in your urine as directed by your doctor.  It is a
convenient way to determine whether your diabetes is being controlled by this
medicine.
     * Eat or drink something containing sugar right away if you experience
any symptoms of hypoglycemia (low blood sugar), such as anxiety, chills, cold
sweats, cool or pale skin, drowsiness, excessive hunger, headache, nausea,
nervousness, rapid heartbeat, shakiness, or unusual tiredness or weakness.  It
is important that your family and friends know the symptoms of low blood sugar
and what to do if they observe any of these symptoms in you.
     * Even if the hypoglycemic symptoms seem to disappear after you eat or
drink a sugar-containing product, it is important to contact your doctor as
soon as possible.  The blood-sugar-lowering effects of tolazamide can last for
hours, and your symptoms may return during this period.  Good sources of sugar
are orange juice, corn syrup, honey, sugar cubes, and table sugar.  You are at
greatest risk of developing low blood sugar if you skip or delay meals,
exercise more than usual, are unable to eat because of nausea or vomiting, or
drink large amounts of alcohol.  You may need to be switched to insulin if you
suffer diabetic coma, have a severe infection, are scheduled for major
surgery, or become pregnant.
     * Be sure to tell your doctor if you are pregnant.  Your dosing
requirements for tolazamide may change during pregnancy.  Although extensive
studies in humans have not been conducted, adverse effects have been observed
in the fetuses of animals that received this type of drug during pregnancy.
Also, tell your doctor if you are breast-feeding an infant.  Small amounts of
tolazamide may pass into breast milk.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
