Treatment with tolbutamide may increase the risk of death from cardiovascular disease compared to treatment of diabetes with diet alone or diet plus insulin. Discuss with your doctor the risks and benefits of treatment with tolbutamide. Know the signs and symptoms of low blood sugar (hypoglycemia), which include headache, drowsiness, weakness, dizziness, fast heartbeat, sweating, tremor, and nausea. Carry a piece of hard candy or glucose tablets with you to treat episodes of low blood sugar. Follow your diet, medication, and exercise routines closely. Changing any of them can affect blood sugar levels. Do not change your dose of tolbutamide without first talking to your doctor. Avoid alcohol. It lowers blood sugar and may interfere with your diabetes treatment.
Sulphinpyrazone, a drug used as an antithrombotic agent and inhibitor of platelet aggregation has a potent side effect as a uricosuric agent. The uricosuric side effect increases the urinary excretion of uric acid effectively blocking hepatic conjugation. Tests show that Sulphinpyrazone’s effect on Tolbutamide is a reduction of liver function to 60% of normal without interfering with protein binding. Taking alpha-lipoic acid or chromium with tolbutamide may require a change in the drugs dosage. Use ephedra with caution when taking tolbutamide; ephedra can raise blood sugar levels.
You should not take tolbutamide if you have had an allergic reaction to it. Tolbutamide should not be taken if you are suffering from diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, nausea, fatigue, pain below the breastbone, and fruity breath). In addition, Tolbutamide should not be used as the sole therapy in treating type 1 (insulin-dependent) diabetes.