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TOLBUTAMIDE: It is classified as first generation sulfonylurea, sole significant action being lowering of blood glucose level in normal and non-insulin dependent diabetics, but not in insulin dependent diabetics. Its mechanism of action is like Glibenclamide.

Indication: Non-insulin dependent diabetes mlliuts (Type II, maturity onset diabets) whenever dietary treatment alone proves inadequate.

Dosage: 1.0 gm a single daily dose before breakfast or the first substantial meal. If more than 1.0 gm daily is required, the rest cab be taken before the evening meal. Max: 0.5-2 gm, daily.

Contra-indications: Insulin dependent diabetes mellitus (Type 1, juvenile diabetes). Diabetic comedibetic metabolic decompensation (ketoacidosis) severe impairment of renal function, hypersensitivity.

Special Precautions; Compliance to diet and regular medication are of utmost importance e for success of treatment. Altered alertness and capacity to react may be impaired. Driving vehicle or to operate machinery, Alcohol might attenuate or potentiate effect of tolbutamide.

Pediatrics: Should not be used.

Pregnancy & Lactation: Should not be used.

Elderly: Safe.

Side-effects: Nausea, sensation of gastric fullness, transient changes of heamotopoietic system. Hypersensitivity skin reactions.

Drug interaction : Hypoglycaemic effect enhanced by dicoumarol, colfibrate, chloremphenicol & cycloophosphamide & effect reduced by corticos teroids, adrenaline, oral contraceptices & thiazide diuretics.