Orinase

Generic name: Tolbutamide

What is Orinase?

Orinase is an oral antidiabetic medication used to treat type 2 (non-insulin-dependent) diabetes. Diabetes occurs when the body does not make enough insulin, or when the insulin that is produced no longer works properly. Insulin works by helping sugar get inside the body's cells, where it is then used for energy.

Insulin or metformin (Glucophage) may also be used in combination with Orinase, if necessary.

What is the most important information I should know about Orinase?

Always remember that Orinase is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan can lead to serious complications, such as dangerously high or low blood sugar levels. Remember, too, that Orinase is not an oral form of insulin, and cannot be used in place of insulin.

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.

If you are taking Orinase, you should check your blood or urine periodically for abnormal sugar (glucose) levels.

Who should not take Orinase?

You should not take Orinase if you have had an allergic reaction to it.

Orinase 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, Orinase should not be used as the sole therapy in treating type 1 (insulin-dependent) diabetes.

What should I tell my doctor before I take the first dose of Orinase?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Orinase. Also, talk to your doctor about your complete medical history, especially if you have kidney disease, liver disease, thyroid disease, type 1 diabetes, diabetic ketoacidosis, a serious infection, illness, injury, or need surgery.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Dosage levels are based on individual needs.

Adults: Usually an initial daily dose of 1 to 2 grams is recommended. Maintenance therapy usually ranges from 0.25 to 3 grams daily. Daily doses greater than 3 grams are not recommended.

Children: Safety and effectiveness have not been established in children.

Older Adults: Older, malnourished, or debilitated people, or those with impaired kidney or liver function, are usually prescribed lower initial and maintenance doses to minimize the risk of low blood sugar (hypoglycemia).

How should I take Orinase?

Take each dose with a full glass of water.

Orinase is usually taken before breakfast or the first main meal if it is taken once a day, or before meals if it is taken multiple times each day. Follow your doctor's instructions.

What should I avoid while taking Orinase?

Avoid alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

What are possible food and drug interactions associated with Orinase?

If Orinase is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Orinase with the following: adrenal corticosteroids such as prednisone (Deltasone) and cortisone (Cortone); airway-opening drugs such as Proventil and Ventolin; alcohol; anabolic steroids such as testosterone; barbiturates such as Amytal, Seconal, and Phenobarbital; beta blockers such as Inderal and Tenormin; blood-thinning drugs such as Coumadin; calcium channel blockers such as Cardizem and Procardia; chloramphenicol (Chloromycetin); cimetidine (Tagamet); clofibrate (Atromid-S); colestipol (Colestid); epinephrine (EpiPen); estrogens (Premarin); fluconazole (Diflucan); furosemide (Lasix); isoniazid (Nydrazid); itraconazole (Sporanox); major tranquilizers such as Stelazine and Mellaril; MAO inhibitors such as Nardil and Parnate; methyldopa (Aldomet); miconazole (Monistat); niacin (Nicobid, Nicolar); nonsteroidal anti-inflammatory agents such as Advil, aspirin, ibuprofen, Naprosyn, phenylbutazone and Voltaren; oral contraceptives; phenytoin (Dilantin); probenecid (Benemid); rifampin (Rifadin); sulfa drugs such as Bactrim and Septra; thiazide and other diuretics such as Diuril and HydroDIURIL; and thyroid medications such as Synthroid.

What are the possible side effects of Orinase?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: bloating, heartburn, nausea

Orinase, like all oral antidiabetics, may cause hypoglycemia (low blood sugar). The risk of hypoglycemia can be increased by missed meals, alcohol, other medications, fever, trauma, infection, surgery, or excessive exercise. To avoid hypoglycemia, you should closely follow the dietary and exercise plan suggested by your physician.

Symptoms of mild hypoglycemia may include cold sweat, drowsiness, fast heartbeat, headache, nausea, and nervousness.

Symptoms of more severe hypoglycemia may include coma, pale skin, seizures, and shallow breathing.

Contact your doctor immediately if these symptoms of severe low blood sugar occur.

Ask your doctor what you should do if you experience mild hypoglycemia. Severe hypoglycemia should be considered a medical emergency, and prompt medical attention is essential.

Can I receive Orinase if I am pregnant or breastfeeding?

The effects of Orinase during pregnancy are unknown. Tell your doctor immediately if you are pregnant, or plan to become pregnant. Orinase is excreted in small amounts in the breast milk of nursing mothers. Therefore, you should discuss with your doctor whether to discontinue Orinase or to stop breastfeeding.

What should I do if I miss a dose of Orinase?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

How should I store Orinase?

Store Orinase at room temperature.