Brand name:
Orinase
Pronounced: OR-in-aze
Generic name:
Tolbutamide
Why is Orinase prescribed?
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.
There are two forms of diabetes: type 1 (insulin-dependent) and
type 2 (non-insulin-dependent). Type 1 diabetes usually requires
taking insulin injections for life, while type 2 diabetes can
usually be treated by dietary changes, exercise, and/or oral
antidiabetic medications such as Orinase. Orinase controls diabetes
by stimulating the pancreas to secrete more insulin and by helping
insulin work better.
Occasionally, type 2 diabetics must take insulin injections
temporarily during stressful periods or times of illness. When diet,
exercise, and an oral antidiabetic medication fail to reduce
symptoms and/or blood sugar levels, a person with type 2 diabetes
may require long-term insulin injections.
Most important fact 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.
How should you take Orinase?
In general, Orinase should be taken 30 minutes before a meal to
achieve the best control over blood sugar levels. However, the exact
dosing schedule, as well as the dosage amount, must be determined by
your physician. Ask your doctor when it is best for you to take this
medication.
To help prevent low blood sugar levels (hypoglycemia) you should:
Understand the symptoms of hypoglycemia.
Know how exercise affects your blood sugar levels.
Maintain an adequate diet.
Keep a product containing quick-acting sugar with you at all
times.
Limit alcohol intake. If you drink alcohol, it may cause
breathlessness and facial flushing.
--If you miss a dose...
Take it as soon as you remember. If it is almost time for the
next dose, skip the one you missed and go back to your regular
schedule. Do not take 2 doses at the same time.
--Storage instructions...
Store at room temperature.
Orinase side effects
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor
can determine if it is safe for you to continue taking Orinase.
Side effects from Orinase are rare and seldom require
discontinuation of Orinase.
- 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,
nervousness.
- Symptoms of more severe hypoglycemia may include:
Coma,
pale skin,
seizures,
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.
Why should Orinase not be prescribed?
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.
Special warnings about Orinase
It's possible that drugs such as Orinase may lead to more heart
problems than diet treatment alone, or diet plus insulin. If you
have a heart condition, you may want to discuss this with your
doctor.
If you are taking Orinase, you should check your blood or urine
periodically for abnormal sugar (glucose) levels.
It is important that you closely follow the diet and exercise
plan recommended by your doctor.
Even people with well-controlled diabetes may find that stress,
illness, surgery, or fever results in a loss of control over their
diabetes. In these cases, your physician may recommend that you
temporarily stop taking Orinase and use injected insulin instead.
In addition, the effectiveness of any oral antidiabetic,
including Orinase, may decrease with time. This may occur because of
either a diminished responsiveness to Orinase or a worsening
of the diabetes.
Like other antidiabetic drugs, Orinase may produce severe low
blood sugar if the dosage is wrong. While taking Orinase, you are
particularly susceptible to episodes of low blood sugar if:
You suffer from a kidney or liver problem;
You have a lack of adrenal or pituitary hormone;
You are elderly, run-down, malnourished, hungry, exercising
heavily, drinking alcohol, or using more than one glucose-lowering
drug.
Possible food and drug interactions when taking 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
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,
Motrin, Naprosyn, 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
Thyroid medications such as Synthroid
Be cautious about drinking alcohol, since excessive alcohol can
cause low blood sugar.
Special information if you are pregnant or breastfeeding
The effects of Orinase during pregnancy have not been adequately
established in humans. Since Orinase has caused birth defects in
rats, it is not recommended for use by pregnant women. Therefore, if
you are pregnant or planning to become pregnant, you should take
Orinase only on the advice of your physician. Since studies suggest
the importance of maintaining normal blood sugar (glucose) levels
during pregnancy, your physician may prescribe injected insulin
during your pregnancy. While it is not known if Orinase enters
breast milk, other similar medications do. Therefore, you should
discuss with your doctor whether to discontinue Orinase or to
stop breastfeeding. If Orinase is discontinued, and if diet
alone does not control glucose levels, your doctor will consider
giving you insulin injections.
Recommended dosage for Orinase
Dosage levels are based on individual needs.
ADULTS
Overdosage
Any medication taken in excess can have serious consequences. An
overdose of Orinase can cause low blood sugar (see "Special
warnings about Orinase"). Eating sugar or a sugar-based
product will often correct mild hypoglycemia. If you suspect an
overdose, seek medical attention immediately.
|