Dosing & Uses
Dosage Forms & Strengths
tablet
- 250mg
- 500mg
Type 2 Diabetes
100-250 mg PO qDay or q12hr
Increase dose by 100-250 mg/day at weekly intervals to response; not to exceed 1 g/day
Fasting blood sugar <200 mg/dL
- 100 mg/day PO
Fasting blood sugar >200 mg/dL
- 250 mg/day PO
Malnurished, underweight, not eating properly, or elderly
- 100 mg/day PO
Safety and efficacy not established
Type 2 diabetes
100-250 mg PO qDay or q12hr
Increase dose by 100-250 mg/day at weekly intervals to response; not to exceed 1 g/day
Fasting blood sugar <200 mg/dL
- 100 mg/day PO
Fasting blood sugar >200 mg/dL
- 250 mg/day PO
Malnurished, underweight, not eating properly, or elderly
- 100 mg/day PO
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (5)
- aminolevulinic acid oral
aminolevulinic acid oral, tolazamide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.
- aminolevulinic acid topical
tolazamide increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.
- ethanol
ethanol, tolazamide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.
- lumacaftor/ivacaftor
lumacaftor/ivacaftor will decrease the level or effect of tolazamide by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Sulfonylureas are CYP2C9 substrates. Lumacaftor/ivacaftor has the potential to induce CYP2C9.
- methyl aminolevulinate
tolazamide, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
Monitor Closely (144)
- aceclofenac
aceclofenac increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- acemetacin
acemetacin increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- albiglutide
albiglutide, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .
- alogliptin
alogliptin, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of alogliptin with insulin and/or insulin secretagogues (eg, sulfonylureas, meglitinide derivatives) may increase risk for hypoglycemia; may require lower dose of insulin or insulin secretagogue .
- aripiprazole
aripiprazole, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- asenapine
asenapine, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- aspirin
aspirin increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- aspirin rectal
aspirin rectal increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- atazanavir
atazanavir decreases effects of tolazamide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- benazepril
benazepril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- bexagliflozin
bexagliflozin, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin secretagogue to avoid hypoglycemia when coadministered with bexagliflozin.
- bexarotene
bexarotene increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Based on the mechanism of action, bexarotene capsules may increase the action of insulin enhancing agents, resulting in hypoglycemia. Hypoglycemia has not been associated with bexarotene monotherapy.
- bitter melon
bitter melon increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.
- canagliflozin
tolazamide, canagliflozin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with canagliflozin.
- captopril
captopril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- celecoxib
celecoxib increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- cinnamon
cinnamon increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.
- ciprofibrate
ciprofibrate increases effects of tolazamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.
- ciprofloxacin
ciprofloxacin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Hyper and hypoglycemia have been reported in patients treated concomitantly with quinolones and antidiabetic agents. Careful monitoring of blood glucose is recommended.
- clarithromycin
clarithromycin increases levels of tolazamide by plasma protein binding competition. Use Caution/Monitor. Risk of hypoglycemia.
- clotrimazole
clotrimazole increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- clozapine
clozapine, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- cyclosporine
tolazamide, cyclosporine. unknown mechanism. Use Caution/Monitor. Cyclosporine may decrease the effects of sulfonylureas. Sulfonylureas may increase the effects of cyclosporine.
- dapagliflozin
tolazamide, dapagliflozin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with dapagliflozin.
- darunavir
darunavir, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Darunavir may increase or decrease levels of tolazamide. Use alternatives if available. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- diclofenac
diclofenac increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- diflunisal
diflunisal increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- disopyramide
disopyramide increases effects of tolazamide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- dulaglutide
dulaglutide, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- empagliflozin
empagliflozin, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with SGLT2 inhibitors.
- enalapril
enalapril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- ertugliflozin
ertugliflozin, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with ertugliflozin.
- etodolac
etodolac increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- exenatide injectable solution
exenatide injectable solution, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypoglycemia when exenatide is used in combination with agents that induce hypoglycemia. Consider lowering dose of sulfonylureas to reduce risk of hypoglycemia. .
- exenatide injectable suspension
exenatide injectable suspension, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypoglycemia when exenatide is used in combination with agents that induce hypoglycemia. Consider lowering dose of sulfonylureas to reduce risk of hypoglycemia.
- fenofibrate
fenofibrate increases effects of tolazamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.
- fenofibrate micronized
fenofibrate micronized increases effects of tolazamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.
- fenofibric acid
fenofibric acid increases effects of tolazamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.
- fenoprofen
fenoprofen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- fleroxacin
fleroxacin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- fluconazole
fluconazole increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- fluoxetine
fluoxetine increases effects of tolazamide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- flurbiprofen
flurbiprofen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- fosamprenavir
fosamprenavir, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Fosamprenavir may increase or decrease levels of tolazamide. Use alternatives if available. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- fosinopril
fosinopril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- gemfibrozil
gemfibrozil increases effects of tolazamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.
- gemifloxacin
gemifloxacin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- ibuprofen
ibuprofen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- ibuprofen IV
ibuprofen IV increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- iloperidone
iloperidone, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- imidapril
imidapril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- indomethacin
indomethacin increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- insulin aspart
tolazamide, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin aspart protamine/insulin aspart
tolazamide, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin degludec
tolazamide, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin degludec/insulin aspart
tolazamide, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin detemir
tolazamide, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin glargine
tolazamide, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin glulisine
tolazamide, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin inhaled
tolazamide, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin isophane human/insulin regular human
tolazamide, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin lispro
tolazamide, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin lispro protamine/insulin lispro
tolazamide, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin NPH
tolazamide, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- insulin regular human
tolazamide, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- isocarboxazid
isocarboxazid increases effects of tolazamide by unknown mechanism. Use Caution/Monitor.
- ketoconazole
ketoconazole increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- ketoprofen
ketoprofen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- ketorolac
ketorolac increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- ketorolac intranasal
ketorolac intranasal increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- ketotifen, ophthalmic
ketotifen, ophthalmic, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.
- levofloxacin
levofloxacin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- levoketoconazole
levoketoconazole increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- linagliptin
tolazamide, linagliptin. Other (see comment). Use Caution/Monitor. Comment: When linagliptin is used in combination with sulfonylureas, a lower dose of the sulfonylurea may be required to reduce risk of hypoglycemia.
- linezolid
linezolid increases effects of tolazamide by unknown mechanism. Use Caution/Monitor.
- liraglutide
liraglutide, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .
- lisinopril
lisinopril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- lixisenatide (DSC)
lixisenatide (DSC), tolazamide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of hypoglycemia increased when coadministered with sulfonylureas. Sulfonylurea dosage reduction may be required.
- lonapegsomatropin
lonapegsomatropin decreases effects of tolazamide by Other (see comment). Use Caution/Monitor. Comment: Closely monitor blood glucose when treated with antidiabetic agents. Lonapegsomatropin may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of their doses of insulin and/or other antihyperglycemic agents.
lonapegsomatropin decreases effects of tolazamide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone. - lopinavir
lopinavir, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Lopinavir may increase or decrease levels of tolazamide. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- lornoxicam
lornoxicam increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- lurasidone
lurasidone, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- marijuana
marijuana decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor.
- mecasermin
mecasermin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.
- meclofenamate
meclofenamate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- mefenamic acid
mefenamic acid increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- meloxicam
meloxicam increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- methyltestosterone
methyltestosterone increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. It is important to monitor all patients with type 2 diabetes on antidiabetic agents receiving androgens for changes in glycemic control. Potential for hypoglycemia.
- metreleptin
tolazamide, metreleptin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of metreleptin with insulin and/or insulin secretagogues (eg, sulfonylureas, meglitinide derivatives) may increase risk for hypoglycemia; may require lower dose of insulin or insulin secretagogue.
- miconazole vaginal
miconazole vaginal increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- moexipril
moexipril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- moxifloxacin
moxifloxacin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- nabumetone
nabumetone increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- nadolol
nadolol decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- naproxen
naproxen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- ofloxacin
ofloxacin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.
- olanzapine
olanzapine, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- opuntia ficus indica
opuntia ficus indica increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- oxaprozin
oxaprozin increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- paliperidone
paliperidone, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- parecoxib
parecoxib increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- perindopril
perindopril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- phenelzine
phenelzine increases effects of tolazamide by unknown mechanism. Use Caution/Monitor.
- pindolol
pindolol decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- piroxicam
piroxicam increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- posaconazole
posaconazole increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- probenecid
probenecid increases levels of tolazamide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- propranolol
propranolol decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- quetiapine
quetiapine, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- quinapril
quinapril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- ramipril
ramipril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- rifabutin
rifabutin decreases levels of tolazamide by increasing metabolism. Use Caution/Monitor.
- rifampin
rifampin decreases levels of tolazamide by increasing metabolism. Use Caution/Monitor.
- rifapentine
rifapentine decreases levels of tolazamide by increasing metabolism. Use Caution/Monitor.
- risperidone
risperidone, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ritonavir
ritonavir, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Ritonavir may increase or decrease levels of tolazamide. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- salicylates (non-asa)
salicylates (non-asa) increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- salsalate
salsalate increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- selegiline
selegiline increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Serum glucose should be monitored closely when MAOIs are added to any regimen containing antidiabetic medications. Hypoglycemic effects may be increased.
- selegiline transdermal
selegiline transdermal increases effects of tolazamide by unknown mechanism. Use Caution/Monitor.
- semaglutide
semaglutide, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin secretagogues with GLP-1 agonists may increase hypoglycemia risk. Lowering the insulin secretagogue dose may reduce hypoglycemia risk. .
- shark cartilage
shark cartilage increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.
- somapacitan
somapacitan decreases effects of tolazamide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone.
- somatrogon
somatrogon decreases effects of tolazamide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone.
- somatropin
somatropin decreases effects of tolazamide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone.
- sotagliflozin
sotagliflozin increases effects of tolazamide by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Hypoglycemia risk increased. Lower dose of sulfonylurea may be required.
- sulfadiazine
sulfadiazine increases levels of tolazamide by plasma protein binding competition. Use Caution/Monitor.
- sulfamethoxazole
sulfamethoxazole increases levels of tolazamide by plasma protein binding competition. Use Caution/Monitor.
- sulfamethoxypyridazine
sulfamethoxypyridazine increases effects of tolazamide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- sulfasalazine
sulfasalazine increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- sulfisoxazole
sulfisoxazole increases levels of tolazamide by plasma protein binding competition. Use Caution/Monitor.
- sulindac
sulindac increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- timolol
timolol decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.
- tolfenamic acid
tolfenamic acid increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolmetin
tolmetin increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- trandolapril
trandolapril increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor.
- tranylcypromine
tranylcypromine increases effects of tolazamide by unknown mechanism. Use Caution/Monitor.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.
- voriconazole
voriconazole increases levels of tolazamide by decreasing metabolism. Use Caution/Monitor.
- warfarin
tolazamide, warfarin. Either increases effects of the other by receptor binding competition. Use Caution/Monitor. Monitor for decreased vitamin K antagonist effects (eg, decreased INR, thrombosis) when combined with metformin. Additionally, consider increased monitoring for hypoglycemia with this combination. Competitive inhibition of CYP2C9-mediated metabolism may also contribute to mechanism.
- xipamide
xipamide decreases levels of tolazamide by increasing renal clearance. Use Caution/Monitor.
- ziprasidone
ziprasidone, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
Minor (86)
- agrimony
agrimony increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- American ginseng
American ginseng increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- amitriptyline
amitriptyline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- amoxapine
amoxapine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- anamu
anamu increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.
- aspirin
aspirin increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- aspirin rectal
aspirin rectal increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- balsalazide
balsalazide increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- bendroflumethiazide
bendroflumethiazide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- budesonide
budesonide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- chloramphenicol
chloramphenicol increases levels of tolazamide by decreasing metabolism. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- chlorthalidone
chlorthalidone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- choline magnesium trisalicylate
choline magnesium trisalicylate increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- chromium
chromium increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- clomipramine
clomipramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- clonidine
clonidine decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
clonidine, tolazamide. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production. - coenzyme Q10
tolazamide decreases levels of coenzyme Q10 by unspecified interaction mechanism. Minor/Significance Unknown.
- cornsilk
cornsilk increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- cortisone
cortisone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- damiana
damiana decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.
- danazol
danazol increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- deflazacort
deflazacort decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- desipramine
desipramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- devil's claw
devil's claw increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- dexamethasone
dexamethasone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- diflunisal
diflunisal increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- doxepin
doxepin increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- elderberry
elderberry increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).
- ethotoin
tolazamide increases levels of ethotoin by plasma protein binding competition. Minor/Significance Unknown.
- eucalyptus
eucalyptus increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.
- fludrocortisone
fludrocortisone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- fluoxymesterone
fluoxymesterone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- fo-ti
fo-ti increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- forskolin
forskolin increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.
- fosphenytoin
tolazamide increases levels of fosphenytoin by plasma protein binding competition. Minor/Significance Unknown.
- gotu kola
gotu kola increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).
- guanfacine
guanfacine decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.
guanfacine, tolazamide. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production. - gymnema
gymnema increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- horse chestnut seed
horse chestnut seed increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- hydrocortisone
hydrocortisone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- imipramine
imipramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- indapamide
indapamide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- isoniazid
isoniazid decreases effects of tolazamide by unspecified interaction mechanism. Minor/Significance Unknown.
- juniper
juniper increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- lofepramine
lofepramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- lycopus
lycopus increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).
- maitake
maitake increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).
- maprotiline
maprotiline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- mesalamine
mesalamine increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- mesterolone
mesterolone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- methylprednisolone
methylprednisolone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- metolazone
metolazone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.
- nettle
nettle increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).
- nortriptyline
nortriptyline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- ofloxacin
ofloxacin, tolazamide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.
- orlistat
orlistat increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- oxandrolone
oxandrolone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- oxymetholone
oxymetholone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- pegvisomant
pegvisomant increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- phenytoin
tolazamide increases levels of phenytoin by plasma protein binding competition. Minor/Significance Unknown.
- potassium acid phosphate
potassium acid phosphate increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- potassium chloride
potassium chloride increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- potassium citrate
potassium citrate increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.
- prednisolone
prednisolone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- prednisone
prednisone decreases effects of tolazamide by pharmacodynamic antagonism. Minor/Significance Unknown.
- protriptyline
protriptyline increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- sage
sage increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- salicylates (non-asa)
salicylates (non-asa) increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- salsalate
salsalate increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- sitagliptin
sitagliptin, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia with combination is unknown.
- stevia
stevia increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- sulfasalazine
sulfasalazine increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
- tacrolimus
tolazamide increases levels of tacrolimus by unknown mechanism. Minor/Significance Unknown.
- testosterone
testosterone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- testosterone buccal system
testosterone buccal system increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- testosterone topical
testosterone topical increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- tongkat ali
tongkat ali increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.
- trazodone
trazodone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- trimipramine
trimipramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- vanadium
vanadium increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- willow bark
willow bark increases effects of tolazamide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.
Adverse Effects
Frequency Not Defined
Hypoglycemia
Dermatologic reactions
Heartburn
Dizziness
Vertigo
Anorexia
Constipation
Nausea/vomiting
Cholestatic jaundice and hepatitis may occur rarely which may progress to liver failure
Warnings
Contraindications
Hypersensitivity, sulfa allergy
Type I diabetes, diabetic ketoacidosis
Cautions
Patients with hypoglycemia, stress due to infection, fever, trauma, or surgery
May cause loss of glycemic control due to secondary failure
First generation sulfonylurea
Intermediate acting agent
Tolazamide demonstrates weak diuretic effect
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if crosses into breast milk, avoid
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Initial effect is to increase beta-cell insulin secretion
May also decrease rate of hepatic glucose production, increases insulin receptor sensitivity, and increases number of insulin receptors
Pharmacokinetics
Half-Life: 7 hr
Duration: 14-24 hr
Onset: 20 minutes
Protein binding: 94%
Peak hypoglycemic effect: 4-6 hr
Metabolism: Hepatic to less active metabolites
Metabolites: Inactive metabolites
Excretion: Urine (85%); feces (7%)
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Formulary
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