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tolbutamide oral

Selected Oral Antidiabetics/Selected Anticoagulants

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medications are taken together, your anticoagulant may cause your body to process the antidiabetic medicine more slowly.

What might happen:

The effects of your antidiabetic medicine may increase and cause low blood sugar.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of this interaction and may be monitoring you for it. If your doctor prescribes these medicines together, it may be necessary to check your blood sugar levels more often.If you experience a sudden onset of cold sweat, dizziness, fatigue, shakiness, rapid heartbeat, nausea, vision changes, confusion, personality change, nervousness, hunger, or sweating, contact your doctor. Do not start, stop, or change the dosage of any medicine without checking with a healthcare professional first.


1.Kristensen M, Hansen JM. Accumulation of chlorpropamide caused by dicoumarol. Acta Med Scand 1968 Jan-Feb;183(1-2):83-6.
2.Solomon HM, Schrogie JJ. Effect of phenyramidol and bishydroxycoumarin on the metabolism of tolbutamide in human subjects. Metabolism 1967 Nov; 16(11):1029-33.
3.Skovsted L, Kristensen M, Hansen M, Siersbaek-Nielsen K. The effect of different oral anticoagulants on diphenylhydantoin (DPH) and tolbutamide metabolism. Acta Med Scand 1976;199(6):513-5.
4.Spruny OM, Wolf JW, Devins GS. Protracted tolbutamide-induced hypoglycemia. Arch Intern Med 1965 Jan;115:53-6.
5.Judis J. Displacement of sulfonylureas from human serum proteins by coumarin derivatives and cortical steroids. J Pharm Sci 1973 Feb; 62(2):232-7.
6.Kristensen M, Hansen JM. Potentiation of the tolbutamide effect by dicoumarol. Diabetes 1967 Apr;16(4):211-4.
7.Chaplin H Jr, Cassell M. Studies on the possible relationship of tolbutamide to dicumarol in anticoagulant therapy. Am J Med Sci 1958 Jun; 235:706-15.
8.Poucher RL, Vecchio TJ. Absence of tolbutamide effect on anticoagulant therapy. JAMA 1966 Sep 26;197(13):1069-70.
9.Jahnchen E, Meinertz T, Gilfrich HJ, Groth U. Pharmacokinetic analysis of the interaction between dicoumarol and tolbutamide in man. Eur J Clin Pharmacol 1976 Sep 30;10(5):349-56.
10.Petitpierre B, Perrin L, Rudhardt M, Herrera A, Fabre J. Behaviour of chlorpropamide in renal insufficiency and under the effect of associated drug therapy. Int J Clin Pharmacol 1972 Jun;6(2):120-4.
11.Kolenda KD, Grille W, Johnsen K. Drug interaction during therapy with tolbutamide. The influence of some commonly used drugs on plasma level and half life in diabetic out- patients (author's transl). Med Klin 1979 Dec 14;74(50):1914-22.
12.Heine P, Kewitz H, Wiegboldt KA. The influence of hypoglycaemic sulphonylureas on elimination and efficacy of phenprocoumon following a single oral dose in diabetic patients. Eur J Clin Pharmacol 1976;10:31-6.
13.Brown KF, Crooks MJ. Displacement of tolbutamide, glibencalmide and chlorpropamide from serum albumin by anionic drugs. Biochem Pharmacol 1976 May 15;25(10):1175-8.

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