Tolbutamide
ORINASE
Pronunciation: toel-BYOO-ta-mide
What it isFirst-generation sulfonylurea; type 2 diabetes.
Why this oneShort-acting and hepatically cleared, so it was once favored in renal impairment.
What limits itThe UGDP trial suggested excess cardiovascular mortality, which shaped sulfonylurea labeling for decades. Obsolete.
FDA-approved for
- type 2 diabetes (~1957)
⚠ BOXED WARNING
- Increased cardiovascular mortality
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityProlonged severe hypoglycemia
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