Drug interactions
Acetylsalicylic acid + Tolbutamide
Severity: Moderate
Acetylsalicylic acid and Tolbutamide: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Salicylates at analgesic or higher doses can enhance the glucose-lowering effect of sulfonylureas such as tolbutamide. This may lead to hypoglycemia, particularly in patients taking regular or high-dose aspirin.
What this interaction means in plain words
Acetylsalicylic acid and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Acetylsalicylic acid belongs to Musculoskeletal; Tolbutamide belongs to Endocrine.
Why it happens
Salicylates displace tolbutamide from plasma protein binding, may reduce its renal elimination, and have intrinsic glucose-lowering effects.
What to do
Monitor blood glucose when starting or stopping regular aspirin and reduce the tolbutamide dose if hypoglycemia occurs. Low-dose antiplatelet aspirin rarely needs adjustment.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
- Alogliptin-metformin + Tolbutamide Moderate
Frequently asked questions
Can I take Acetylsalicylic acid with Tolbutamide?
MediHelp rates the interaction as moderate. Acetylsalicylic acid and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Salicylates at analgesic or higher doses can enhance the glucose-lowering effect of sulfonylureas such as tolbutamide. This may lead to hypoglycemia, particularly in patients taking regular or high-dose aspirin.
How serious is the interaction between Acetylsalicylic acid and Tolbutamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose when starting or stopping regular aspirin and reduce the tolbutamide dose if hypoglycemia occurs. Low-dose antiplatelet aspirin rarely needs adjustment.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
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