Drug interactions
Dexamethasone + Tolbutamide
Severity: Moderate
Dexamethasone 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
Dexamethasone raises blood glucose and can offset the effect of tolbutamide. Glycemic control may deteriorate, and hypoglycemia can occur after steroid reduction.
What this interaction means in plain words
Dexamethasone 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.
Dexamethasone belongs to Endocrine; Tolbutamide belongs to Endocrine.
Why it happens
Glucocorticoids increase gluconeogenesis and insulin resistance, opposing the sulfonylurea.
What to do
Monitor blood glucose during dexamethasone therapy and adjust tolbutamide dosing as needed. Reduce doses again as the steroid is tapered.
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 Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine Contraindicated
Other interactions of Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Dexamethasone with Tolbutamide?
MediHelp rates the interaction as moderate. Dexamethasone 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. Dexamethasone raises blood glucose and can offset the effect of tolbutamide. Glycemic control may deteriorate, and hypoglycemia can occur after steroid reduction.
How serious is the interaction between Dexamethasone 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 during dexamethasone therapy and adjust tolbutamide dosing as needed. Reduce doses again as the steroid is tapered.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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