Drug interactions
Diflunisal + Tolbutamide
Severity: Moderate
Diflunisal 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 and some NSAIDs may potentiate the hypoglycemic action of tolbutamide. Patients on stable sulfonylurea therapy may experience unexpectedly low glucose after diflunisal is added.
What this interaction means in plain words
Diflunisal 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.
Diflunisal belongs to Musculoskeletal; Tolbutamide belongs to Endocrine.
Why it happens
Possible displacement of the sulfonylurea from albumin and a direct salicylate glucose-lowering effect; not fully established.
What to do
Monitor blood glucose closely when starting or stopping diflunisal and reduce the tolbutamide dose if hypoglycemia occurs.
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 Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
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 Diflunisal with Tolbutamide?
MediHelp rates the interaction as moderate. Diflunisal 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 and some NSAIDs may potentiate the hypoglycemic action of tolbutamide. Patients on stable sulfonylurea therapy may experience unexpectedly low glucose after diflunisal is added.
How serious is the interaction between Diflunisal 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 closely when starting or stopping diflunisal and reduce the tolbutamide dose if hypoglycemia occurs.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
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