Drug interactions
Disulfiram + Tolbutamide
Severity: Moderate
Disulfiram 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
Disulfiram inhibits several hepatic enzymes, including CYP2C9, which is the main route of tolbutamide metabolism. Tolbutamide exposure may rise and its hypoglycemic effect may be prolonged. Sulfonylureas can also cause a disulfiram-like reaction with alcohol, which adds relevance in patients treated with disulfiram.
What this interaction means in plain words
Disulfiram 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.
Why it happens
Disulfiram inhibits CYP2C9-mediated metabolism of tolbutamide, reducing its clearance.
What to do
Monitor blood glucose closely when disulfiram is started or stopped 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 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 Disulfiram with Tolbutamide?
MediHelp rates the interaction as moderate. Disulfiram 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. Disulfiram inhibits several hepatic enzymes, including CYP2C9, which is the main route of tolbutamide metabolism. Tolbutamide exposure may rise and its hypoglycemic effect may be prolonged. Sulfonylureas can also cause a disulfiram-like reaction with alcohol, which adds relevance in patients treated with disulfiram.
How serious is the interaction between Disulfiram 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 disulfiram is started or stopped and reduce the tolbutamide dose if hypoglycemia occurs.
What other medicines interact with Tolbutamide?
MediHelp also lists interactions of Tolbutamide with, for example, Glyburide-metformin, Insulin degludec-liraglutide, Aceclofenac. The full list is on the Tolbutamide page.
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