Drug interactions
Hydrocortisone + Tolbutamide
Severity: Moderate
Hydrocortisone 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
Hydrocortisone raises blood glucose through increased gluconeogenesis and insulin resistance, opposing the glucose-lowering effect of tolbutamide. Glycemic control may deteriorate during systemic corticosteroid therapy.
What this interaction means in plain words
Hydrocortisone 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.
Hydrocortisone belongs to Endocrine; Tolbutamide belongs to Endocrine.
Why it happens
Pharmacodynamic antagonism: glucocorticoid-induced hepatic glucose output and peripheral insulin resistance counter sulfonylurea action.
What to do
Monitor blood glucose when systemic hydrocortisone is started, changed or stopped, and adjust the tolbutamide dose or add therapy as needed; reduce the dose again when the steroid is withdrawn.
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 Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone 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 Hydrocortisone with Tolbutamide?
MediHelp rates the interaction as moderate. Hydrocortisone 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. Hydrocortisone raises blood glucose through increased gluconeogenesis and insulin resistance, opposing the glucose-lowering effect of tolbutamide. Glycemic control may deteriorate during systemic corticosteroid therapy.
How serious is the interaction between Hydrocortisone 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 systemic hydrocortisone is started, changed or stopped, and adjust the tolbutamide dose or add therapy as needed; reduce the dose again when the steroid is withdrawn.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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