20 to 50     : Dose as in normal renal function. Use with caution
10 to 20     : Dose as in normal renal function. Use with caution
<10           : Dose as in normal renal function. Use with caution
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                : Unlikely to be dialysed. Dose as in GFR <10 mL/min
HD                     : Not dialysed. Dose as in GFR <10 mL/min
HDF/high flux   : Unknown dialysability. Dose as in GFR <10 mL/min
CAV/VVHD      : Not dialysed. Dose as in GFR=10– 20 mL/min
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Analgesics: effects enhanced by NSAIDs – avoid with azapropazone
Antibacterials: effects enhanced by chloramphenicol, sulphonamides, and trimethoprim; effect reduced by rifamycins
Anticoagulants: effect possibly enhanced by coumarins; also possibly changes to INR
Antifungals: concentration increased by fluconazole and miconazole, and possibly voriconazole Sulfinpyrazone: enhanced effect of sulphonylureas
ADMINISTRATION
Reconstition
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Route
Oral
Rate of Administration
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Comments
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OTHER INFORMATION
Tolbutamide is not removed by dialysis. It is contraindicated in severe renal impairment, and should be used with great caution in mild to moderate renal impairment because of risk of hypoglycaemia .