Drug General Information (ID: DDI5KWVEAD)
  Drug Name Phenylbutazone Drug Info Tolazamide Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Analgesics Antidiabetic Agents
  Structure

 Mechanism of Phenylbutazone-Tolazamide Interaction (Severity Level: Moderate)
     Decreased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
      Drug Name Phenylbutazone Tolazamide
      Mechanism 1 Inhibition of sulfonylurea metabolism Sulfonylurea
      Key Mechanism Factor 1
Factor Name Pharmacokinetics
Factor Description Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
      Mechanism Description
  • Decreased metabolism of Tolazamide caused by Phenylbutazone 
     Decreased renal excretion (Unspecific) Click to Show/Hide Mechanism Graph
      Drug Name Phenylbutazone Tolazamide
      Mechanism 2 Inhibition of sulfonylurea renal clearance Sulfonylurea
      Key Mechanism Factor 2
Factor Name Pharmacokinetics
Factor Description Alters the excretion of the drug, resulting in changes in the plasma concentration of the drug and affecting the pharmacological effects.
      Mechanism Description
  • Decreased renal excretion of Tolazamide caused by Phenylbutazone 

Recommended Action
      Management Patients receiving this combination should be monitored for increased hypoglycemic effects and advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs. The sulfonylurea dosage may require reduction in affected patients.

References
1 Mahfouz M, Abdel-Maguid R, El-Dakhakhny M "Potentiation of the hypoglycaemic action of tolbutamide by different drugs." Arzneimittelforschung 20 (1970): 120-2. [PMID: 5467602]
2 Pond SM, Birkett DJ, Wade DN "Mechanisms of inhibition of tolbutamide metabolism: phenylbutazone, oxyphenbutazone, sulfaphenazole." Clin Pharmacol Ther 22 (1977): 573-9. [PMID: 913025]
3 Tannenbaum H, Anderson LG, Soeldner JS "Phenylbutazone-tolbutamide drug interaction." N Engl J Med 290 (1974): 344. [PMID: 4809290]