Occasionally, reports have appeared in the literature implicating tolbutamide in the initiation or reactivation of a peptic ulcer. The cases upon which these reports were based were not sufficiently detailed to justify such a conclusion. A recent study of this drug in reference to its ulcerogenic properties has been reported by Weiss and Sciales in a recent issue of the Annals of Internal Medicine.1
The action of the drug on the acid-pepsin secretory mechanism was evaluated in 21 patients. These patients were without x-ray evidence of peptic ulcer and did not have clinical diabetes mellitus. Gastric juice was aspirated before and after the intravenous injection of tolbutamide. The effect on the acid-pepsin secretory mechanism was observed for several hours.
The results showed an increase of 27.0 in mean volume, of 92% in the output of free acid, of 75% in the total acid output, of 41% in pepsin output,
TOLBUTAMIDE AND GASTRIC SECRETION. JAMA. 1962;179(3):221-222. doi:10.1001/jama.1962.03050030035010