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The release of the orally given hypoglycemic agent tolbutamide (Orinase) for prescription use in the management of selected cases of patients with diabetes mellitus imposes new responsibilities on the physician. While tolbutamide may make unnecessary the routine use of insulin in many such patients, it is mandatory that the physician acquaint himself with the details of selection of patients and their management with this drug. In patients with a satisfactory response to tolbutamide, the blood sugar level falls, glycosuria diminishes, and such symptoms as pruritus, polyuria, and polyphagia disappear; however, failure to observe recommended precautions can cause deterioration of the patient's state of health and well-being.
This drug is a member of the sulfonamide family and carries with it a risk for some patients, even though apparently slight, because of its chemical structure. The real and more serious problem, however, will arise if the drug is dispensed without a prescription
TOLBUTAMIDE FOR DIABETES MELLITUS. JAMA. 1957;164(5):562–564. doi:10.1001/jama.1957.02980050052016
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