Sulfinpyrazone Tolbutamide

Sulfinpyrazone may increase die anticoagulant activity of oral anticoagulants. There is an increased risk of hypoglycemia when sulfinpyrazone is administered with tolbutamide. Concurrent administration of sulfinpyrazone widi verapamil may decrease die effectiveness of verapamil. 

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A detailed study of the pharmacokinetics of tolbutamide in 6 healthy subjects found that sulfinpyrazone 200 mg every 6 hours for a week, almost doubled the half-life of a 500-mg intravenous dose of tolbutamide, from 7.3 to 13.2 hours, and reduced the plasma clearance by 40%. ... 

Sulfinpyrazone is an inhibitor of the cytochrome P450 isoenzyme CYP2C9, by which tolbutamide and nateglinide are metabolised. 

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