Tolbutamide & Nutrient Depletion
Also searched as Orinase. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Tolbutamide has been associated with depletion of COENZYME Q10. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Tolbutamide long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Tolbutamide pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Tolbutamide
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
COENZYME Q10
Insignificant DepletionANTIDIABETES DRUGS
Some antidiabetes drugs, including metformin and sulfonylureas, appear to inhibit coenzyme Q10 enzyme activity and decrease endogenous levels of coenzyme Q10. However, there is no strong evidence that coenzyme Q10 depletion is the cause of antidiabetes drug-related side effects. Furthermore, taking coenzyme Q10 does not seem to improve fasting glucose levels or glycated hemoglobin in patients with diabetes.
Tolbutamide belongs to the sulfonylurea family of diabetes medications, and there is some evidence that drugs in this class can modestly lower the body's own production of coenzyme Q10, a nutrient your cells use to generate energy. The effect appears to involve interfering with the enzyme activity your body needs to make coenzyme Q10 on its own. That said, this is rated as insignificant depletion, meaning the real-world impact for most people taking tolbutamide is considered minimal. No routine supplementation is recommended, but if you have questions or any concerns, your pharmacist or doctor is the right person to ask.
What Coenzyme Q10 (CoQ10) does & food sources
CoQ10 helps cells produce energy and acts as an antioxidant; heart and muscle tissue use it heavily.
Common food sources:
- Organ meats and fatty fish
- Whole grains
- Nuts and seeds
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
There is no routine blood test for CoQ10 in everyday practice. If you have new, unexplained muscle symptoms on a medication linked to CoQ10 (statins are the best-known example), talk to your prescriber before changing anything — symptoms have many possible causes and your prescriber has several options.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
CoQ10 is generally well tolerated, but evidence for supplementing (for example, for statin muscle symptoms) is mixed. It may also modestly affect warfarin — check with your pharmacist before combining.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Do not stop a prescribed medication because of this association — discuss any symptoms with your prescriber first.
Learn more about this nutrient: Coenzyme Q10 — uses, safety & interactions
References (4)
- Kishi T, Kishi H, Watanabe T, et al. Bioenergetics in clinical medicine. XI. Studies on coenzyme Q and diabetes mellitus. J Med 1976;7:307-21.
- Moradi M, Haghighatdoost F, Feizi A, Larijani B, Azadbakht L. Effect of coenzyme Q10 supplementation on diabetes biomarkers: a systematic review and meta-analysis of randomized controlled clinical trials. Arch Iran Med. 2016;19(8):588-96. doi: 0161908/AIM
- Stojanovic M, Radenkovic M. A meta-analysis of randomized and placebo-controlled clinical trials suggests that coenzyme Q10 at low dose improves glucose and HbA1c levels. Nutr Res. 2017 Feb;38:1-12. PubMed
- Suksomboon N, Poolsup N, Juanak N. Effects of coenzyme Q10 supplementation on metabolic profile in diabetes: a systematic review and meta-analysis. J Clin Pharm Ther. 2015 Aug;40(4):413-8.
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Tolbutamide
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Tolbutamide & nutrients: FAQs
Does Tolbutamide deplete COENZYME Q10?
Should I take a supplement because I take Tolbutamide?
Should I stop taking Tolbutamide?
Where does this information come from?
Questions about Tolbutamide and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Tolbutamide are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.