Last Updated: June 25, 2026

CLINICAL TRIALS PROFILE FOR TOLBUTAMIDE


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All Clinical Trials for TOLBUTAMIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00082238 ↗ Increased Gluconeogenesis is One Cause of Cystic Fibrosis Related Diabetes (CFRD) Completed National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) N/A 2003-03-01 People with CF have a high incidence of diabetes, called CFRD. CFRD is an important cause of worsened morbidity and mortality, thus understanding the pathophysiology underlying its development is imperative. Insulin deficiency has been well recognized as one cause of CFRD; however the clinical presentation and studies of pathogenesis indicate that the etiology is more complex. There is strong evidence that normal metabolism of carbohydrate, protein and fat is altered in CF. We believe that the inflammatory response to chronic underlying lung disease is responsible for insulin resistance and alters substrate metabolism, and that these changes, in addition to insulin deficiency cause CFRD. Our global hypothesis is that hyperglycemia is caused, in part, by high rates of gluconeogenesis resulting from excessive amino acid substrate availability caused by cytokine-mediated protein catabolism. We further hypothesize that inflammation alters normal fatty acid metabolism leading to lipogenesis, an energy wasteful pathway. We will recruit 24 adult CF subjects and 10 controls (similar in distribution in lean tissue mass, age and gender) and will categorize them according to glucose tolerance (OGTT), as well as insulin secretion and insulin sensitivity using the Tolbutamide-stimulated IVGTT and the Minimal Model. Clinical status will be characterized by measuring pulmonary function and modified NIH scores, in addition to measuring levels of circulating cytokines. Gluconeogenesis (GNG) will be quantified by measuring the incorporation 2H into the 2nd, 5th and 6th carbons of glucose. Amino acid turnover rates will be measured using stable isotopes of lactate and alanine and whole body protein turnover (WBPT) will be measured using [1-13C]leucine and [15N2]urea. Fat metabolism will be evaluated by measuring ketone body turnover using stable isotopes, and by quantifying lipogenesis using the isotopomer equilibration method. Key enzymes of fatty acid metabolism will also be measured. We will utilize indirect calorimetry to measure resting energy expenditure. Subjects will be recruited from the CF centers at the University of Texas- Southwestern and the South Central CF Consortium. Our proposal is intended to better describe the unique metabolism of people with CF, and to provide a comprehensive evaluation of pathophysiologic changes which contribute to the development of CFRD and to wasting; and are part of the applicant's long-range goal which is to identify the underlying causes of CF related diabetes and catabolism so that disease-specific therapies can be developed. We fully expect that the proposed studies will provide new and important information.
NCT00369304 ↗ Study Evaluating the Pharmacokinetics of the Potential Drug Interaction Between CYP2C9 Inhibitor and Substrate Completed Wyeth is now a wholly owned subsidiary of Pfizer Phase 1 2006-07-01 This is an open-label, randomized, 2-period crossover, inpatient study to be performed in healthy subjects. The study will consist of 2 treatment periods: There will be 2 parallel cohorts of 12 subjects each who will be enrolled to receive single doses of tolbutamide or AGG-523 plus tolbutamide in periods 1 and 2 in a crossover design. Doses of test article will be administered after an overnight fast of at least 10 hours.
NCT00668395 ↗ Effects of CYP2B6 Genetic Polymorphisms on Efavirenz Pharmacokinetics Completed Indiana University N/A 2007-05-01 1. To see how the liver breaks down efavirenz by an enzyme called CYP2B6. It is suggested that when Efavirenz is taken repeatedly it may increase the amount of CYP2B6 in your liver and thus speed up your liver's ability to get rid of efavirenz from your body. This may render efavirenz and other medications ineffective. 2. To see how efavirenz interact with other drugs taken at the same time with it. 3. To see if genetic differences can change the way how the liver breaks down efavirenz and its interactions with other co-administered drugs.
NCT00676910 ↗ A Research Study of JNJ-26854165 to Determine the Safety and Dose in Patients With Advanced Stage or Refractory Solid Tumors. Completed Johnson & Johnson Pharmaceutical Research & Development, L.L.C. Phase 1 2006-11-01 The purpose of this study is to assess the safety of JNJ-26854165 (a new drug in development for cancer) in patients with advanced or refractory solid tumors on the maximum dose tolerated by these patients.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for TOLBUTAMIDE

Condition Name

Condition Name for TOLBUTAMIDE
Intervention Trials
Healthy 6
Diabetes Mellitus, Type 2 3
Healthy Volunteers 2
Hypertension 1
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Condition MeSH

Condition MeSH for TOLBUTAMIDE
Intervention Trials
Diabetes Mellitus 5
Diabetes Mellitus, Type 2 5
Neoplasms 2
Pancreatitis 1
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Clinical Trial Locations for TOLBUTAMIDE

Trials by Country

Trials by Country for TOLBUTAMIDE
Location Trials
United States 22
United Kingdom 8
Canada 7
Germany 2
Netherlands 2
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Trials by US State

Trials by US State for TOLBUTAMIDE
Location Trials
Texas 3
Michigan 2
Arizona 2
California 2
Connecticut 1
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Clinical Trial Progress for TOLBUTAMIDE

Clinical Trial Phase

Clinical Trial Phase for TOLBUTAMIDE
Clinical Trial Phase Trials
Phase 4 3
Phase 1 21
N/A 3
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Clinical Trial Status

Clinical Trial Status for TOLBUTAMIDE
Clinical Trial Phase Trials
Completed 23
Terminated 3
Active, not recruiting 1
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Clinical Trial Sponsors for TOLBUTAMIDE

Sponsor Name

Sponsor Name for TOLBUTAMIDE
Sponsor Trials
Canadian Institutes of Health Research (CIHR) 4
Canadian Network for Observational Drug Effect Studies, CNODES 3
Drug Safety and Effectiveness Network, Canada 3
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Sponsor Type

Sponsor Type for TOLBUTAMIDE
Sponsor Trials
Industry 20
Other 19
NIH 2
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Tolbutamide Clinical Trials Update, Market Analysis, and Exclusivity-Driven Projection

Last updated: May 21, 2026

Tolbutamide is an older first-generation sulfonylurea used for type 2 diabetes. There is no current, consolidated FDA development pipeline data or late-stage (Phase 3) trial footprint that can support a forward-looking clinical-trials update in a single, defensible snapshot. Commercially, tolbutamide remains a legacy/off-patent commodity in the United States, so near-term revenue direction is tied to generics supply, shortages, and payer preference rather than new clinical development.


Tolbutamide clinical trials update: what studies are ongoing and what is the latest readout?

Featured snippet: No verified, up-to-date ongoing Phase 3 or pivotal program for tolbutamide is available from a single authoritative source set in the information available here, so a trial-by-trial “latest readout” update cannot be produced to a litigation-grade standard.

What trial types typically exist for legacy sulfonylureas (and what that means for tolbutamide)

Legacy sulfonylureas like tolbutamide usually show up in:

  • Bioequivalence (BA/BE) studies for generic approvals
  • Small investigator-initiated pharmacodynamic studies (glucose lowering, insulin secretion markers)
  • Safety comparisons in real-world or retrospective datasets

These are not the same as drug development “readouts” that move valuation via exclusivity or a new indication.

How to interpret the absence of late-stage reads

A lack of current Phase 3 visibility for tolbutamide generally implies:

  • No new patent-protected clinical program likely entering the FDA review queue
  • Market behavior is dominated by generic penetration, labeling, and supply chain variability

(That interpretation is consistent with tolbutamide’s age as a drug substance, but it does not substitute for verified trial listings.)


What is tolbutamide’s market size and sales trend: how much revenue is at stake?

Featured snippet: Tolbutamide is a legacy generic drug with no patent-backed revenue retention, so the addressable US market is primarily driven by residual prescribing, switching dynamics among sulfonylureas, and episodic access issues. A precise, current-year market size cannot be stated from the available dataset in this prompt.

Competitive landscape inside sulfonylureas

Tolbutamide competes mainly with other sulfonylureas and alternative oral agents:

  • Second-generation sulfonylureas: glipizide, glyburide (glibenclamide), glimepiride
  • Newer classes: DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, thiazolidinediones

For business planning, the key competitive mechanism is not efficacy novelty. It is:

  • Safety profile preference and clinician switching
  • Payer formulary tiering
  • Per-unit cost pressure from generic supply

Demand drivers

  • Continuation prescribing for patients stabilized on tolbutamide (treatment persistence)
  • Substitution pressure to longer-acting or better-tolerated sulfonylureas
  • Shortage-driven substitution cascades during supply constraints (if any)

Revenue projection logic for a legacy generic

Without new development milestones, a defensible projection model typically uses:

  • Generic share and pack availability
  • Wholesale acquisition cost (WAC) and pharmacy benefit manager (PBM) contracting
  • Prescribing trends by segment (commercial vs Medicare vs Medicaid)

No verified numeric inputs are available here, so projections cannot be quantified without risking fabrication.


When does tolbutamide lose exclusivity in the US: what is the Orange Book status?

Featured snippet: Tolbutamide is not expected to have active regulatory exclusivity that would delay generic entry; it is treated as off-patent/legacy for practical purposes. A specific, itemized Orange Book listing and exclusivity end date cannot be produced from the information provided in this prompt.

Why Orange Book listings matter for legacy drugs

For generic underwriting, you need:

  • Application number(s) and product listing status
  • Patent numbers tied to the drug product
  • Exclusivity codes and dates (NCE, new clinical, pediatric, orphan, etc.)
  • Patent expiry and any listed method-of-use or formulation patents

This requires Orange Book data that is not present in the prompt context.


What patents protect tolbutamide: formulation, method-of-use, or manufacturing protections?

Featured snippet: A complete patent estate map cannot be produced from the information available here. Tolbutamide is a first-generation sulfonylurea and is widely available as generic; patent protection, if any today, is typically limited to specific drug-product formulations or manufacturing processes rather than the active moiety.

Typical surviving IP categories for legacy generics

When legacy molecules still show up in litigation or licensing, it is commonly via:

  • Composition or formulation patents tied to specific dosage forms (tablets, specific excipient systems)
  • Process patents (manufacturing, granulation, compression parameters)
  • Method-of-use patents, less commonly for older diabetes drugs, due to broad clinical practice coverage and earlier genericization

A litigation-grade “which patents protect what” breakdown requires specific patent numbers and assignees.


What generic entry risks exist for tolbutamide: Paragraph IV and litigation scenarios

Featured snippet: Paragraph IV risk analysis cannot be completed without Orange Book patent numbers and any existing Paragraph IV dockets tied to tolbutamide products.

What would drive Paragraph IV for a legacy sulfonylurea

  • A listed patent on an RLD product that is still within term
  • A formulation or process patent that blocks generic manufacture
  • A method-of-use patent tied to a narrower labeled use that generics may challenge

No such structured patent listing inputs are available in this prompt.


Biosimilar risk for tolbutamide: is it a biologic product?

Featured snippet: No. Tolbutamide is a small-molecule drug; biosimilar risk is not applicable.


Regulatory status: what is tolbutamide’s FDA pathway and labeling posture?

Featured snippet: Tolbutamide is an FDA-approved small-molecule drug with current labeling, but an up-to-date labeling and approval pathway summary cannot be compiled here without product-specific FDA reference information (e.g., application type, reference listed drug, current label text).

What matters commercially for labeling

  • Dosing recommendations and hypoglycemia warnings
  • Concomitant therapy language (metformin combinations, insulin adjustments)
  • Contraindications and geriatrics considerations (key for payer and safety monitoring)

How does tolbutamide compare with glipizide, glimepiride, and glyburide: what drives switching?

Featured snippet: Switching within sulfonylureas is usually driven by hypoglycemia risk management, dosing convenience, and payer formulary rules. Tolbutamide’s older status typically makes it less preferred than second-generation agents.

Business implications of switching

  • If second-generation sulfonylureas gain formulary position, tolbutamide loses scripts even if cost remains low.
  • If a patient is stable on tolbutamide, switching can occur slowly due to tolerance and risk review cycles.
  • In tender-driven markets, pack availability and contracted price volatility can dominate clinical preference.

Market projection for tolbutamide: what is the 3- to 5-year outlook?

Featured snippet: A quantified projection cannot be produced from the provided prompt inputs. In general for off-patent legacy generics, the most realistic drivers of 3- to 5-year outlook are:

  • continued generic pricing compression
  • supply stability and competitive undercutting
  • substitution toward other sulfonylureas or newer oral agents

Projection framework (non-numeric)

  1. Volume trend: flat to declining prescriptions as newer classes expand and prescriber preference shifts
  2. Price trend: downward or capped by generic competition, with occasional spikes tied to shortages
  3. Net revenue trend: modest compression unless supply constraints improve realized pricing

Numeric forecasting requires market time series and product-level sales.


Key Takeaways

  • Tolbutamide is a legacy generic sulfonylurea; near-term commercial outcomes are more supply-and-formulary driven than development driven.
  • No authoritative, up-to-date clinical-trials “latest readouts” can be compiled from the provided context to a high standard suitable for investment or litigation work.
  • Orange Book and patent estate mapping cannot be itemized here without listed patent numbers, expiration dates, and any current exclusivity codes.
  • A credible 3- to 5-year outlook depends on generic pricing, pack availability, and formulary substitution dynamics rather than new FDA exclusivity events.

FAQs

  1. Is tolbutamide still prescribed for type 2 diabetes in the US?
  2. How does tolbutamide dosing frequency compare with glipizide and glimepiride in practice?
  3. What are the key safety and hypoglycemia monitoring considerations that affect formulary uptake of tolbutamide?
  4. Does tolbutamide have any active patent estate that could block generic competition?
  5. What supply-chain factors most often drive short-term pricing changes for legacy generic diabetes drugs like tolbutamide?

References

  1. U.S. FDA, Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations.
  2. U.S. FDA Labeling for tolbutamide (current package insert / PI).
  3. ClinicalTrials.gov. Tolbutamide search results and study records.

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