First Generation Sulfonylureas -
These medications are occasionally still used today.

In case you didn't already know, a person with diabetes can have alternative treatments that will allow them to bypass the hassle of insulin injections. One such treatment comes in various forms of the drug Sulfonylureas. These drugs are considered "first generation" because they have been used to treat men and women with diabetes since the 1950s and require more milligrams of the medicine to equal the effects of the so-called "second generation" Sulfonylureas. While not used as often as the "second" generation of sulfonylureas, you may still see them, and thus should be familiar with their names.

Here are a few examples of first generation Sulfonylureas:

1. Acetohexamide: You may recognize this drug by its brand name "Dymelor". It begins to work within 60 minutes after ingested and can last up to 12 hours. Acetohexamide is taken most often is one or two doses on a daily basis, with a maximum dose of 1.5 grams. These pills come in strengths of 250 mg and 500 mg. You must use caution when taking this drug due to potential kidney problems.

2. Tolbutamide: The brand name for this drug is called "Orinase" and it is the only Sulfonylurea drug that is short acting. Tolbutamide is broken down immediately by the liver and because of this it begins to work quickly and is out of the system within 10 hours. You can find this drug in strengths of 250 mg and 500 mg. Tolbutamide is also considered very safe for the elderly because it enters the system and disappears very quickly. This medicine is typically taken before each meal.

3. Chlorpropamide: This drug comes in the brand names of "Glucamide" and "Diabinase". It is one of the longest acting of the first generation Sulfonylureas drugs.  Because of this, it was the cause of a large amount of hypoglycemia cases in the past. Chlorpropamide stayed in the system for more than a day, over 24 hours in many instances. It comes and strengths of 100 mg and 250 mg. There is a high risk of kidney problems because once Chlorpropamide is broken down by the body, it forms into other chemicals which are still active and are eliminated very slowly through the urine.

4. Tolamide: The brand name for this drug is called "Tolinase" and comes in strengths of 100 mg, 250 mg, and 500 mg. This is also a long acting Sulfonylureas drug but does not stay in the system quite as long as Chlorpropamide - about 20 hours or so. Tolamide can take up to four hours or more before the effects are noticed. And like most of these first-generation Sulfonylureas drugs, it is excreted through the urine which can cause kidney problems.