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Acetohexamide, chlorpropamide, tolazamide and tolbutamide are oral blood sugar-lowering drugs in a class of medications for diabetes called sulfonylureas. They were the first four sulfonylureas to be used to manage type II diabetes and are commonly referred to as first generation sulfonylureas. The second generation sulfonylureas are glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase), and glimepiride (Amaryl). The primary difference between the first and second generation sulfonylureas is in the way they are eliminated from the body. As a result, second generation sulfonylureas usually are taken less frequently each day than first generation sulfonylureas and generally are preferred when there is poor function of the kidneys. It is believed that strict glucose control in diabetics reduces the chances of eye, kidney, and nerve damage. The first generation sulfonylureas are used in type II diabetes to help lower and control blood glucose that is not controlled by diet and exercise. They are usually tried before turning to insulin for therapy.
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