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Acetohexamide and tolazamide are not recommended even though they have mild diuretic activity, because their metabolic and excretion patterns may result in accumulation and hypoglycemia.
The flush also occurs occasionally in those taking tolbutamide, acetohexamide and tolazamide, and it occurs rarely in those taking second generation agents.
The overall frequency of side effects for first-generation agents, however, ranges between 3% and 4% for tolbutamide, acetohexamide, and tolazamide, and 9% for chlorpropamide, as compared with a side-effects frequency of 6% to to 7% for both glyburide and glipizide.
The first generation of agents, which consists of tolbutamide, tolazamide, chlorpropamide, and acetohexamide, has been in clinical use for several decades.