tolmetin

Tolmetin is anonsteroidal anti-inflammatory drug(NSAID) that is effective in treatingfever,pain, and inflammation in the body. It is similar toibuprofen(MotrinorAdvil),naproxen(Naprosyn), and others. As a group,NSAIDsare non-narcotic relievers of mild to moderatepainof many causes, including injury,menstrual cramps,arthritis, and other musculoskeletal conditions. They work by reducing the levels of prostaglandins, chemicals that are responsible for pain,fever, and inflammation. Tolmetin blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced. The FDA approved Tolectin in March 1976.

Is tolmetin available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for tolmetin?

Yes

Most patients benefit from tolmetin and other NSAIDs with few side effects. However, serious side effects can occur, and generally tend to be dose related. Therefore, it is advisable to use the lowest effective dose to minimize side effects. The most common side effects of tolmetin involve the gastrointestinal system, and these include:

• ulcerations,
• abdominal pain,
• cramping,
• nausea,
• gastritis,
• serious gastrointestinal bleeding,
• livertoxicity,
• stomach ulceration
• blacktarry stools, and
• weakness.

Tolmetin should be avoided by patients with a history ofasthma,hives, or otherallergicreactions toaspirinor other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients withpeptic ulcerdisease or poor kidney function, since this medication can aggravate both conditions.

Other important side effects include:

• heart attacks
• strokes
• accumulation of fluid, and
• increased chance ofheart failure.

Tolmetin may cause or worsenhigh blood pressureandkidney failure.

The recommended dose is 200-600 mg three times daily. The maximum daily dose is 1800 mg. Tolmetin should be taken with food and 8-12 ounces of water to avoid stomach upset.

Tolmetin is generally used with caution in patients taking blood thinning medications (anticoagulants), such aswarfarin(Coumadin), because of an increased risk of bleeding. Patients takinglithium(Eskalith,Lithobid) ormethotrexate(Rheumatrex,Trexall) can develop toxic blood levels of either drug because tolmetin may inhibit their elimination from the body by the kidney. Side effects fromcyclosporinealso may be increased by tolmetin. Tolmetin may reduce the effectiveness of antihypertensives because it causes or worsenshigh blood pressure. NSAIDs may diminish the antihypertensive effect ofACE inhibitors.

Combining NSAIDs with angiotensin receptor blockers (for example,valsartan[Diovan],losartan[Cozaar],irbesartan[Avapro]) or angiotensin converting enzyme inhibitors (for example,enalapril[Vasotec],captopril[Capoten]) in patients who are elderly, volume-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, includingkidney failure. These effects usually are reversible.

Persons who have more than three alcoholicbeveragesper day are at increased risk of developing stomach ulcers when taking tolmetin or other NSAIDs.

Tolmetin is generally avoided duringpregnancy.

Tolmetin is excreted inbreast milk. To avoid adverse effects in the infant,nursingmothers should decide whether to stop nursing or stop tolmetin.

What preparations of tolmetin are available?

Tablets or capsules: 200, 400, and 600 mg

How should I keep tolmetin stored?

Tolmetin should be stored at room temperature in a sealed container and protected from moisture.