tolmetin, Tolectin (Discontinued Brand): NSAID Side Effects & Dosage (original) (raw)

• What is tolmetin, and how does it work (mechanism of action)?
• What are the uses for tolmetin?
• What are the side effects of tolmetin?
• What is the dosage for tolmetin?
• Which drugs or supplements interact with tolmetin?
• Is tolmetin safe to take if I'm pregnant or breastfeeding?
• What else should I know about tolmetin?

What is tolmetin, and how does it work (mechanism of action)?

Tolmetin is a nonsteroidal anti-inflammatory drug (NSAID) that is effective in treating fever, pain, and inflammation in the body. It is similar to ibuprofen (Motrin or Advil), naproxen (Naprosyn), and others. As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of 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

What are the uses for tolmetin?

Tolmetin is used for the treatment of inflammation and pain that results from rheumatoid arthritis, juvenile arthritis, or osteoarthritis.

What are the side effects of tolmetin?

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,
• liver toxicity,
• stomach ulceration
• black tarry stools, and
• weakness.

Tolmetin should be avoided by patients with a history of asthma, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients with peptic ulcer disease 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 worsen high blood pressure and kidney failure.

What is the dosage for tolmetin?

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.

QUESTION What joints are most often affected by osteoarthritis? See Answer

Which drugs or supplements interact with tolmetin?

Tolmetin is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of an increased risk of bleeding. Patients taking lithium (Eskalith, Lithobid) or methotrexate (Rheumatrex, Trexall) can develop toxic blood levels of either drug because tolmetin may inhibit their elimination from the body by the kidney. Side effects from cyclosporine also may be increased by tolmetin. Tolmetin may reduce the effectiveness of antihypertensives because it causes or worsens high blood pressure. NSAIDs may diminish the antihypertensive effect of ACE 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, including kidney failure. These effects usually are reversible.

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

Is tolmetin safe to take if I'm pregnant or breastfeeding?

Tolmetin is generally avoided during pregnancy.

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

What else should I know about 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.

Health News

Summary

Tolmetin (Tolectin [Discontinued Brand]) is a nonsteroidal anti-inflammatory drug (NSAID) prescribed for the treatment of inflammation and pain that results from rheumatoid arthritis, juvenile arthritis, or osteoarthritis. Review side effects, drug interactions, dosage, and pregnancy safety information prior to taking this medication.

Related Disease Conditions

• Rheumatoid Arthritis (RA) Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body.
• Arthritis (Joint Inflammation) Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and gout.
• Osteoarthritis (OA or Degenerative Arthritis) Osteoarthritis, or degenerative arthritis, is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
• Pain Management The goal of pain management for each patient is to minimize suffering and improve quality of life. This goal may be different depending on the patient’s circumstances and disease or injury.
• Ankylosing Spondylitis Ankylosing spondylitis (AS) is a form of chronic inflammation of the spine and the sacroiliac joints. The tendency to develop ankylosing spondylitis is genetically inherited. Treatment incorporates medications, physical therapy, and exercise.
• Ankle Pain (Tendonitis) Ankle pain is commonly due to a sprain or tendonitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendonitis of the ankle can be caused by trauma or inflammation.
• Psoriatic Arthritis Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms of psoriatic arthritis include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves anti-inflammatory medications and exercise.
• Juvenile Rheumatoid Arthritis (JRA) Juvenile rheumatoid arthritis (JRA) affects one child in every thousand annually. There are six types of juvenile rheumatoid arthritis. Treatment of rheumatoid arthritis depends upon the type the child has and should focus on treating the symptoms.
• Nonsteroidal Anti-inflammatory Drugs and Ulcers Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
• Reactive Arthritis Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary, or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with anti-inflammatory medications.
• SAPHO Syndrome SAPHO syndrome is a chronic disorder that involves the skin, bone, and joints. SAPHO syndrome is an eponym for the combination of synovitis, acne, pustulosis, hyperostosis, and osteitis. SAPHO syndrome is related to arthritic conditions such as ankylosing spondylitis and reactive arthritis. Treatment is directed toward the individual symptoms that are present.

Treatment & Diagnosis

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Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

References

FDA Prescribing Information