Tolmetin

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Approved Treatment Indication:

Juvenile Arthritis, Rheumatoid Arthritis ... show more

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Summary

What conditions is Tolmetin used for?
Tolmetin is used to relieve pain, swelling, and stiffness caused by conditions like rheumatoid arthritis, osteoarthritis, and juvenile rheumatoid arthritis. It's also used to treat ankylosing spondylitis and certain conditions causing muscle strain or swelling in the shoulder or elbow, as well as injuries like recent sprains.
How does Tolmetin work in the body?
Tolmetin works by inhibiting the production of prostaglandins, substances in the body that cause inflammation and pain. By reducing these substances, Tolmetin helps alleviate symptoms associated with conditions like arthritis.
What are the usual dosages and routes of administration for Tolmetin?
For adults, the usual starting dose of Tolmetin is 400 mg taken three times daily. For children aged 2 years and older, the starting dose is 20 mg/kg/day in divided doses. The dose can be adjusted based on the patient's response. Tolmetin should be taken on an empty stomach.
What are the most commonly observed adverse effects of Tolmetin?
Common side effects of Tolmetin include nausea, dyspepsia, abdominal pain, diarrhea, constipation, headache, dizziness, and skin irritation. Serious adverse effects include cardiovascular events like heart attack and stroke, gastrointestinal bleeding, and allergic reactions.
What are important safety warnings and contraindications for Tolmetin?
Tolmetin carries significant warnings including an increased risk of cardiovascular events like heart attack and stroke, especially with long-term use. It can also cause serious gastrointestinal issues such as ulcers and bleeding. Tolmetin is contraindicated in patients with known hypersensitivity to NSAIDs, those who have experienced asthma or allergic reactions to aspirin, and in the setting of coronary artery bypass graft surgery.

Government Approvals

US(FDA)

WHO Essential Medicine

NO

Known Teratogen

NO

Pharmaceutical Class

Nonsteroidal Anti-inflammatory Drug

Controlled Drug Substance

No

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Drug Ingredient

Tolmetin

Summary

What conditions is Tolmetin used for?
Tolmetin is used to relieve pain, swelling, and stiffness caused by conditions like rheumatoid arthritis, osteoarthritis, and juvenile rheumatoid arthritis. It's also used to treat ankylosing spondylitis and certain conditions causing muscle strain or swelling in the shoulder or elbow, as well as injuries like recent sprains.
How does Tolmetin work in the body?
Tolmetin works by inhibiting the production of prostaglandins, substances in the body that cause inflammation and pain. By reducing these substances, Tolmetin helps alleviate symptoms associated with conditions like arthritis.
What are the usual dosages and routes of administration for Tolmetin?
For adults, the usual starting dose of Tolmetin is 400 mg taken three times daily. For children aged 2 years and older, the starting dose is 20 mg/kg/day in divided doses. The dose can be adjusted based on the patient's response. Tolmetin should be taken on an empty stomach.
What are the most commonly observed adverse effects of Tolmetin?
Common side effects of Tolmetin include nausea, dyspepsia, abdominal pain, diarrhea, constipation, headache, dizziness, and skin irritation. Serious adverse effects include cardiovascular events like heart attack and stroke, gastrointestinal bleeding, and allergic reactions.
What are important safety warnings and contraindications for Tolmetin?
Tolmetin carries significant warnings including an increased risk of cardiovascular events like heart attack and stroke, especially with long-term use. It can also cause serious gastrointestinal issues such as ulcers and bleeding. Tolmetin is contraindicated in patients with known hypersensitivity to NSAIDs, those who have experienced asthma or allergic reactions to aspirin, and in the setting of coronary artery bypass graft surgery.

Indications and Purpose

How does Tolmetin work?

Tolmetin works by inhibiting the enzyme cyclooxygenase (COX), which is involved in the production of prostaglandins. Prostaglandins are chemicals in the body that promote inflammation, pain, and fever. By reducing the production of prostaglandins, Tolmetin helps decrease inflammation and alleviate pain and swelling associated with conditions like arthritis.

Is Tolmetin effective?

Tolmetin is effective in treating both acute flares and long-term management of rheumatoid arthritis, osteoarthritis, and juvenile rheumatoid arthritis. Clinical studies have shown that Tolmetin is as effective as aspirin and indomethacin in controlling disease activity, with fewer gastrointestinal and central nervous system side effects compared to these medications. It works by inhibiting prostaglandin synthesis, which reduces inflammation, pain, and fever.

What is Tolmetin?

Tolmetin is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and stiffness caused by conditions like rheumatoid arthritis, osteoarthritis, and juvenile rheumatoid arthritis. It works by inhibiting the production of prostaglandins, substances in the body that cause inflammation and pain. By reducing these substances, Tolmetin helps alleviate symptoms associated with these conditions.

Directions for Use

For how long do I take Tolmetin?

Tolmetin is typically used for both short-term relief of acute symptoms and long-term management of chronic conditions like rheumatoid arthritis and osteoarthritis. The duration of use depends on the individual's condition and response to treatment. It is important to use the lowest effective dose for the shortest duration necessary to manage symptoms, as advised by a healthcare provider.

How do I take Tolmetin?

Tolmetin should be taken on an empty stomach, usually three times a day for adults and three to four times a day for children over 2 years old. If it upsets your stomach, your doctor may recommend taking it with an antacid. There are no specific food restrictions, but it's important to follow your doctor's instructions and not to take more or less than prescribed.

How long does it take for Tolmetin to start working?

Tolmetin may help control symptoms within one week of starting treatment, but it can take several weeks to feel the full benefit of the medication. Patients should communicate with their healthcare provider about how the medication is working and any side effects they experience.

How should I store Tolmetin?

Tolmetin should be stored in its original container, tightly closed, and kept out of reach of children. It should be stored at room temperature, away from excess heat and moisture, and not in the bathroom. To prevent accidental ingestion by children, always lock safety caps and store the medication in a safe location, out of sight and reach.

What is the usual dose of Tolmetin?

For adults, the usual starting dose of Tolmetin is 400 mg taken three times daily, totaling 1200 mg per day. The dose can be adjusted based on the patient's response, typically ranging from 600 mg to 1800 mg daily. For children aged 2 years and older, the starting dose is 20 mg/kg/day in divided doses, with a usual range of 15 to 30 mg/kg/day. Doses higher than 30 mg/kg/day have not been studied and are not recommended.

Warnings and Precautions

Can I take Tolmetin with other prescription drugs?

Tolmetin can interact with several medications, increasing the risk of side effects. Notable interactions include anticoagulants like warfarin, other NSAIDs, corticosteroids, SSRIs, and SNRIs, which can increase the risk of gastrointestinal bleeding. It may also reduce the effectiveness of antihypertensive drugs like ACE inhibitors and diuretics. Patients should inform their healthcare provider of all medications they are taking to avoid potential interactions.

Can Tolmetin be taken safely while breastfeeding?

Tolmetin is excreted in human milk, and due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or the drug. The importance of the drug to the mother should be considered. Nursing mothers should consult their healthcare provider to discuss the risks and benefits of using Tolmetin while breastfeeding.

Can Tolmetin be taken safely while pregnant?

Tolmetin should be avoided during pregnancy, especially after 20 weeks, due to the risk of fetal harm, including premature closure of the fetal ductus arteriosus and renal dysfunction leading to oligohydramnios. If necessary, it should be used at the lowest effective dose for the shortest duration. Pregnant women should consult their healthcare provider to weigh the benefits and risks of using Tolmetin.

Is it safe to drink alcohol while taking Tolmetin?

Drinking alcohol while taking Tolmetin can increase the risk of gastrointestinal issues such as ulcers and bleeding. Alcohol can irritate the stomach lining, and when combined with Tolmetin, which also affects the stomach, the risk of adverse effects is heightened. It is advisable to limit or avoid alcohol consumption while taking this medication to reduce these risks.

Is it safe to exercise while taking Tolmetin?

Tolmetin may cause dizziness or drowsiness, which could potentially affect your ability to exercise safely. If you experience these side effects, it is advisable to avoid activities that require full alertness, such as exercising, until you know how the medication affects you. Consult your doctor if you have concerns about exercising while taking Tolmetin.

Is Tolmetin safe for the elderly?

Elderly patients are at a higher risk for serious gastrointestinal events and cardiovascular issues when taking Tolmetin. It is important to use the lowest effective dose for the shortest duration possible. Regular monitoring by a healthcare provider is recommended to manage potential side effects and adjust treatment as needed. Elderly patients should be informed about the signs of serious side effects and advised to seek medical attention if they occur.

Who should avoid taking Tolmetin?

Tolmetin carries significant warnings, including an increased risk of cardiovascular events like heart attack and stroke, especially with long-term use. It can also cause serious gastrointestinal issues such as ulcers and bleeding. Tolmetin is contraindicated in patients with known hypersensitivity to NSAIDs, those who have experienced asthma or allergic reactions to aspirin, and in the setting of coronary artery bypass graft surgery. Patients should be aware of these risks and consult their doctor if they have a history of heart disease, gastrointestinal issues, or are pregnant.