Wednesday, October 19, 2016

tolmetin


Generic Name: tolmetin (TOLE met in)

Brand names: Tolectin, Tolectin DS, Tolectin 600


What is tolmetin?

Tolmetin is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.


Tolmetin is used to treat pain, inflammation, and stiffness caused by arthritis.


Tolmetin may also be used for other purposes not listed in this medication guide.


What is the most important information I should know about tolmetin?


This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use tolmetin. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).


Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.


This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal. These gastrointestinal effects can occur without warning at any time while you are taking tolmetin. Older adults may have an even greater risk of these serious gastrointestinal side effects.


Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.


Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar to tolmetin (such as ibuprofen, ketoprofen, or naproxen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen. Do not drink alcohol while taking tolmetin. Alcohol can increase the risk of stomach bleeding caused by tolmetin.

What should I discuss with my healthcare provider before taking tolmetin?


Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).


NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal. These gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.


Do not use this medication if you have ever had an allergic reaction to tolmetin, aspirin, or other NSAIDs.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take tolmetin:



  • a history of heart attack, stroke, or blood clot;




  • heart disease, congestive heart failure, high blood pressure;




  • a history of stomach ulcers or bleeding;



  • liver or kidney disease;


  • asthma;




  • polyps in your nose;




  • a bleeding or blood clotting disorder; or




  • if you smoke.




FDA pregnancy category C. It is not known whether tolmetin is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking tolmetin during the last 3 months of pregnancy may result in birth defects. Do not take tolmetin during pregnancy unless your doctor has told you to. Tolmetin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 2 years old without the advice of a doctor.

How should I take tolmetin?


Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.


Take this medicine with a full glass of water. It is best to take tolmetin on an empty stomach. However, if tolmetin upsets your stomach you may take it with food, milk, or an antacid (but not sodium bicarbonate or baking soda).

If you take tolmetin for a long period of time, your doctor may want to check you on a regular basis to make sure this medication is not causing harmful effects. Do not miss any scheduled visits to your doctor.


You may need to take tolmetin for several days before you notice improvement in your symptoms.


Store tolmetin at room temperature away from moisture, heat, and light.

See also: Tolmetin dosage (in more detail)

What happens if I miss a dose?


Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, and fainting.

What should I avoid while taking tolmetin?


Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar to tolmetin (such as ibuprofen, ketoprofen, or naproxen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen. Do not drink alcohol while taking tolmetin. Alcohol can increase the risk of stomach bleeding caused by tolmetin. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Tolmetin can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Tolmetin side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using tolmetin and call your doctor at once if you have any of these serious side effects:

  • chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;




  • black, bloody, or tarry stools;




  • coughing up blood or vomit that looks like coffee grounds;




  • swelling or rapid weight gain;




  • urinating less than usual or not at all;




  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);




  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;




  • bruising, severe tingling, numbness, pain, muscle weakness; or




  • fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).



Less serious side effects may include:



  • upset stomach, mild heartburn, diarrhea, constipation;




  • bloating, gas;




  • dizziness, headache, nervousness;




  • skin itching or rash;




  • blurred vision; or




  • ringing in your ears.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Tolmetin Dosing Information


Usual Adult Dose for Osteoarthritis:

200 to 400 mg orally 3 times a day.
Doses generally range from 600 to 1800 mg/day in 3 divided doses.

Usual Adult Dose for Rheumatoid Arthritis:

200 to 400 mg orally 3 times a day.
Doses generally range from 600 to 1800 mg/day in 3 divided doses.

Usual Adult Dose for Acute Gout:

600 mg orally one time, followed by 400 mg every 6 to 8 hours until the gouty attack has resolved, usually 2 to 3 days.

Usual Adult Dose for Pain:

200 to 400 mg orally every 6 to 8 hours.

Usual Pediatric Dose for Pain:

Greater than 2 years:
5 to 7 mg/kg/dose every 6 to 8 hours.

Usual Pediatric Dose for Anti-inflammatory:

Greater than 2 years:
Initial dose: 20 mg/kg/day in 3 to 4 divided doses.
Maintenance dose: 15 to 30 mg/kg/day in 3 divided doses.
Doses greater than 30 mg/kg/day are not recommended.


What other drugs will affect tolmetin?


Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs with tolmetin may cause you to bruise or bleed easily.


Before taking tolmetin, tell your doctor if you are using any of the following drugs:



  • lithium (Eskalith, Lithobid);




  • diuretics (water pills) such as furosemide (Lasix).




  • methotrexate (Rheumatrex, Trexall);




  • steroids (prednisone and others);




  • a blood thinner such as warfarin (Coumadin);




  • an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik); or.




  • aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), and others;



This list is not complete and there may be other drugs that can interact with tolmetin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.



More tolmetin resources


  • Tolmetin Side Effects (in more detail)
  • Tolmetin Dosage
  • Tolmetin Use in Pregnancy & Breastfeeding
  • Drug Images
  • Tolmetin Drug Interactions
  • Tolmetin Support Group
  • 0 Reviews for Tolmetin - Add your own review/rating


  • tolmetin Advanced Consumer (Micromedex) - Includes Dosage Information

  • Tolmetin MedFacts Consumer Leaflet (Wolters Kluwer)

  • Tolmetin Prescribing Information (FDA)

  • Tolectin Monograph (AHFS DI)



Compare tolmetin with other medications


  • Back Pain
  • Gout, Acute
  • Inflammatory Conditions
  • Osteoarthritis
  • Pain
  • Rheumatoid Arthritis
  • Sciatica


Where can I get more information?


  • Your pharmacist can provide more information about tolmetin.

See also: tolmetin side effects (in more detail)


No comments:

Post a Comment