Tolmetin (Tolectin, Tolectin DS)

Category:

  • Analgesic

Description:

  • Nonsteroidal anti-inflammatory (NSAID) drug

Indications:

  • Mild to moderate pain, osteoarthritis

  • Rheumatoid arthritis, ankylosing spondylitis

Contraindications:

  • Asthma, severe renal disease

  • Severe hepatic disease, ulcer disease

Precautions:

  • Pregnancy category B (D near term), small amounts excreted in breast milk, compatible with breast feeding

  • Children, bleeding disorders

  • GI disorders, cardiac disorders

  • Hypersensitivity to other anti-inflammatory agents, peptic ulcer disease

Adverse Reactions (Side Effects):

  • CNS: anxiety, confusion, depression, dizziness, drowsiness, fatigue, insomnia, tremors

  • CV: dysrhythmias, hypertension, palpitations, peripheral edema, tachycardia

  • EENT: blurred vision, hearing loss, tinnitus

  • GI: anorexia, bleeding, cholestatic hepatitis, constipation, cramps, diarrhea, jaundice, nausea, peptic ulcer, perforation, ulceration, vomiting

  • GU: azotemia, dysuria, hematuria, nephrotoxicity, oliguria, pseudoproteinuria

  • HEME: blood dyscrasias

  • SKIN: pruritus, purpura, rash, sweating

Dosage:

Administered orally

  • Adult:   PO 400mg 3-4 times daily, not to exceed 2g daily

  • Child >2 years: PO 15-30 mg/kg/day in 3 or 4 divided doses

 Drug interactions:

  • Methotrexate: potentially increase methotrexate concentrations and toxicity

  • Potassium sparing diuretics: potential for acute renal failure (i.e., indomethacin and triamterene)

  • Cyclosporine: Other NSAIDs increase cyclosporine concentrations

  • Angiotensin-converting enzyme (ACE) inhibitors: inhibits the antihypertensive effects of ACE inhibitors

  • Beta-blockers: reduced hypotensive effects of beta-blockers

    

 
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