Tolmetin
Generic name: tolmetin [ TOL-met-in ]
Brand names: Tolectin, Tolectin DS, Tolectin 600
Dosage forms: oral capsule (400 mg), oral tablet (600 mg)
Drug class: Nonsteroidal anti-inflammatory drugs
What is tolmetin?
Tolmetin is a nonsteroidal anti-inflammatory drug (NSAID).
Tolmetin is used to treat pain or inflammation caused by osteoarthritis or rheumatoid arthritis. Tolmetin is also used to treat juvenile rheumatoid arthritis in children who are at least 2 years old.
Tolmetin may also be used for purposes not listed in this medication guide.
Tolmetin side effects
Get emergency medical help if you have signs of an allergic reaction (hives, sneezing, runny nose, wheezing, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath.
Tolmetin may cause serious side effects. Stop using tolmetin and call your doctor at once if you have:
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changes in your vision;
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shortness of breath (even with mild exertion);
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swelling or rapid weight gain;
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any skin rash, no matter how mild;
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signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
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liver problems--nausea, upper stomach pain, itching, tired feeling, flu-like symptoms, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
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kidney problems--little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or
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low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.
Common side effects of tolmetin may include:
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indigestion, stomach pain, nausea, vomiting;
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diarrhea, gas;
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headache, dizziness;
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weakness; or
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changes in weight.
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.
Warnings
Tolmetin can increase your risk of fatal heart attack or stroke. Do not use tolmetin just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Tolmetin may also cause stomach or intestinal bleeding, which can be fatal.
Before taking this medicine
Tolmetin can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Tolmetin may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using tolmetin, especially in older adults.
You should not use tolmetin if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.
Tell your doctor if you have ever had:
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heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;
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a history of heart attack, stroke, or blood clot;
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a history of stomach ulcers or bleeding;
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asthma;
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liver or kidney disease; or
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if you take aspirin to prevent heart attack or stroke.
If you are pregnant, you should not take tolmetin unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.
You should not breastfeed while using this medicine.
Tolmetin is not approved for use by anyone younger than 2 years old.
How should I take tolmetin?
Follow all directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the lowest dose that is effective in treating your condition.
Take tolmetin on an empty stomach, at least 1 hour before or 2 hours after a meal.
It may take up to 1 week before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.
If you use tolmetin long-term, you may need frequent medical tests.
This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using tolmetin.
Store at room temperature away from moisture, heat, and light.
Tolmetin dosing information
Usual Adult Dose for Rheumatoid Arthritis:
Initial dose: 400 mg orally 3 times a day
Maintenance dose: 600 to 1800 mg orally in 3 divided doses
Maximum dose: 1800 mg orally per day
Comments:
-It is recommended to include a dose upon awaking and a dose at bedtime.
-Doses should be adjusted according to response to treatment after 1 or 2 weeks.
-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient's treatment goals.
Use: For the relief of signs and symptoms of rheumatoid arthritis, including acute flares and long term management of chronic disease.
Usual Adult Dose for Osteoarthritis:
Initial dose: 400 mg orally 3 times a day
Maintenance dose: 600 to 1800 mg orally in 3 divided doses
Maximum dose: 1800 mg orally per day
Comments:
-It is recommended to include a dose upon awaking and a dose at bedtime.
-Doses should be adjusted according to response to treatment after 1 or 2 weeks.
-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient's treatment goals.
Use: For the relief of signs and symptoms of osteoarthritis, including acute flares and long term management of chronic disease.
Usual Pediatric Dose for Juvenile Rheumatoid Arthritis:
2 years or older:
Initial dose: 20 mg/kg/day orally in 3 to 4 divided doses
Maintenance dose: 15 to 30 mg/kg/day orally in 3 to 4 divided doses
Maximum dose: 30 mg/kg/day
Comments:
-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient's treatment goals.
Use: For the relief of signs and symptoms of juvenile rheumatoid arthritis, including acute flares and long term management of chronic disease.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking tolmetin?
Avoid drinking alcohol. It may increase your risk of stomach bleeding.
Avoid taking aspirin unless your doctor tells you to.
Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to tolmetin (such as aspirin, ibuprofen, ketoprofen, or naproxen).
What other drugs will affect tolmetin?
Ask your doctor before using tolmetin if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.
Tell your doctor about all your other medicines, especially:
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lithium;
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heart or blood pressure medication, including a diuretic or "water pill"; or
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insulin or oral diabetes medicine.
This list is not complete. Other drugs may affect tolmetin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Related/similar drugs
gabapentin, acetaminophen, aspirin, prednisone, ibuprofen, tramadol, duloxetine, meloxicam, cyclobenzaprine, naproxen
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Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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