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Tolmetin

    Generic Only

    DEA Class;  Rx

    Common Brand Names; Tolectin

     NSAIDs

    Nonsteroidal anti-inflammatory drug (NSAID) of the heterocyclic acetic acid chemical class
    Used for osteoarthritis and rheumatoid arthritis in adults; also used in pediatric patients as young as 2 years for juvenille idiopathic arthritis (JIA)
    All NSAIDs may cause an increased risk of serious gastrointestinal or cardiovascular events; use lowest effective dose for the shortest possible duration

    For the treatment of acute flares or for the chronic management of rheumatoid arthritis or osteoarthritis.

    For the treatment of juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA).

    Absolute: ASA allergy, hepatic disease (severe chronic), hepatitis, jaundice, nursing mother

    Relative: Bleeding disorder, duodenal/gastric/peptic ulcer, stomatitis, SLE, ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of ductus arteriosus)

    >10%

    Increased liver function test (up to 15%)

    1-10%

    Nausea (10%)

    Hypertension (3-9%)

    Myocardial infarction (<2%)

    Edema

    Weight gain, Weight loss

    Abdominal pain

    Diarrhea

    Flatulence

    Indigestion

    Nausea, Vomiting

    Asthenia

    Dizziness

    Headache

    Use caution in asthma (bronchial), cardiac disease, CHF, hepatic impairment, HTN, renal impairment

    Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs

    Strong cross-sensitivity may exist for ASA allergic patients

    Food reduces bioavailability

    Heart Failure(HF) risk

    Pregnancy Category: C; avoid in late pregnancy, may cause premature closure of ductus arteriosus

    Lactation: excreted in breast milk; safety in nursing infants not known

    Adults

    1,800 mg/day PO.

    Geriatric

    1,800 mg/day PO.

    Adolescents

    30 mg/kg/day PO or 1,800 mg/day PO, whichever is less.

    Children

    2 to 12 years: 30 mg/kg/day PO or 1,800 mg/day PO, whichever is less.
    Less than 2 years: Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    tablet

    • 200mg
    • 600mg

    capsule

    • 400mg