Tolectin

Indications

Tolmetin is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling and stiffness in rheumatoid arthritis and osteoarthritis. It is also used for juvenile rheumatoid arthritis in children under a doctor's care.

How It Works

Tolmetin blocks the cyclo-oxygenase (COX) enzymes that make prostaglandins, natural chemicals that cause pain, swelling and fever. Lowering prostaglandins eases joint pain and inflammation.

Dosage and Administration

Adults: usually 400 mg three times a day to start, with one dose on waking and one at bedtime. Your doctor may adjust the dose; the usual total is 600 mg to 1,800 mg a day, divided into three doses. Do not take more than 1,800 mg a day unless your doctor tells you to. Take with water, preferably with food or milk if it upsets your stomach. Children: as prescribed by a doctor according to body weight. Use the lowest dose that works for the shortest time.

Interactions

Taking Tolmetin with other NSAIDs, Aspirin, Corticosteroids, Warfarin or SSRI antidepressants increases the risk of stomach bleeding. It can reduce the effect of blood pressure medicines (ACE inhibitors, ARBs, diuretics) and may raise levels of Lithium and Methotrexate. Avoid alcohol.

Contraindications

• Allergy to Tolmetin, Aspirin or other NSAIDs (including asthma, hives or swelling after taking them).
• Active stomach or intestinal ulcer or bleeding.
• Severe heart failure, or pain relief around heart bypass surgery.
• Severe kidney or liver disease.
• Last three months of pregnancy.

Side Effects

Common side effects include indigestion, stomach pain, nausea, heartburn, diarrhoea or constipation, headache, dizziness, swelling of the ankles and a rise in blood pressure.

Get urgent medical help for black or bloody stools, vomiting blood, chest pain, shortness of breath, weakness on one side or slurred speech, yellowing of the skin or eyes, a severe skin rash or blistering, swelling of the face or throat, or passing very little urine.

Pregnancy and Lactation

Avoid in pregnancy unless a doctor advises it; do not use from 20 weeks onwards unless clearly needed, and never in the last three months, as it can harm the baby's heart and kidneys. Small amounts pass into breast milk; ask your doctor before using it while breastfeeding.

Precautions and Warnings

NSAIDs can increase the risk of heart attack, stroke and stomach bleeding, especially with long use, in older people, and in those with heart disease or a history of ulcers. Tell your doctor if you have high blood pressure, asthma, kidney or liver problems, or are dehydrated. Long-term users may need blood, kidney and liver checks.

Overdose

Overdose may cause drowsiness, nausea, vomiting, stomach pain and, rarely, stomach bleeding or kidney problems. Seek medical help at once and take the pack with you.

Therapeutic Class

Non-steroidal anti-inflammatory drug (NSAID); pyrrole acetic acid derivative.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.