Generic Name: Tolmetin sodium Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: C

Uses

What is Tolmetin Sodium used for?

Tolmetin Sodium is used alone or with other treatments to reduce pain, swelling, and joint stiffness from rheumatoid arthritis and osteoarthritis. It is also used for juvenile rheumatoid arthritis.

If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.

Tolmetin is known as a nonsteroidal anti-inflammatory drug (NSAID).

How should I take Tolmetin Sodium?

Take this medication by mouth, usually 3 times a day with a full glass of water (8 ounces or 240 milliliters) or as directed by your doctor. Do not lie down for at least 10 minutes after taking this drug. If stomach upset occurs, take this medication with food, milk, or an antacid (except sodium bicarbonate).

Dosage is based on your medical condition and response to therapy. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose, take it more frequently, or take it for a longer time than prescribed. Discuss the risks and benefits with your doctor or pharmacist.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. It may take 1-2 weeks of taking this drug regularly until you get the full benefit.

Inform your doctor if your condition worsens or if you develop new symptoms.

How do I store Tolmetin Sodium?

Tolmetin Sodium is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Tolmetin Sodium in the bathroom or the freezer. There may be different brands of Tolmetin Sodium that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Tolmetin Sodium down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Tolmetin Sodium?

Before taking tolmetin, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (e.g., ibuprofen, naproxen, zomepirac, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: aspirin-sensitive asthma (a history of worsening breathing with runny/stuffy nose after taking aspirin or other NSAIDs), recent heart bypass surgery (CABG).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, bleeding/clotting problems, blood disorders (e.g., anemia), high blood pressure, diabetes, heart disease (e.g., history of heart attack), liver disease, growths in the nose (nasal polyps), obesity, tobacco use, stomach/intestine/esophagus problems (bleeding sores/ulcer, gastrointestinal bleeding, reflux disease), stroke, swelling of the ankles/feet/hands.

Kidney problems can sometimes occur with the use of NSAID medications, including tolmetin. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.

Before having surgery, tell your doctor or dentist that you are using this medication.

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana.

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.

This medicine contains sodium. If you are on a salt-restricted diet or have any condition that requires you to restrict your intake of salt, consult your doctor or pharmacist about using this drug safely.

Older adults may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding and ulcers, and kidney problems.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.

This drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Tolmetin Sodium during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Tolmetin Sodium. Tolmetin Sodium is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Tolmetin Sodium?

Nausea, vomiting, heartburn, dizziness, drowsiness, diarrhea, and headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, persistent/severe headache, fast/pounding heartbeat, hearing changes (e.g., ringing in the ears), mental/mood changes, stomach pain, difficult/painful swallowing, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).

Stop taking tolmetin and tell your doctor right away if any of these rare but very serious side effects occur: easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), unexplained stiff neck, change in the amount/color of urine, vision changes.

This drug may rarely cause serious, possibly fatal liver disease. If you notice any of the following rare but very seriousside effects, stop taking tolmetin and consult your doctor or pharmacist right away: persistent nausea/vomiting, severe stomach/abdominal pain, weakness, dark urine, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, stop taking tolmetin and immediately seek medical attention if you notice any of the following symptoms of a serious allergic reaction: rash/blisters, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Tolmetin Sodium?

Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), cidofovir, corticosteroids (e.g., prednisone), lithium, methotrexate, “water pills” (diuretics such as furosemide).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to tolmetin and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

This product can affect the results of certain lab tests (e.g., protein in urine), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Tolmetin Sodium may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Tolmetin Sodium?

Tolmetin Sodium may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Tolmetin Sodium?

Tolmetin Sodium may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Tolmetin Sodium.

What is the dose of Tolmetin Sodium for an adult?

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.

What is the dose of Tolmetin Sodium for a child?

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.

How is Tolmetin Sodium available?

Tolmetin Sodium is available in the following dosage forms and strengths:

  • Oral tablet,
  • Oral capsule.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Tolmetin Sodium, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 6, 2018 | Last Modified: November 6, 2018

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