Tolmetin should be avoided by patients with a history of asthma, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can aggravate both conditions.
Other important side effects include:
- heart attacks
- accumulation of fluid, and
- increased chance ofheart failure.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets or capsules: 200, 400, and 600 mg
STORAGE: Tolmetin should be stored at room temperature in a sealed container and protected from moisture.
DOSING: The recommended dose is 200-600 mg three times daily. The maximum daily dose is 1800 mg. Tolmetin should be taken with food and 8-12 ounces of water to avoid stomach upset.
DRUG INTERACTIONS: Tolmetin is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of an increased risk of bleeding. Patients taking lithium (Eskalith, Lithobid) or methotrexate (Rheumatrex, Trexall) can develop toxic blood levels of either drug because tolmetin may inhibit their elimination from the body by the kidney. Side effects from cyclosporine also may be increased by tolmetin. Tolmetin may reduce the effectiveness of antihypertensives because it causes or worsens high blood pressure. NSAIDs may diminish the antihypertensive effect of ACE inhibitors.
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