tolmetin (Tolectin)
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Introduction
Tradename: Tolectin.
Indications
- temporary relief of minor aches, pains, fever & inflammation
Dosage
- 200-600 mg PO TID; maximum 1800 mg/day
- expect a therapeutic response in a few days to a week
- if GI irritation occurs, give with an antacid
- bioavailability is affected by food & milk
Pharmacokinetics
- primarily metabolized by oxidation
- elimination 1/2 life is 5 hours[3]
elimination via liver
1/2life = 1.0-1.5 hours
1/2life = 5 hours
protein binding = >99 %
elimination by hemodialysis = -
elimination by peritoneal dialysis = -
Adverse effects
- GI distress
- GI bleeding
- nausea
- headache
- higher frequency of anaphylactoid reactions than other NSAIDs
- aseptic meningitis
- rarely leukopenia, thrombocytopenia, hemolytic anemia
Drug interactions
- corticosteroids
- increase the clearance of salicylates
- increase the nephrotoxicity & GI toxicity of NSAIDs
- decreased antihypertensive effects of ACE inhibitors
- warfarin: prolonged bleeding time
- tolmetin decreases clearance & increases toxicity of:
- drug interaction(s) of cholinesterase inhibitors with NSAIDs
- drug interaction(s) of lithium carbonate with NSAIDs
- drug interaction(s) of NSAIDs with oral contraceptive
- drug interaction(s) of NSAIDs with SSRIs
- drug interaction(s) of NSAIDs with antidepressants
- drug interaction(s) of aspirin with NSAIDs
- drug interaction(s) of apixaban with NSAIDs
- drug interaction(s) of warfarin with NSAIDs
- drug interaction(s) of NSAIDs with beta blockers
- drug interaction(s) of NSAIDs with ARBs
- drug interaction(s) of NSAIDs with aldosterone antagonis
- drug interaction(s) of NSAIDs with glucocorticoid
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
- drug interaction(s) of NSAIDs with ACE inhibitors
- drug interaction(s) of NSAIDs & antihypertensives
- drug interaction(s) of NSAIDs & loop diuretics
- drug interaction(s) of NSAIDs & aspirin
Laboratory
Mechanism of action
- acetic acid class NSAID
- analgesic, antipyretic, anti-inflammatory
- non-selective cyclooxygenase inhibitor
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 792
- ↑ 3.0 3.1 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
- ↑ Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995