Tolmetin
(Tolectin, Tolectin DS)
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Category:
Description:
Indications:
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Mild
to moderate pain, osteoarthritis
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Rheumatoid
arthritis, ankylosing spondylitis
Contraindications:
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Asthma,
severe renal disease
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Severe
hepatic disease, ulcer disease
Precautions:
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Pregnancy
category B (D near term), small amounts excreted in breast milk,
compatible with breast feeding
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Children,
bleeding disorders
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GI
disorders, cardiac disorders
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Hypersensitivity
to other anti-inflammatory agents, peptic ulcer disease
Adverse
Reactions (Side Effects):
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CNS:
anxiety, confusion, depression, dizziness, drowsiness, fatigue,
insomnia, tremors
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CV:
dysrhythmias, hypertension, palpitations, peripheral edema,
tachycardia
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EENT:
blurred vision, hearing loss, tinnitus
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GI:
anorexia, bleeding, cholestatic hepatitis, constipation, cramps,
diarrhea, jaundice, nausea, peptic ulcer, perforation, ulceration,
vomiting
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GU:
azotemia, dysuria, hematuria, nephrotoxicity, oliguria,
pseudoproteinuria
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HEME:
blood dyscrasias
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SKIN:
pruritus, purpura, rash, sweating
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Dosage:
Administered
orally
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Adult:
PO 400mg 3-4 times daily, not to exceed 2g daily
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Child
>2 years: PO 15-30 mg/kg/day in 3 or 4 divided doses
Drug
interactions:
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Methotrexate:
potentially increase methotrexate concentrations and toxicity
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Potassium
sparing diuretics: potential for acute renal failure (i.e.,
indomethacin and triamterene)
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Cyclosporine:
Other NSAIDs increase cyclosporine concentrations
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Angiotensin-converting
enzyme (ACE) inhibitors: inhibits the antihypertensive effects of ACE
inhibitors
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Beta-blockers:
reduced hypotensive effects of beta-blockers
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Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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