Indications for Tolmetin 600mg:
Relief of signs and symptoms of rheumatoid arthritis and osteoarthritis. Treatment of acute flares and the long-term management of the chronic disease. Treatment of juvenile rheumatoid arthritis.
Initially 400mg 3 times daily. Maintenance: 600–1800mg daily in divided doses; max 1800mg/day.
<2yrs: not recommended. ≥2yrs: Initially 20mg/kg/day in divided doses (3–4 times daily). Maintenance: usual dose range: 15–30mg/kg/day; max 30mg/kg/day.
Aspirin allergy. Coronary artery bypass graft surgery.
Advanced renal disease: not recommended. Hypertension; monitor. CHF. Edema. Asthma. History of ulcer disease or GI bleeding. Bleeding disorders. Dehydration. Monitor blood, hepatic, and renal function in chronic use. Elderly. Debilitated. Labor & delivery. Pregnancy (Cat. C: <30 weeks gestation; Cat. D: ≥30 weeks gestation: avoid). Nursing mothers: not recommended.
Avoid aspirin. May antagonize ACE inhibitors, diuretics. Increased risk of GI bleed with oral corticosteroids, anticoagulants (monitor), alcohol, smoking. Methotrexate excretion reduced. Increases lithium levels.
GI upset, abdominal pain, dyspepsia, flatulence, headache, asthenia, elevated BP, edema, dizziness, weight gain, weight loss; rash (discontinue if occurs), GI ulcer/bleed, elevated liver enzymes (discontinue if hepatotoxicity develops), blood dyscrasias, renal papillary necrosis. See literature re: risk of cardiovascular events.
Formerly known under the brand name Tolectin 600.