Tolmetin (Oral)

Tolmetin is used to treat juvenile rheumatoid arthritis and osteoarthritis. It is a NSAID and is used sparingly to treat other issues.

Overview

Tolmetin, available in the branded form 'Tolectin' or generic forms, is a drug often prescribed to treat forms of arthritis, including juvenile rheumatoid arthritis and osteoarthritis. It is used sparingly in generic forms to treat other issues, but it's primary purpose is geared towards patients suffering from arthritis.

It has a number of side effects, with most people experiencing headaches, heartburn, and nausea shortly after taking the drug. These side effects may linger until your body adjusts to the medication, but if they persist, contact your doctor. To many users, these side effects are minimal, and do not outweigh the positive impact the drug has on their bodies, pain levels, and daily functions.

Tolmetin is an nonsteroidal anti-inflammatory drug (NSAID), which may affect how some patients are able to take and benefit from the medication. If you have heart problems, have a family history of heart issues, or are at risk of having a stroke, do not take Tolmetin or any other form of NSAID on the market. Speak to your doctor if you believe that you should avoid taking NSAIDs like Tolmetin, and look to other avenues for treatment.

Do not take Tolmetin if you have asthma, as it may narrow your airways and cause asthma attacks. Speak to your doctor about other medications. If you must take Tolmetin, use it sparingly and on your doctor's orders. Carry your inhaler, and only take Tolmetin as long as it is necessary.

Pregnant individuals, people with liver damage, and people at risk for kidney damage should avoid taking Tolmetin, and discuss other options with their doctor before committing to the drug. While Tolmetin is a medication designed to improve health, it comes with a number of risks that may make it unsuitable for certain groups of people. Do not take Tolmetin blindly, and speak to your doctor about risks, dosage, treatment duration, and alternatives before beginning any prescription of Tolmetin.

Tolmetin comes in tablet or capsule forms. It is recommended that patients take Tolmetin on an empty stomach with a full glass of water. As it sometimes causes heartburn, many doctors also recommend that it be combined with a light antacid to prevent any discomfort. It may take a few weeks for Tolmetin to reach its full effect, so do not skip doses or stop your treatment if you do not see immediate results.

Conditions Treated

  • Rheumatoid Arthritis
  • Juvenile Rheumatoid Arthritis
  • Osteoarthritis
  • Other forms of joint pain

In generic forms, Tolmetin is also used to treat

  • Arthritis of the spine
  • Muscle strain of the shoulder/elbow
  • Sprains and assorted injuries
  • Gout

Type of Medicine

  • nonsteroidal anti-inflammatory drug (NSAID)

Side Effects

Many side effects that come with taking Tolmetin are mild, and may lessen or disappear the longer you take the drug. The body requires time to adjust to medication, and it takes a few weeks for some people to fully accept the treatment. Some doctors may prescribe non-conflicting medications to help with these side effects, while others can be alleviated with natural methods or a change in diet/activity.

Here is a list of common yet harmless side effects you may experience while taking Tolmetin. These are not something to be alarmed about, but if they persist and become a problem, contact your doctor or pharmacist.

  • Nausea and vomiting (Anti-nausea medications may be prescribed if this becomes a serious issue.)
  • Headaches (Beware of OTC pain relievers like aspirin or ibuprofen, as they may interact with this medication. Talk to your doctor if you are experiencing headaches and need a drug to counteract them.)
  • Heartburn (Your doctor may prescribe a non-interacting antacid to combat this side effect.)
  • Drowsiness and dizziness (Avoid driving or operating large machinery if you experience these side effects.)
  • Diarrhea (Which may in turn cause dehydration, so it is recommended that you stay hydrated while taking this drug.)

However, it is wise to keep an eye on the changes/symptoms you experience while taking Tolmetin, especially when you first begin your treatment with the drug. Some side effects may be symptoms of a larger problem, and you may need to discuss them with your doctor. If any of these side effects occur, stop taking Tolmetin and contact your doctor.

  • Severe, long-term headache
  • Stomach pain
  • Fainting
  • Fatigue
  • Increased heartbeat
  • Change in hearing
  • Mood swings
  • Difficulty swallowing
  • Hearing changes
  • Swelling of the extremities
  • Unexplained weight gain

While these side effects are troublesome on their own, they could be a sign that NSAIDs such as Tolmetin are not right for you. If you persistently experience any of these, contact your doctor as soon as possible and begin thinking about alternative forms of treatment.

While rare, some side effects are serious and may require immediate assistance. If you experience any of these side effects, stop taking Tolmetin immediately and ask your doctor to switch you to another treatment. These side effects can become serious and lead to permanent damage if left ignored.

  • Signs of infection (Fever, sore throat)
  • Unexplained and persistent stiff neck
  • Changes in urine coloration
  • Easy bruising or bleeding
  • Vision changes

Stop taking Tolmetin immediately and speak to your doctor if you experience any of these. Even if it is a false alarm, it is better to be safe than sorry when it comes to taking new medications. It is partly your responsibility to record and take notice of how you react after starting a new prescription, so do not hesitate to voice concerns to your doctor if they become persistent.

Dosage

Dosage for Tolmetin can be determined by your condition, age, how you react to your first dose, and various other factors that are decided by your doctor. Dosage may vary between patients, and some conditions may require more treatment than others. No set dosage is appropriate for every person taking Tolmetin, so your doctor's orders outrank any information you may find on the internet.

That being said, there are guidelines on how you may be advised to take Tolmetin, depending on the reason you are taking the drug. Here are a few fast and loose rules to help you get a good idea of what you may be prescribed.

Adult dosage for rheumatoid arthritis:

Dosage for oral tablet (generic): 200mg

Dosage for oral capsule (generic): 400mg

400mg taken three times a day, evenly spaced. No dose higher than 1800mg per day is recommended under any conditions, as no conclusive studies have been done on treatments that extreme.

Adult dosage for osteoarthritis:

Dosage for oral tablet (generic): 200mg

Dosage for oral capsule (generic): 400mg

400mg taken three times a day, evenly spaced. No dose higher than 1800mg per day is recommended under any conditions, as no conclusive studies have been done on treatments that extreme.

Child/Teen dosage for juvenile rheumatoid arthritis

Dosage for oral tablet (generic): 200mg

Dosage for oral capsule (generic): 400mg

Complete dose depends on how much your child weighs. Talk to your doctor before deciding on any dose that will be given to a child or teenager in your care. Do not give any child more than 30 mg/kg a day, as it will likely result in an overdose or extreme side effects. Do not give Tolmetin to any child under the age of 2 years old.

These dosages are the usual, recommended doses for a completely regular patient. Every person is different, so it is recommended that you follow your doctor's orders closely and only change your dosage when advised to do so. Many factors may change your dosage, and it may be adjusted differently as time goes on.

Tolmetin may cause health risks if not taken properly. Overdose symptoms include:

  • Vomit that looks like coffee grounds
  • Slow and shallow breathing
  • Severe stomach pain
  • Loss of consciousness or extreme drowsiness
  • Seizures

If overdose symptoms occur, contact poison control immediately and seek professional medical attention. Do not take any severe symptoms lightly, as they may result in death or permanent damage if left untreated. If overdose is suspected, collect any possible suspect medications and present them to poison control. Do not attempt to alleviate the situation yourself.

If you miss a dose, take it as soon as you remember, or wait until your next dose. Do not double-dose, as it may cause side effects. Do not abruptly stop taking this medication unless you are told to do so, even if you feel better. Is is likely that the medication is the only thing making you feel better.

You are responsible for your own health in these situations. If taken properly, it is unlikely that Tolmetin will cause serious issues.

Interactions

Tolmetin may interact with other factors, including diet and additional medications. It is important to discuss any possible interactions with your doctor before beginning your prescription. Likewise, you should also let them know if you begin any new medications while on Tolmetin, herbal/OTC or otherwise.

Food interaction may occur if you take Tolmetin with a meal. It is recommended that you take Tolmetin with an empty stomach and a glass of water, as food may cause the drug to be absorbed less effectively. Milk also causes this effect, so avoid taking Tolmetin with anything but water. It is common for people to use milk as an antacid, so it may be wise to ask your doctor for a non-interactive form of heartburn treatment when you begin taking Tolmetin.

Taking Tolmetin with other blood thinners/NSAIDs may lead to more intense side effects and increased risk of heart problems, high blood pressure, liver/kidney damage, stomach ulcers, and stroke. Talk to your doctor before doubling up on any form of NSAID medication, and be cautious of what your OTC medications may contain. If you have any doubts or concerns, speak to your doctor before taking any drugs that may have interactions with Tolmetin. Common OTC NSAIDs include ibuprofen, naproxen, and aspirin.

As Tolmetin often causes high blood pressure, it can interact with blood pressure related medications such as diuretics. Angiotensin-converting enzyme (ACE) inhibitors may also be affected, and taking Tolmetin in tandem with these drugs may contradict their effects. If you already suffer from high blood pressure, you may need to keep a closer eye on the issue while taking Tolmetin.

If you suffer from bipolar disorder, Tolmetin may interact with your lithium prescription. This interaction may lead to an overabundance of lithium in your body, which can lead to lithium poisoning. Symptoms of lithium poisoning include tremors, confusion, diarrhea, nausea, and vomiting. Contact a poison control center immediately if you think you may be experiencing this interaction.

A prescription of Tolmetin may show up in drug screenings or tests, so be sure to keep a thorough record of all your prescriptions so that you do not encounter any misunderstandings.

Not all possible interactions are listed here, so be sure to speak to your doctor before beginning Tolmetin or any new medications. It is also important to remember that a doctor can only help you if you are honest, so do not keep details from them.

Warnings

Like many other prescription drugs, there is a reason that they are not available to anyone. Tolmetin has a variety of risks, all of which should be taken seriously and discussed with your doctor before beginning any prescription. If you have an existing condition that puts you at risk, discuss other avenues of treatment before settling on Tolmetin. If there is another medication that works for you, you should not needlessly put yourself at risk.

Tolmetin is an NSAID, so if you are allergic to any form of NSAIDs such as aspirin, ibuprofen, and naproxen, do not take Tolmetin. Likewise, if you have experienced an allergic reaction to any secondary or inactive ingredients in Tolmetin tablets/capsules, do not take the drug or look for an allergen-free alternative.

Symptoms of an allergic reaction include rash, swelling, stomach upset, hives, and shortness of breath. Stop taking Tolmetin and contact a doctor immediately if you experience these issues. If you have an allergy record on-hand, provide it to your doctor before making any prescription decisions.

Tolmetin may adversely affect a number of people, especially ones with existing conditions involving their heart. If you have experienced a heart attack, have a history of heart problems in the family, or have recently had heart bypass surgery, it is recommended that you do not take Tolmetin. If you are expecting to have heart bypass surgery, stop taking Tolmetin and discuss your options with a doctor a few weeks beforehand.

Tolmetin, like all NSAIDs, is a blood thinner. If you have a problem with stomach ulcers, high blood pressure, anemia, or other blood-related issues, discuss your options with your doctor. Do not double-up on NSAID medications unless it is explicitly necessary and advised by your doctor.

Liver and kidney issues may worsen while taking Tolmetin. If you have kidney disease or liver disease, talk to your doctor. Patients with kidney disease should monitor their urine and stay hydrated, as filtering out Tolmetin through weak kidneys may cause dehydration. Contact your doctor if you encounter serious changes in urine quality/quantity.

Women of childbearing age should speak to their doctor about their reproductive health/fertility before taking Tolmetin. This drug may cause problems for any woman attempting to get pregnant, or even cause health defects during pregnancy. Tolmetin is also passed through breastmilk, so make sure to mention if you are pregnant or breastfeeding when discussing a Tolmetin prescription.

Senior citizens may need to pay closer attention to their reaction and health while taking Tolmetin. Many issues caused by old age can be aggravated by Tolmetin, so make sure that you or your healthcare provider know the risks before beginning a prescription.

If you experience problems while taking this drug, contact your doctor to determine whether you should continue the prescription. Only use Tolmetrin as long as you have to, and long-term users should be aware of the added risk of heart problems or stroke when taking NSAIDs like Tolmetrin.

Storage

Tolmetin, in both its capsule and tablet forms, should be stored in a dry location. Heat and humidity may change the ingredients of the drug, and freezing may reduce its effectiveness. Avoid storing Tolmetin in a bathroom, as they often become hot and humid. Tolmetin should not be crushed or dissolved in water.

Keep this drug out of the reach of children and pets. Overdose can be fatal, so make sure that your prescription is kept sealed within a child-safe container. If your child is old enough to open preventive locks, store the medication somewhere out-of-sight and out-of-reach. It is recommended that you do not keep them in weekly medication containers, as those are easily opened by children.

If you suspect a child or pet has overdosed on Tolmetin, contact poison control immediately and bring the prescription bottle with you. Do not throw the bottle away, and do not attempt to make them vomit unless you are told to do so. Attempts to self-mediate the situation may result in further damage or death.

It is important that you keep track of your medication, so keep track of how much you take and when. This way, you can avoid overdose and determine if anyone else has been stealing medication.

Tolmetin should never be stored in a location where it may be stolen or used by other members of the household. If need be, keep it in a locked medicine cabinet or pill container if you suspect someone may be stealing doses of the drug. Likewise, if you find Tolmetin on the ground or in a random location, do not take it, even if you have identified the drug or have a prescription. There is no guarantee that you are taking Tolmetin.

Do not share your medication with anyone, and do not accept drugs from anyone but your doctor or pharmacist. Do not take outdated medication, especially if you do not know the expiration date.

If you need to dispose of your prescription drug, do so properly. Put unused or expired medication in a marked bag, or put it back into the prescription bottle. Throw them away normally, within an opaque trash bag. Do not leave loose pills where they can be eaten by animals. If you can, search for take-back programs within your community. Only give your unused medication to trustworthy programs.

If you have no use for the medication, throw it away or give it to a take-back program. Do not give it to friends, and do not keep it yourself. The medication may expire or become damaged. Do not take Tolmetin longer than you have to, and do not buy/take Tolmetin off-prescription.

Summary

Tolmetin is used to treat and alleviate pain in many patients suffering joint issues. It works to reduce swelling, dull pain, and allow a wider range of movement in those joints. This treatment can be invaluable for many people suffering from a number of issues, including forms of arthritis and various joint injuries. While it poses risks, it can be safely taken by many groups. If you are concerned about the safety of the medication in relativity to you, discuss your options with your doctor to determine a solution.

Like many NSAIDs, Tolmetin should be taken with caution to avoid overdose, severe side effects, and permanent damage. You are partly responsible for your own health, so monitor your reaction to this drug carefully and follow your doctor's instructions. If you experience severe issues, allergic reactions, or any drug interactions, do not take Tolmetin unless explicitly ordered to continue treatment.

Many of the serious issues caused by Tolmetin are rare. As long as you are taking it as prescribed with the approval of your doctor, it is unlikely that you will experience anything more than mild side effects. The benefits of Tolmetin are well-documented, so if it is recommended for you, it may be worth looking into. Discuss your options with your doctor, be aware of the risks, and take Tolmetin responsibly.

Resources
Last Reviewed:
December 22, 2017
Last Updated:
April 05, 2018