Tolmetin

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Dosage 4 Pharmacokinetics 5 Adverse-effects 6 Drug-interactions 7 Laboratory 8 Mechanism-of-action 9 More General Terms 10 Internet Database 11 References

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 adverse effects of NSAIDs

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:

• methotrexate
• Li+
• digoxin
  

• drug interaction(s) of lithium carbonate with NSAIDs
• drug interaction(s) of NSAIDs with SSRIs
• drug interaction(s) of aspirin with NSAIDs
• drug interaction(s) of NSAIDs with beta blockers
• drug interaction(s) of NSAIDs with ARBs
• drug interaction(s) of NSAIDs with ACE inhibitors
• drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
• drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
• drug interaction(s) of NSAIDs & loop diuretics
• drug interaction(s) of NSAIDs & aspirin

Laboratory

• specimen: serum, plasma, urine
• methods:

• serum/ plasma: HPLC, GC
• urine: TLC

Mechanism-of-action

• acetic acid class NSAID
• analgesic, antipyretic, anti-inflammatory
• non-selective cyclooxygenase inhibitor

More General Terms

• non-steroidal anti-inflammatory agent (NSAID)

Internet Database

PubChem: 5509
PubChem: 47400
PubChem: 5508
PubChem: 656499

References

1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 792
3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
4. Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995

tolmetin (Tolectin)