Tolmetin
Mechanism :
Reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors; has antipyretic, analgesic, and anti-inflammatory properties.
Indication :
- Juvenile rheumatoid arthritis
- Off-Label: Analgesia (children and adolescents).
Contraindications :
Hypersensitivity to tolmetin or any component of the formulation; patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.
Dosing :
Oral:
Initial: 20 mg/kg/day in 3 to 4 divided doses; Maintenance: 15 to 30 mg/kg/day in 3 to 4 divided doses.
Maximum: 30 mg/kg/day.
Adverse Effect :
Increased liver function test, nausea, hypertension, myocardial infarction, edema, abdominal pain.
Interaction :
Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid.
Ketorolac (Systemic): May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Nonsteroidal Anti-Inflammatory Agents (COX-2 Selective): Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents (COX-2 Selective).
Hepatic Dose :
Use cautiously. Dose reduction may be needed. Monitor carefully any patient with abnormal liver function tests.