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What should I discuss with my healthcare provider before taking tolmetin (Tolectin)?

Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal. These gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Do not use this medication if you have ever had an allergic reaction to tolmetin, aspirin, or other NSAIDs.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take tolmetin:

• a history of heart attack, stroke, or blood clot;
• heart disease, congestive heart failure, high blood pressure;
• a history of stomach ulcers or bleeding;
• liver or kidney disease;
• asthma;
• polyps in your nose;
• a bleeding or blood clotting disorder; or
• if you smoke.

FDA pregnancy category C. It is not known whether tolmetin is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking tolmetin during the last 3 months of pregnancy may result in birth defects. Do not take tolmetin during pregnancy unless your doctor has told you to.

Tolmetin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 2 years old without the advice of a doctor.

How should I take tolmetin (Tolectin)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

It is best to take tolmetin on an empty stomach. However, if tolmetin upsets your stomach you may take it with food, milk, or an antacid (but not sodium bicarbonate or baking soda).

If you take tolmetin for a long period of time, your doctor may want to check you on a regular basis to make sure this medication is not causing harmful effects. Do not miss any scheduled visits to your doctor.

You may need to take tolmetin for several days before you notice improvement in your symptoms.

Store tolmetin at room temperature away from moisture, heat, and light.

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