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Overview: Tolmetin is a non-steroidal anti-inflammatory drug (NSAID), which is a medicine that is used to treat osteoarthritis, rheumatoid arthritis, and juvenile arthritis. Tolmetin works to block specific substances in the body that cause pain, inflammation, and fever. Common side effects include nausea, vomiting, upset stomach, and stomach pain. Before taking tolmetin, make sure to tell your healthcare provider about any health conditions or medications you are taking.

Uses

What is tolmetin used for?

Tolmetin is commonly used for the following conditions.

Tolmetin may also be used for other conditions as determined by your healthcare provider.

How does tolmetin work (mechanism of action)?

Tometin works by blocking certain substances in the body that cause pain, inflammation, and fever.

How is tolmetin supplied (dosage forms)?

Brands and other names

  • Tolectin
  • Tolectin DS

Dosage forms and strengths

  • 400 mg oral capsules
  • 600 mg oral tablets

How should I store tolmetin?

Tolmetin should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place, away from light.

Side Effects

What are the most common side effects of tolmetin?

The most common side effects of tolmetin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Nausea and vomiting
  • Upset stomach and stomach pain
  • Diarrhea
  • Gas 
  • Headache
  • Feeling unusually weak or tired
  • High blood pressure
  • Fluid retention
  • Dizziness
  • Changes in weight

There may be other side effects of tolmetin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of tolmetin?

While less common, the most serious side effects of tolmetin are described below, along with what to do if they happen.

Severe Allergic Reactions. Tolmetin can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Heart Attack and Stroke. Tolmetin can increase your risk of a heart attack or stroke that can lead to death. This risk is increased in people with existing heart disease and with longer use of tolmetin and higher doses. Do not take tolmetin if you have had a recent heart attack without talking to your healthcare provider. This could increase your risk of having another heart attack. Get emergency help if you have any of the following symptoms of a heart attack or stroke.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Increased Blood Pressure (Hypertension). Tolmetin may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your healthcare provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Fluid Retention (Edema) and Heart Failure. Tolmetin can cause fluid retention, also called edema which can lead to heart failure. Fluid retention can also cause serious issues in people with heart failure. Call your healthcare provider right away if you have any of the following symptoms. 

  • Chest pain
  • Irregular heartbeat
  • Shortness of breath
  • Stretched or shiny skin
  • Swollen body parts, such as the belly or ankles
  • Unusually fast weight gain
  • Unusual tiredness

Stomach Bleeding. Tolmetin can increase your risk of bleeding, ulcers, and tears (perforation) in your gut. The risk is higher if you have a history of stomach ulcers, bleeding problems, take higher doses of tolmetin or take it for longer than directed, have poor health, are of older age, have liver disease, smoke, drink alcohol, or take certain other medicines. Stop taking tolmetin and get emergency help if you have any of the following symptoms.

  • Vomit blood
  • Black or tarry poop
  • Stomach pain that does not go away
  • Upset stomach
  • Feel faint

Kidney Damage. Kidney damage can happen when taking tolmetin. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Severe Skin Reactions. Tolmetin can cause severe skin reactions, called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop tolmetin and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Eye Problems. Tolmetin may cause eye problems. Call your healthcare provider if you have any changes in your vision.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking tolmetin. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Anemia. Tolmetin may cause anemia, which is when you have low levels of red blood cells. Tell your healthcare provider if you have any of the following symptoms of anemia.

  • Unusual weakness or tiredness
  • Cold hands and feet
  • Fast or abnormal heartbeat
  • Pale or yellowish skin 
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Shortness of breath

Warnings & Precautions

Who should not use tolmetin?

Allergies to Ingredients. People who are allergic to any of the following should not take tolmetin.

  • Tolmetin
  • Tolectin
  • Aspirin or any other medicine known as a non-steroidal anti-inflammatory (NSAID)
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific tolmetin products they stock.

Heart Surgery. Do not take tolmetin right before or after a heart surgery called coronary artery bypass graft (CABG). Taking tolmetin during this time can increase your risk of heart attack or stroke.

What should I know about tolmetin before using it?

People who are 65 and older can be at greater risk for some side effects from tolmetin. Talk to your healthcare provider about your risks if you are in this age group.

Do not take tolmetin unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share tolmetin with other people, even if they have the same condition as you. It may harm them.

Keep tolmetin out of the reach of children.

What should I tell my healthcare provider before using tolmetin?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if tolmetin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Liver or kidney problems
  • High blood pressure
  • Asthma
  • Heart conditions including heart failure or a recent heart attack
  • Anemia

Pregnancy. Do not take tolmetin 20 weeks or later in pregnancy without talking to your healthcare provider. Taking tolmetin during this time may cause harm to an unborn baby and complications during delivery. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take tolmetin while you are pregnant or trying to get pregnant.

Breastfeeding. Tolmetin passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop tolmetin.

Interactions

Does tolmetin interact with foods or drinks?

Eating a meal or drinking milk at the same time or right after taking tolmetin can lower the amount of medicine that gets into your body. 

It is unknown if drinking alcohol will affect tolmetin, but both tolmetin and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.

Does tolmetin interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking tolmetin

  • An angiotensin-converting enzyme (ACE) inhibitor, such as enalapril or lisinopril, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), such as losartan or valsartan, which is a medicine for high blood pressure, heart failure, and other heart conditions
  • Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
  • A diuretic, also called a water pill, such as furosemide or thiazides, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Lithium, which is a medicine for certain mental health conditions
  • Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancer
  • Warfarin, which is a blood thinner.

This may not be a complete list of medicines that can interact with tolmetin. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much tolmetin?

If you or someone else has used too much tolmetin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of tolmetin?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.