Tolmetin

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Tolmetin
Skeletal formula
Space-filling model
Clinical data
Trade namesTolectin
AHFS/Drugs.comMonograph
MedlinePlusa681033
Routes of
administration		By mouth
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
Pharmacokinetic data
Elimination half-life1-2 hours, next phase up to 5 hours
Identifiers
  • [1-methyl-5-(4-methylbenzoyl)-1H-pyrrol-2-yl]acetic acid
JSmol)
  • O=C(c1ccc(n1C)CC(=O)O)c2ccc(cc2)C
  • InChI=1S/C15H15NO3/c1-10-3-5-11(6-4-10)15(19)13-8-7-12(16(13)2)9-14(17)18/h3-8H,9H2,1-2H3,(H,17,18) checkY
  • Key:UPSPUYADGBWSHF-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Tolmetin (/ˈtɒlmətɪn/) is a nonsteroidal anti-inflammatory drug (NSAID) of the heterocyclic acetic acid derivative class.

Tolmetin was originally approved by the US FDA in 1976. It is available internationally.[1]

It is used primarily to reduce hormones that cause pain, swelling, tenderness, and stiffness in conditions such as osteoarthritis and rheumatoid arthritis, including juvenile rheumatoid arthritis. In the United States it was marketed as Tolectin and comes as a tablet or capsule.

Clinical usage

Tolmetin is applicable in the treatment of

osteoarthrosis,[4][5] pain,[6] and ankylosing spondylitis.[7]

Mechanism of action

Although the

prostaglandin synthetase in vitro and reduces plasma levels of prostaglandin E
, possibly causing the anti-inflammatory response.

When tested in rats, tolmetin prevented experimentally stimulated polyarthritis and reduced inflammation. In patients with rheumatoid arthritis or osteoarthritis tolmetin was as effective as aspirin and indometacin, although the occurrence of mild gastrointestinal adverse effects and tinnitus was lower in patients treated with tolmetin than it was with aspirin-treated patients and the occurrence of adverse effects of the central nervous system was lower with tolmetin than it was with indomethacin.[8]

Side effects

Tolmetin can increase the risk of heart or circulatory conditions such as

heart attacks and strokes. It should not be taken shortly before or after coronary artery bypass surgery.[9] Tolmetin can also increase the risk of gastrointestinal conditions such as perforation or bleeding, which can be fatal. Antacids can be taken with tolmetin to relieve stomachaches that often occur.[9] Overdose can result in drowsiness, nausea
, epigastric pain, and vomiting.

In October 2020, the U.S.

anti-inflammatory medications to describe the risk of kidney problems in unborn babies that result from low amniotic fluid.[10][11] They recommend avoiding NSAIDs in pregnant women at 20 weeks or later in pregnancy.[10][11]

References

  1. ^ "Tolmetin: MedlinePlus Drug Information". medlineplus.gov. Retrieved 2023-10-27.
  2. S2CID 26040280
    .
  3. PMID 800970
    .
  4. PMID 343992
    .
  5. PMID 7002480
    .
  6. PMID 381221
    .
  7. S2CID 33879936
    .
  8. ^ "Tolmetin". DrugBank. Retrieved 2007-07-02.
  9. ^ a b "Tolmetin". MedlinePlus. Archived from the original on 2007-06-10. Retrieved 2007-07-02.
  10. ^ a b "FDA Warns that Using a Type of Pain and Fever Medication in Second Half of Pregnancy Could Lead to Complications". U.S. Food and Drug Administration (FDA) (Press release). 15 October 2020. Retrieved 15 October 2020. Public Domain This article incorporates text from this source, which is in the public domain.
  11. ^ a b "NSAIDs may cause rare kidney problems in unborn babies". U.S. Food and Drug Administration. 21 July 2017. Retrieved 15 October 2020. Public Domain This article incorporates text from this source, which is in the public domain.
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