- NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction (MI) and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk (see WARNINGS).
- Tolmetin sodium is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery (see CONTRAINDICATIONS and WARNINGS).
- NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events (see WARNINGS).
Tolmetin sodium is a nonselective non-steroidal anti-inflammatory agent.
Carefully consider the potential benefits and risks of tolmetin sodium capsules and other treatment options before deciding to use tolmetin sodium capsules. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals (see WARNINGS).
Carefully consider the potential benefits and risks of tolmetin sodium tablets and other treatment options before deciding to use tolmetin sodium tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals (see WARNINGS).
Tolmetin sodium tablets are indicated for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis. Tolmetin is indicated in the treatment of acute flares and the long-term management of the chronic disease.
Tolmetin is also indicated for treatment of juvenile rheumatoid arthritis. The safety and effectiveness of tolmetin have not been established in pediatric patients under 2 years of age (see PRECAUTIONS: Pediatric Use and DOSAGE AND ADMINISTRATION).
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Published Studies Related to Tolmetin
Morphological features of rat gastric mucosa after acute and chronic treatment with amtolmetin guacyl: comparison with non-selective and COX-2-selective NSAIDs. 
BACKGROUND/AIMS: The compound amtolmetin guacyl (AMG) has been characterized in both animal and human studies as a novel non-selective non-steroidal anti-inflammatory drug (NSAID) endowed with lower ulcerogenicity in comparison with traditional NSAIDs due to a unique mechanism of action, namely the increase in endogenous production of gastric nitric oxide... CONCLUSION: Endothelial cell damage in the gastric microvasculature is an early event following both non-selective and COX-2-selective inhibitors. The low gastric mucosal toxicity of AMG is confirmed after acute and chronic treatment. Copyright 2003 S. Karger AG, Basel
[An evaluation of the therapeutic activity and tolerance of ST-679 in patients with osteoarthritis at different sites. A controlled double-blind study vs tolmetin] [1993.01]
A multicentered study was carried out, under double-blind conditions, on 160 elderly patients afflicted with differently localized symptomatic osteoarthritis, for the purpose of evaluating the therapeutical efficacy and tolerability of ST-679 (per-os at a dose of 1200 mg pro die in 80 patients) and to compare them with those of tolmetin (per os at a dose of 1200 mg pro die in 80 patients).
Double-blind, placebo-controlled endoscopic comparison of the mucosal protective effects of misoprostol versus cimetidine on tolmetin-induced mucosal injury to the stomach and duodenum. [1988.08]
Ninety normal volunteers were entered into a double-blind, placebo-controlled study to compare the efficacy of misoprostol (200 micrograms q.i.d.) vs... It is concluded that misoprostol is highly effective and significantly better than cimetidine in protecting the gastric mucosa from tolmetin-induced injury; however, both agents were highly protective in the duodenum.
A crossover study of naproxen, diclofenac and tolmetin in seronegative juvenile chronic arthritis. [1988.04]
Nonsteroidal anti-inflammatory drugs (NSAID) are useful in the management of juvenile chronic arthritis (JCA) and efficacy has usually been compared with aspirin... America, therefore naproxen or diclofenac are recommended as the first line of treatment in children with chronic arthritis over the age of 5.