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Nonsteroidal anti-inflammatory drugs, like tolmetin, carry certain risks that users should be aware of. Below are important safety considerations and warnings to keep in mind:

• Heart Risk: Using tolmetin may infrequently increase the likelihood of a heart attack or stroke. This risk can arise at any point during treatment but is more prevalent with prolonged use. Older adults and individuals with existing heart conditions or risk factors such as smoking, a family history of heart disease, high blood pressure, or diabetes are at heightened risk. Avoid using this medication immediately before or after coronary artery bypass graft (CABG) surgery.

• Gastrointestinal Bleeding: Tolmetin may infrequently lead to severe, potentially fatal bleeding in the stomach or intestines. This can occur unexpectedly and at any time during the course of treatment. The risk is greater for older adults.

• Emergency Symptoms: Cease taking the medication and seek immediate medical attention if you experience any of the following rare but serious side effects: persistent stomach or abdominal pain, black or tarry stools, vomit resembling coffee grounds, chest, jaw, or left arm pain, shortness of breath, unusual sweating, confusion, weakness on one side of the body, difficulty speaking, or sudden changes in vision.

Discuss with your healthcare provider or pharmacist the potential benefits and risks of using tolmetin to ensure it's a suitable option for you.

When taking this medication, you may experience some mild side effects such as nausea, vomiting, heartburn, dizziness, drowsiness, diarrhea, and headache. These are generally well-tolerated by most people and often do not require medical attention unless they persist or worsen. Monitoring your blood pressure is important, as this medication can cause it to rise. If you notice a significant increase, it's advisable to consult a healthcare provider.

There are certain serious side effects that require immediate attention. These include fainting, a rapid or pounding heartbeat, changes in hearing like ringing in the ears, mood changes, difficulty swallowing, unusual bruising or bleeding, signs of kidney issues such as changes in urination, vision changes, and symptoms of heart failure like swollen ankles, unusual tiredness, or sudden weight gain. Additionally, though rare, this medication may lead to serious liver disease. Symptoms of liver damage include persistent nausea or vomiting, stomach pain, loss of appetite, dark urine, and yellowing of the skin or eyes.

Furthermore, while uncommon, a severe allergic reaction could occur. Signs to watch for include fever, swollen lymph nodes, rash, itching or swelling of the face, tongue, or throat, severe dizziness, and difficulty breathing. Should any of these symptoms appear, seek medical help immediately. Always keep an open line of communication with your healthcare provider regarding any side effects you experience.

Tolmetin can interact with various medications, so it's important to inform your doctor and pharmacist about all the drugs and supplements you are currently taking, including prescriptions, over-the-counter medications, vitamins, and herbal products. Below is a summary of potential interactions:

1. Strongly Not Recommended Combinations: It's generally advised to avoid taking Tolmetin with ketorolac due to the potential for adverse effects.

2. Cautionary Combinations: Some medications may require careful consideration and possible dose adjustments if used with Tolmetin. These include blood thinners like warfarin, dabigatran, and enoxaparin; anti-platelet drugs such as clopidogrel; and other NSAIDs like ibuprofen and celecoxib. Taking these together can increase the risk of bleeding and other side effects.

3. Potential for Increased Side Effects: Using Tolmetin with drugs such as ACE inhibitors (e.g., lisinopril, captopril), angiotensin II receptor blockers (e.g., losartan, valsartan), diuretics like furosemide, and corticosteroids (e.g., prednisone) might heighten certain side effects. Your doctor might need to adjust your medication regimen to mitigate these risks.

Additionally, Tolmetin can interfere with specific laboratory tests, potentially leading to inaccurate results. Ensure all healthcare providers and lab personnel are aware that you are taking this medication.

If you have been prescribed low-dose aspirin for heart health, continue taking it unless instructed otherwise by your healthcare provider. Always read medication labels carefully to avoid unintentional duplication of similar drugs. For more detailed guidance tailored to your situation, consult with your doctor or pharmacist.