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Tolmetin, a nonsteroidal anti-inflammatory drug (NSAID), carries certain risks and requires careful consideration before use. Below are important safety and warning details for users and healthcare providers:

• Heart Risks: Use of tolmetin may occasionally elevate the risk of heart attack or stroke. This can occur at any stage during treatment but is more probable with prolonged use. The risk is heightened in older adults and individuals with heart disease or increased risk factors such as smoking, family history of heart disease, high blood pressure, or diabetes. It is crucial not to use this medication immediately before or after heart bypass surgery (CABG).

• Gastrointestinal Concerns: There is a rare potential for serious, sometimes fatal, bleeding in the stomach or intestines. This can arise without any forewarning signs at any time while on this medication. Older adults are particularly susceptible to this effect.

• Emergency Situations: Discontinue use and seek immediate medical attention if you experience any of the following severe side effects: persistent stomach or abdominal pain, black or tarry stools, vomit resembling coffee grounds, pain in the chest, jaw, or left arm, shortness of breath, unusual sweating, confusion, unilateral weakness, difficulty speaking, or sudden changes in vision.

Patients are advised to discuss the advantages and potential hazards of tolmetin with their healthcare provider to make informed decisions about its use.

Common side effects:

• Nausea
• Vomiting
• Heartburn
• Dizziness
• Drowsiness
• Diarrhea
• Headaches

Less common but important to monitor:

• Elevated blood pressure

Serious side effects:

• Fainting
• Rapid or pounding heartbeat
• Changes in hearing like ringing in the ears
• Mood alterations
• Difficulty or pain when swallowing
• Easy bruising or bleeding
• Changes in urination
• Vision problems
• Symptoms of heart failure such as swelling in the ankles or feet
• Unusual fatigue
• Sudden weight gain
• Significant liver damage, indicated by persistent nausea or vomiting, stomach pain, loss of appetite, dark urine, or yellowing of the skin or eyes
• Severe allergic reaction, indicated by fever, swollen lymph nodes, rash, itching or swelling of the face, tongue, or throat, severe dizziness, or difficulty breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Ketorolac

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Abciximab
• Aspirin
• Clopidogrel
• Dabigatran
• Enoxaparin
• Warfarin
• ACE inhibitors (such as captopril, lisinopril)
• Angiotensin II receptor blockers (such as losartan, valsartan)
• Corticosteroids (such as prednisone)
• Diuretics (such as furosemide)