Classes
DEA Class; Rx
Common Brand Names; Tolectin
NSAIDs
Description
Nonsteroidal anti-inflammatory drug (NSAID) of the heterocyclic acetic acid chemical class
Used for osteoarthritis and rheumatoid arthritis in adults; also used in pediatric patients as young as 2 years for juvenille idiopathic arthritis (JIA)
All NSAIDs may cause an increased risk of serious gastrointestinal or cardiovascular events; use lowest effective dose for the shortest possible duration
Indications
For the treatment of acute flares or for the chronic management of rheumatoid arthritis or osteoarthritis.
Contraindications
Absolute: ASA allergy, hepatic disease (severe chronic), hepatitis, jaundice, nursing mother
Relative: Bleeding disorder, duodenal/gastric/peptic ulcer, stomatitis, SLE, ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of ductus arteriosus)
Adverse Effects
>10%
Increased liver function test (up to 15%)
1-10%
Nausea (10%)
Hypertension (3-9%)
Myocardial infarction (<2%)
Edema
Weight gain, Weight loss
Abdominal pain
Diarrhea
Flatulence
Indigestion
Nausea, Vomiting
Asthenia
Dizziness
Headache
Warnings
Use caution in asthma (bronchial), cardiac disease, CHF, hepatic impairment, HTN, renal impairment
Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs
Strong cross-sensitivity may exist for ASA allergic patients
Food reduces bioavailability
Heart Failure(HF) risk
Pregnancy and Lactation
Pregnancy Category: C; avoid in late pregnancy, may cause premature closure of ductus arteriosus
Lactation: excreted in breast milk; safety in nursing infants not known
Maximum Dosage
1,800 mg/day PO.
1,800 mg/day PO.
30 mg/kg/day PO or 1,800 mg/day PO, whichever is less.
2 to 12 years: 30 mg/kg/day PO or 1,800 mg/day PO, whichever is less.
Less than 2 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
tablet
- 200mg
- 600mg
capsule
- 400mg
