Also known as Tolmetina, Tolmetino, Tolmetinum, Tolmétine
An arylalkanoic acid and non-steroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory and antipyretic activities. Although the exact mechanism through which tolmetin exerts its effects has yet to be fully elucidated, this agent appears to inhibit the enzyme prostaglandin synthase. This prevents the formation of prostaglandins from prostaglandin precursors, including the synthesis of the inflammatory prostaglandin E2 (PGE2) from the precursor prostaglandin H2 (PGH2). This prevents prostaglandin-mediated effects, including pain, inflammation and fever.
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Can I take Tolmetin while breastfeeding?
Because of the low levels of tolmetin in breastmilk and its short half-life, it is unlikely to adversely affect the breastfed infant. However, because there is no published experience with breastfeeding during tolmetin use, other agents may be preferred, especially while nursing a newborn or preterm infant.
Drug levels
Maternal Levels. Following a single 400 mg dose of tolmetin in a woman who was 2 months postpartum, peak milk levels occurred at 40 and 60 minutes after the dose in the right and left breasts, respectively, and averaged 160 mcg/L. The drug was undetectable (<30 mcg/L) in milk by 5 hours after the dose and its half-life in breastmilk was 1.54 hours.[1] Using the peak milk level data, the estimated maximum intake of an exclusively breastfed infant would be 0.4% of the maternal weight-adjusted dosage. Infant Levels. Relevant published information was not found as of the revision date.
Effects in breastfed infants
Maternal Levels. Following a single 400 mg dose of tolmetin in a woman who was 2 months postpartum, peak milk levels occurred at 40 and 60 minutes after the dose in the right and left breasts, respectively, and averaged 160 mcg/L. The drug was undetectable (<30 mcg/L) in milk by 5 hours after the dose and its half-life in breastmilk was 1.54 hours.[1] Using the peak milk level data, the estimated maximum intake of an exclusively breastfed infant would be 0.4% of the maternal weight-adjusted dosage. Infant Levels. Relevant published information was not found as of the revision date.
Possible effects on lactation
Relevant published information was not found as of the revision date.
Alternate drugs to consider
Acetaminophen, Flurbiprofen, Ibuprofen, Indomethacin, Naproxen, Piroxicam
References
1. Sagraves R, Waller ES, Goehrs HR. Tolmetin in breast milk. Drug Intell Clin Pharm. 1985;19:55-6. Letter. PMID: 3967576
Last Revision Date
20150310
Disclaimer:Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
Source: LactMed – National Library of Medicine (NLM)