Indications And Dose
Treatment of acute migraine ▶BY MOUTH ▶Adult: 200 mg, dose to be taken at onset, then 200 mg after 1–2 hours if required
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Drug reference
Treatment of acute migraine ▶BY MOUTH ▶Adult: 200 mg, dose to be taken at onset, then 200 mg after 1–2 hours if required
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Active gastro-intestinal bleeding. active gastro-intestinal ulceration. history of gastro- intestinal bleeding related to previous NSAID therapy. history of gastro-intestinal haemorrhage (two or more distinct episodes). history of gastro-intestinal perforation related to previous NSAID therapy. history of recurrent gastro-intestinal ulceration (two or more distinct episodes). severe heart failure
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Allergic disorders. cardiac impairment (NSAIDs may impair renal function). cerebrovascular disease. coagulation defects. connective-tissue disorders. dehydration (risk of renal impairment). elderly (risk of serious side-effects and fatalities). heart failure. history of gastro-intestinal disorders (e.g. ulcerative colitis, Crohn’s disease). ischaemic heart disease. peripheral arterial disease. risk factors for cardiovascular events. uncontrolled hypertension
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Contra-indicated in patients with a history of hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other NSAID.
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→Appendix 1: NSAIDs
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Agranulocytosis. angioedema. aplastic anaemia. asthma. confusion. constipation. Crohn’s disease aggravated. depression. diarrhoea. dizziness. drowsiness. dyspnoea. dysuria (most common in men). euphoric mood. fatigue. fertility decreased female. gastrointestinal discomfort. gastrointestinal disorders. haemolytic anaemia. haemorrhage. hallucination. headache. heart failure. hepatic disorders. hypersensitivity. hypertension. increased risk of arterial thromboembolism. malaise. meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible). nausea. nephritis tubulointerstitial. nephropathy. neutropenia. oedema. optic neuritis. oral ulceration. pancreatitis. paraesthesia. photosensitivity reaction. renal failure (more common in patients with pre-existing renal impairment). respiratory disorders. severe cutaneous adverse reactions (SCARs). skin reactions. thrombocytopenia. tinnitus. tremor. vertigo. visual impairment. vomiting SIDE-EFFECTS, FURTHER INFORMATION For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non- steroidal anti-inflammatory drugs. p. 1193
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Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment.
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Avoid unless the potential benefit outweighs the risk. Avoid during the third trimester (risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn); onset of labour Nervous system may be delayed and duration may be increased.
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Amount too small to be harmful. Use with caution during breast-feeding.
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Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
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Avoid if possible or use with caution. Dose adjustments The lowest effective dose should be used for the shortest possible duration. Monitoring In renal impairment monitor renal function; sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Tolfenamic acid (Non-proprietary) Tolfenamic acid 200 mg Tolfenamic acid 200mg tablets | 10 tablet P £24.63 DT = £24.63 ▶Clotam Rapid (Galen Ltd) Tolfenamic acid 200 mg Clotam Rapid 200mg tablets | 10 tablet P £12.75 DT = £24.63 ANTIHISTAMINES › SEDATING ANTIHISTAMINES
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200 mg, dose to be taken at onset, then 200 mg
First-line fragment. Read the complete Indications and Dose section above.
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