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MUSCULO-SKELETAL SYSTEM › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS › Fenamates
tolfenamic acid
M01AG02
Adult Dosing
- Acute migraine attack: 200 mg at the onset of symptoms; may be repeated after 1-2 hours if necessary
- Maximum daily dose: 400 mg
Pediatric Dosing
- Safety and efficacy in pediatric patients under 18 years have not been established
Indications
- Acute treatment of migraine attacks
Mechanism of Action
- Inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis, which decreases inflammation and pain transmission
Contraindications
- Hypersensitivity to tolfenamic acid or other NSAIDs
- Active peptic ulcer disease or gastrointestinal bleeding
- Severe heart failure
- Severe hepatic or renal impairment
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
Adverse Reactions
- Nausea
- Vomiting
- Dyspepsia
- Abdominal pain
- Diarrhea
- Headache
- Dizziness
- Rash
- Elevated liver enzymes
Drug Interactions
- Anticoagulants and antiplatelet agents (increased risk of bleeding)
- Other NSAIDs or corticosteroids (increased risk of gastrointestinal adverse effects)
- Lithium (decreased renal clearance, leading to toxicity)
- Methotrexate (increased hematotoxicity due to reduced clearance)
- Antihypertensives and diuretics (decreased antihypertensive efficacy and increased nephrotoxicity risk)
Curated Content: Needs Vetting Before Put to Clinical Use