{"id":4422,"date":"2025-03-31T18:12:07","date_gmt":"2025-03-31T18:12:07","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/tolfenamic-acid-txt\/"},"modified":"2025-03-31T18:12:07","modified_gmt":"2025-03-31T18:12:07","slug":"tolfenamic-acid-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/tolfenamic-acid-txt\/","title":{"rendered":"Tolfenamic acid.txt"},"content":{"rendered":"

CLINICAL USE <\/H3> NSAID: Treatment of migraine

DOSE IN NORMAL RENAL FUNCTION <\/H3> 200 mg when first symptoms appear; repeat once after 1\u20132 hours if satisfactory response is not obtained

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 261.7 <\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : >99 <\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 8 (90% as metabolites) <\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp : 0.16 <\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp : 2.5

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Use with cution and monitor renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Avoid

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Removal unlikely. Use with caution <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Not dialysed. Use with caution
  • HDF\/high flux &nbsp : Unknown dialysability. Use with caution
  • CAV\/VVHD &nbsp &nbsp &nbsp: Unlikely to be dialysed. Use with caution

    IMPORTANT DRUG INTERACTIONS <\/H3> Potentially hazardous interactions with other drugs ACE inhibitors and angiotensin-II antagonists: antagonism of hypotensive effect; increased risk of nephrotoxicity and hyperkalaemia\n
  • Analgesics: avoid concomitant use of 2 or more NSAIDs, including aspirin (increased side effects); avoid with ketorolac (increased risk of side effects and haemorrhage)\n
  • Antibacterials: possibly increased risk of convulsions with quinolones\n
  • Anticoagulants: effects of coumarins enhanced; possibly increased risk of bleeding with heparins and coumarins\n
  • Antidepressants: increased risk of bleeding with SSRIs and venlafaxine Antidiabetic agents: effects of sulphonylureas enhanced\n
  • Anti-epileptics: possibly increased phenytoin concentration\n
  • Antivirals: increased risk of haematological toxicity with zidovudine; concentration possibly increased by ritonavir\n
  • Ciclosporin: may potentiate nephrotoxicity Cytotoxic agents: reduced excretion of methotrexate; increased risk of bleeding with erlotinib\n
  • Diuretics: increased risk of nephrotoxicity; antagonism of diuretic effect; hyperkalaemia with potassium-sparing diuretics\n
  • Lithium: excretion decreased Pentoxifylline: increased risk of bleeding\n
  • Tacrolimus: increased risk of nephrotoxicity

    ADMINISTRATION <\/H3>

    Reconstition<\/H4> \u2013

    Route <\/H4> Oral

    Rate of Administration <\/H4> \u2013

    Comments<\/H4> \u2013

    OTHER INFORMATION <\/H4>\n
  • Contraindicated in significantly impaired kidney or liver function The urine may become a little more lemon-coloured due to coloured metabolites Use only with extreme caution (or not at all) in haemodialysis patients with some degree of urine output, especially if other risk factors are present, e.g. nephrotic syndrome or diabetes mellitus or treatment with loop diuretics Use normal doses in patients with CKD 5 on dialysis as long as they no longer pass any urine Inhibition of renal prostaglandin synthesis by NSAIDs may interfere with renal function, especially in the presence of existing renal disease \u2013 avoid NSAIDs if . ToLFEnAMiC ACid 737 possible; if not, check serum creatinine 48\u201372 hours after starting NSAID \u2013 if increased, discontinue therapy Use with caution in renal transplant recipients as can reduce intrarenal autocoid synthesis .
    \n","protected":false},"excerpt":{"rendered":"

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