What is Tonopan 12.5mg?
Tonopan 12.5mg is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and other symptoms of arthritis of the joints (eg, osteoarthritis), such as inflammation, swelling, stiffness, and joint pain. However, Tonopan 12.5mg does not cure osteoarthritis and will help you only as long as you continue to use it.
Tonopan 12.5mg topical 3% gel is also used to treat actinic keratosis, a skin problem that may become cancerous if not treated. The exact way that topical Tonopan 12.5mg helps this condition is unknown.
Tonopan 12.5mg topical solution is used to treat pain and swelling caused by osteoarthritis of the knees.
Tonopan 12.5mg topical patch is used to treat acute pain caused by minor strains, sprains, and contusions (bruises).
Tonopan 12.5mg is available only with your doctor's prescription.
Tonopan 12.5mg indications
Intramuscular
Renal colic
Adult: As Tonopan 12.5mg Na: 75 mg, may repeat once after 30 min if needed. Max: 150 mg/day. Max period: 2 days.
Intramuscular
Bursitis, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis, Acute gout, Dysmenorrhoea
Adult: As Tonopan 12.5mg Na: 75 mg once daily, injected into the gluteal muscle, may increase to 75 mg bid in severe conditions. Max period: 2 days.
Intravenous
Postoperative pain
Adult: As Tonopan 12.5mg Na: 75 mg infusion in glucose 5% or NaCl 0.9% (previously buffered w/ Na bicarbonate) given over 30-120 min or as bolus inj, may repeat after 4-6 hr if necessary. Max period: 2 days.
Intravenous
Prophylaxis of postoperative pain
Adult: As Tonopan 12.5mg Na: Initially, 25-50 mg infusion given after surgery over 15-60 min followed by 5 mg/hr. Alternatively, initial dose may be given as bolus inj over 5-60 sec followed by additional inj, may repeat after 4-6 hr if necessary. Max: 150 mg/day. Max period: 2 days.
Ophthalmic
Postoperative ocular inflammation
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill into the appropriate eye 4 times daily starting 24 hr after surgery for up to 28 days.
Ophthalmic
Inflammation and discomfort after strabismus surgery
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill 1 drop 4 times daily for the 1st wk; then tid in the 2nd wk, bid in the 3rd wk, and as required for the 4th wk.
Ophthalmic
Pain and discomfort after radial keratotomy
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.
Ophthalmic
Pain after accidental trauma
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill 1 drop 4 times daily for up to 2 days.
Ophthalmic
Control of inflammation after argon laser trabeculoplasty
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill 1 drop 4 times during the 2 hr before procedure followed by 1 drop 4 times daily, up to 7 days after procedure.
Ophthalmic
Prophylaxis of intra-operative miosis
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill into appropriate eye 4 times w/in 2 hr before surgery.
Ophthalmic
Post-photorefractive keratectomy pain
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill into the affected eye twice, an hr before surgery, then 1 drop twice at 5-min intervals immediately after surgery, then every 2-5 hr while awake for up to 24 hr.
Ophthalmic
Seasonal allergic conjunctivitis
Adult: As Tonopan 12.5mg Na (0.1% soln): Instill 1 drop before surgery followed by 1 drop immediately after surgery, and then 1 drop 4 times daily for up to 2 days.
Oral
Bursitis, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis, Acute gout, Dysmenorrhoea
Adult: As Tonopan 12.5mg Na: 75-150 mg/day in divided doses. Max: 150 mg/day.
Oral
Migraine
Adult: As Tonopan 12.5mg K: Initially, 50 mg taken at the 1st sign of an attack, an additional dose of 50 mg may be taken after 2 hr if symptoms persist. If needed, further doses of 50 mg may be taken 4-6 hrly. Max: 200 mg/day.
Rectal
Acute gout, Bursitis, Dysmenorrhoea, Pain and inflammation associated with musculoskeletal and joint disorders, Rheumatoid arthritis, Sprains, Strains, Tendinitis
Adult: As Tonopan 12.5mg Na: 100 mg once daily.
Topical/Cutaneous
Actinic keratoses
Adult: As Tonopan 12.5mg Na (3% gel): Apply bid for 60-90 days.
Topical/Cutaneous
Osteoarthritis
Adult: As Tonopan 12.5mg Na (1.6% soln): Apply in small amounts (20 or 40 drops) onto affected area 4 times daily. As Na: (1% gel): Apply to the affected area 4 times daily. Max: 32 g/day over the affected area.
Topical/Cutaneous
Local symptomatic relief of pain and inflammation
Adult: As Tonopan 12.5mg Na (1% gel): Apply onto affected area 3 or 4 times daily.
Transdermal
Acute pain
Adult: Sprains, strains, contusions: 1 patch bid.
How should I use Tonopan 12.5mg?
Use Tonopan 12.5mg solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Tonopan 12.5mg solution comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Tonopan 12.5mg solution refilled.
- Do not apply Tonopan 12.5mg solution to infected skin; open wounds; or red, swollen, or peeling skin.
- Wash your hands immediately before and after using Tonopan 12.5mg solution.
- Wash the affected area and dry completely before using Tonopan 12.5mg solution.
- To apply Tonopan 12.5mg solution, dispense 10 drops at a time onto the knee or into your hand. Spread Tonopan 12.5mg solution evenly around the front, back, and sides of the knee. Repeat until you have used the whole dose.
- Be sure that you cover your entire knee with your dose of Tonopan 12.5mg solution. Do not use more than the recommended amount.
- Do not apply sunscreens, cosmetics, insect repellants, other topical medicines, or any other substance to the treated area until it is completely dry.
- Do not put on clothes over the treated area until it is completely dry.
- Do not wrap, bandage, or apply heat to the treated area.
- Let the treated skin dry before touching it or letting it touch anyone else's skin.
- Do not shower, bathe, or wash the treated area for at least 30 minutes after you use Tonopan 12.5mg solution.
- If you miss a dose of Tonopan 12.5mg solution, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Tonopan 12.5mg solution.
Uses of Tonopan 12.5mg in details
Tonopan 12.5mg is used to relieve pain from various conditions. This form of Tonopan 12.5mg is used to treat migraine headaches. Tonopan 12.5mg is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to treat gout attacks.
How to use Tonopan 12.5mg
Read the Medication Guide provided by your pharmacist before you start taking Tonopan 12.5mg and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth as directed by your doctor. Empty the contents of one packet into a cup containing 1 to 2 ounces (30 to 60 milliliters) of water. Mix well and drink all of it right away. Do not mix with any liquid other than water. If stomach upset occurs while taking this medication, take it with food, milk, or an antacid. However, if you take this medication with a meal high in fat, it may not work as well.
There are different brands and forms of this medication available. Because different forms do not have the same effects at equal strengths, do not switch forms of Tonopan 12.5mg unless your doctor tells you to.
To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose. Do not increase your dose or take it more often than prescribed.
Pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.
Tell your doctor if your condition persists or worsens.
Tonopan 12.5mg description
The active substance is sodium-[o[(2,6-dichlorophenyl)-amino]-phenyl]-acetate (= Tonopan 12.5mg sodium).
Each enteric tablet contains 25 mg or 50 mg of Tonopan 12.5mg sodium.
One prolonged-release tablet contains 100 mg of Tonopan 12.5mg sodium.
Excipients/Inactive Ingredients: Gastro-Resistant Tablet: Core for 25 mg and 50 mg: Cellulose microcrystalline; lactose monohydrate; magnesium stearate; maize starch; povidone; silica, colloidal anhydrous; sodium starch glycolate (type A).
Coating for 25 mg and 50 mg: Hypromellose; iron oxide yellow (E172); macrogoglycerol hydroxystearate; methacrylic acid-ethyl acrylate copolymer; macrogol 8000; talc; titanium dioxide (E171); simeticone; alpha-octadecyl-omega-hydroxy-polyglykolether; sorbic acid.
Coating for 50 mg: Iron oxide red (E172).
SR Tablet: Tablet Core: Cetyl alcohol; magnesium stearate; povidone; silica; colloidal anhydrous; sucrose.
Tablet Coating: Hypromellose; iron oxide red (E172); macrogol 8000; polysorbate 80; sucrose; talc; titanium dioxide (E171). Printing Ink: Carbon black, shellac, ammonium hydroxide, simethicone.
Injection: Each ampoule also contains the following excipients: Mannitol, sodium metabisulfite (E223), benzyl alcohol, propylene glycol, water for injection, sodium hydroxide.
Tonopan 12.5mg dosage
General Dosing Instructions
Carefully consider the potential benefits and risks of Tonopan 12.5mg and other treatment options before deciding to use Tonopan 12.5mg. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
The effectiveness of Tonopan 12.5mg when taken with food has not been studied in clinical studies. Taking Tonopan 12.5mg with food may cause a reduction in effectiveness compared to taking Tonopan 12.5mg on an empty stomach.
Acute Pain
For management of mild to moderate acute pain, the dosage is 18 mg or 35 mg orally three times daily.
Osteoarthritis Pain
For management of osteoarthritis pain, the dosage is 35 mg orally three times daily.
Dosage Adjustments in Patients with Hepatic Impairment
Patients with hepatic disease may require reduced doses of Tonopan 12.5mg compared to patients with normal hepatic function. As with other Tonopan 12.5mg products, start treatment at the lowest dose. If efficacy is not achieved with the lowest dose, discontinue use.
Non-Interchangeability with Other Formulations of Tonopan 12.5mg
Tonopan 12.5mg capsules are not interchangeable with other formulations of oral Tonopan 12.5mg even if the milligram strength is the same. Tonopan 12.5mg capsules contain Tonopan 12.5mg free acid whereas other Tonopan 12.5mg products contain a salt of Tonopan 12.5mg, i.e., Tonopan 12.5mg potassium or sodium. A 35 mg dose of Tonopan 12.5mg is approximately equal to 37.6 mg of sodium Tonopan 12.5mg or 39.5 mg of potassium Tonopan 12.5mg. Therefore, do not substitute similar dosing strengths of other Tonopan 12.5mg products without taking this into consideration.
Tonopan 12.5mg interactions
See also:
What other drugs will affect Tonopan 12.5mg?
Aspirin: Concomitant administration of Tonopan 12.5mg and aspirin is not recommended because Tonopan 12.5mg is displaced from its binding sites during the concomitant administration of aspirin, resulting in lower plasma concentrations, peak plasma levels and AUC values.
Anticoagulants: While studies have not shown Tonopan 12.5mg to interact with anticoagulants of the warfarin type, caution should be exercised, nonetheless, since interactions have been seen with other NSAIDs. Because prostaglandins play an important role in hemostasis and NSAIDs affect platelet function as well, concurrent therapy with all NSAIDs, including Tonopan 12.5mg and warfarin, requires close monitoring of patients to be certain that no change in their anticoagulant dosage is required.
Digoxin, Methotrexate, Cyclosporine: Tonopan 12.5mg, like other NSAIDs, may affect renal prostaglandins and increase the toxicity of certain drugs. Ingestion of Tonopan 12.5mg may increase serum concentrations of digoxin and methotrexate and increase cyclosporine's nephrotoxicity. Patients who begin taking Tonopan 12.5mg or who increase their Tonopan 12.5mg dose or any other NSAID while taking digoxin, methotrexate or cyclosporine may develop toxicity characteristics for these drugs. They should be observed closely, particularly if renal function is impaired. In the case of digoxin, serum levels should be monitored.
Lithium: Tonopan 12.5mg decreases lithium renal clearance and increases lithium plasma levels. In patients taking Tonopan 12.5mg and lithium concomitantly, lithium toxicity may develop.
Oral Hypoglycemics:
Tonopan 12.5mg does not alter glucose metabolism in normal subjects nor does it alter the effects of oral hypoglycemic agents. There are rare reports, however, from marketing experiences, of changes in effects of insulin or oral hypoglycemic agents in the presence of Tonopan 12.5mg that necessitated changes in the doses of such agents. Both hypo- and hyperglycemic effects have been reported. A direct causal relationship has not been established, but physicians should consider the possibility that Tonopan 12.5mg may alter a diabetic patient's response to insulin or oral hypoglycemic agents.Diuretics: Tonopan 12.5mg and other NSAIDs can inhibit the activity of diuretics. Concomitant treatment with potassium-sparing diuretics may be associated with increased serum potassium levels.
Other Drugs: In small groups of patients (7-10/interaction study), the concomitant administration of azathioprine, gold, chloroquine, D-penicillamine, prednisolone, doxycycline or digitoxin did not significantly affect the peak levels and AUC values of Tonopan 12.5mg. Phenobarbital toxicity has been reported to have occurred in a patient on chronic phenobarbital treatment following the initiation of Tonopan 12.5mg therapy.
Tonopan 12.5mg side effects
See also:
What are the possible side effects of Tonopan 12.5mg?
There have been cases reported of Tonopan 12.5mg being associated with the development of symptoms resembling the syndrome of inappropriate antidiuretic hormone secretion in elderly women. A patient who had been taking Tonopan 12.5mg for several years and had increasingly complained of dry, gritty eyes noticed that eye irritation disappeared within 3 days when Tonopan 12.5mg had to be discontinued because of GI effects.
The most frequent adverse effects reported in patients given Tonopan 12.5mg are GI in nature. Typical reactions include epigastric pain, nausea, vomiting and diarrhoea. Rarely, peptic ulcer and GI bleeding have occurred. Tonopan 12.5mg has also been implicated as the causative agent in colonic ulceration, small bowel perforation and pseudomembranous colitis.
Renal papillary necrosis and nephritic syndrome have been reported in patients taking Tonopan 12.5mg. Elevations of serum aminotransferase activity and clinical hepatitis, including fetal fulminant hepatitis have occurred in patients taking Tonopan 12.5mg. Self-limiting skin reaction eg, rash or pruritus may occur in patients given Tonopan 12.5mg.
Aspirin-sensitive asthmatic patients have developed reactions (rhinorrhoea, tightness of chest, wheezing, dyspnoea) when challenged with Tonopan 12.5mg in doses of 10-25 mg and the CMS in the UK have received a report of 1 aspirin-sensitive patient who died from acute asthma 4 hrs after a single 25-mg dose of Tonopan 12.5mg.
Tonopan 12.5mg contraindications
See also:
What is the most important information I should know about Tonopan 12.5mg?
Hypersensitivity to Tonopan 12.5mg sodium or to any of the excipients of Tonopan 12.5mg.
Active gastric or intestinal ulcer, bleeding or perforation.
Last trimester of pregnancy.
Hepatic, renal and severe cardiac failure.
Patients in whom attacks of asthma, urticaria or acute rhinitis are precipitated by acetylsalicylic acid and/or other drugs with prostaglandin-synthetase inhibitory activity.
Treatment of peri-operative pain in setting of coronary artery bypass graft (CABG) surgery.
The use of high dose Tonopan 12.5mg (150 mg/day) for >4 weeks is contraindicated in patients with established cardiovascular disease (congestive heart failure, established ischemic heart disease, peripheral arterial disease) or uncontrolled hypertension.
Established Cardiovascular Disease or Significant Cardiovascular Risk Factors: The use of high dose Tonopan 12.5mg (150mg/day) for >4 weeks is contraindicated in patients with established cardiovascular disease (congestive heart failure, established ischemic heart disease, peripheral arterial disease) or uncontrolled hypertension. If Tonopan 12.5mg treatment is needed, patients with established cardiovascular disease, uncontrolled hypertension or significant cardiovascular risk factors (eg, hypertension, hyperlipidaemia, diabetes mellitus and smoking) should be treated only after careful consideration and at doses ≤100 mg daily if the treatment is for >4 weeks. As the cardiovascular risks of Tonopan 12.5mg may increase with dose and duration of exposure, Tonopan 12.5mg should always be prescribed at the lowest effective daily dose and for the shortest duration possible.
Renal Impairment: Tonopan 12.5mg is contraindicated in patients with renal failure. No specific studies have been carried out in patients with renal impairment, therefore, no specific dose adjustment recommendations can be made. Caution is advised when administering Tonopan 12.5mg to patients with mild to moderate renal impairment.
Hepatic Impairment: Tonopan 12.5mg is contraindicated in patients with hepatic failure. No specific studies have been carried out in patients with hepatic impairment, therefore, no specific dose adjustment recommendations can be made. Caution is advised when administering Tonopan 12.5mg to patients with mild to moderate hepatic impairment.
Active ingredient matches for Tonopan 12.5mg:
Diclofenac in Switzerland.
List of Tonopan 12.5mg substitutes (brand and generic names) | Sort by popularity |
Unit description / dosage (Manufacturer) | Price, USD |
Tonopan Neue Formel (Switzerland) | |
Tablets, Film-Coated; Oral; Diclofenac Potassium 12.5 mg | |
Tontarin (Taiwan) | |
Tontarin 25 mg | |
Tontarin 50 mg | |
Topac (India) | |
Topac 1% GEL / 30g (Piramal Healthcare) | $ 0.35 |
1 % x 30g (Piramal Healthcare) | $ 0.35 |
Topac 30 gm Gel (Piramal Healthcare) | $ 0.35 |
TOPAC 50 MG TABLET 1 strip / 10 tablets each (Piramal Healthcare) | $ 0.23 |
TOPAC INJECTION 1 vial / 1 ML injection each (Piramal Healthcare) | $ 0.16 |
TOPAC topical gel 1 % x 30g (Piramal Healthcare) | $ 0.35 |
Topac 50mg Tablet (Piramal Healthcare) | $ 0.02 |
Topac 75mg Injection (Piramal Healthcare) | $ 0.16 |
Topac Fast Gel (India) | |
Topac Fast Gel Diclofenac sodium 1 % w/w, Methylsalicylate 5 % w/w, Menthol 5 % w/w, Capsaicin0.025 % w/w. GEL / 20g (AHPL) | $ 0.35 |
20g (AHPL) | $ 0.35 |
Topac Fast Gel Diclofenac sodium 1 % w/w, methylsalicylate 5 % w/w, menthol 5 % w/w, capsaicin0.025 % w/w. T-GEL / 20g (AHPL) | $ 0.35 |
TOPAC FAST GEL topical gel 20g (AHPL) | $ 0.35 |
TOPAC IM | |
TOPAC IM INJECTION 1 vial / 3 ML injection each (Abbott India Ltd) | $ 0.10 |
Topac InJ (India) | |
Topac InJ 25mg VIAL / 30ml (AHPL) | $ 0.29 |
Topac InJ 25mg AMP / 3ml (AHPL) | $ 0.10 |
25 mg x 30ml (AHPL) | $ 0.29 |
25 mg x 3ml (AHPL) | $ 0.10 |
TOPAC INJ inj 25 mg x 30ml (AHPL) | $ 0.29 |
TOPAC INJ inj 25 mg x 3ml (AHPL) | $ 0.10 |
Topac Tab (India) | |
Topac Tab 50mg TAB / 10 (AHPL) | $ 0.25 |
50 mg x 10's (AHPL) | $ 0.25 |
TOPAC TAB tab 50 mg x 10's (AHPL) | $ 0.25 |
Topalgon (Greece) | |
Topfans (Italy) | |
Topflam (Vietnam) | |
Topflam 100mg TAB / 100 (Acme Pharmaceuticals) | $ 2.77 |
Topflam 25 mg x 1 Blister x 6 Tablet (Acme Pharmaceuticals) | |
100 mg x 100's (Acme Pharmaceuticals) | $ 2.77 |
Topflam 100 mg Tablet (Acme Pharmaceuticals) | $ 0.03 |
TOPFLAM 100MG TABLET 1 strip / 10 tablets each (Acme Pharmaceuticals) | $ 0.29 |
TOPFLAM tab 100 mg x 10's (Acme Pharmaceuticals) | $ 0.28 |
Topflam 100mg Tablet (Acme Pharmaceuticals) | $ 0.03 |
Toryxil (Germany) | |
Trabona (Finland) | |
Tratul (Austria, Romania) | |
Tratul 50 mg (Austria) | |
Tratul Retard (Austria) | |
Tratul retard 100 mg (Austria) | |
Traulen (Italy) | |
Traumasport (Switzerland) | |
See 7738 substitutes for Tonopan 12.5mg |
References
- DailyMed. "DICLOFENAC EPOLAMINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "diclofenac". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "diclofenac". http://www.drugbank.ca/drugs/DB00586 (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology