NSAID (anthranilic acid)
Tolfenamic acid
Brand names: Clotam Rapid
Adult dose
Dose: 200mg PO at onset of migraine, may repeat after 1-2h
Route: PO
Frequency: PRN
Clinical pearls
- Acute migraine
- Rapidly disintegrating tablet — useful with nausea
Contraindications
- Active peptic ulcer
- Severe HF
- Severe renal impairment
- Pregnancy (3rd trimester)
- NSAID asthma
Side effects
- GI upset
- Dysuria
- Renal impairment
- Headache
- CV events
Interactions
- Anticoagulants
- Methotrexate
- Lithium
- ACEi/ARB
Monitoring
- U&E
- BP
Reference: BNF; NICE CG150; https://bnf.nice.org.uk/drugs/tolfenamic-acid/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- RSBI (Rapid Shallow Breathing Index) — Weaning Readiness · Ventilator Weaning
- CART Score for Cardiac Arrest Risk Triage · Resuscitation
- Rapid Emergency Medicine Score (REMS) · Severity Scoring
- 4AT — Rapid Assessment for Delirium · Diagnosis
- Tumor Lysis Syndrome Risk (Cairo-Bishop) · Oncological Emergency
- Rapid Arterial oCclusion Evaluation (RACE) Scale for Stroke · Stroke
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Acute Stroke Management · NICE NG128 / RCP 2023
- TIA Assessment (ABCD2) · NICE NG128 / NICE CG68
- Bacterial Meningitis (Adults) · NICE CG102 / BIA 2016
- Parkinson's Disease Management · NICE NG71 2017