About tolfenamic acid

It is not clear what causes migraine. It is thought that some chemicals in the brain increase in activity, and as a result parts of the brain then send out confused signals which result in the symptoms of migraine.

It is also not clear why people with migraine should develop these chemical changes and many migraine attacks occur for no apparent reason. In some people, however, there may be things which trigger an attack, like certain foods or drinks.

Tolfenamic acid is an NSAID used to relieve pain in migraine attacks. It works by blocking the production of irritant chemicals during a migraine attack.

Before taking tolfenamic acid

Before taking tolfenamic acid make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you are under 18 years of age or over 65 years of age.
• If you have liver or kidney problems.
• If you have asthma or any other allergic disorder.
• If you have ever had a stomach or duodenal ulcer.
• If you have heart problems or high blood pressure.
• If you have problems with your circulation.
• If you have ever had a stroke or a transient ischaemic attack (also referred to as a TIA or 'mini-stroke').
• If you have ever had blood clotting problems.
• If you have blood in your stools.
• If you have systemic lupus erythematosus (an inflammatory condition also called lupus or SLE).
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
• If you have ever had an allergic or unusual reaction to any other NSAID (this includes aspirin, naproxen, diclofenac and ibuprofen) or to any other medicine.

How to take tolfenamic acid

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
• Take tolfenamic acid exactly as your doctor has told you. Take the tablets with food or just after a snack if possible.
• Take one tablet as soon as possible at the first sign of an attack. You may take a second tablet after 1-2 hours if needed.

Getting the most from your treatment

• Tolfenamic acid is used to treat a migraine once it has started, but there are other medicines that are available that may help prevent you having migraines. If you have migraines frequently, discuss this with your doctor.
• If you find that tolfenamic acid does not relieve your migraine, make an appointment to discuss this with your doctor, as an alternative preparation may prove to be more effective for you.
• If you buy any 'over-the-counter' medicines, check with your pharmacist which medicines are safe for you to take alongside tolfenamic acid.
• Many things can trigger migraines. These can include some foods (for example cheese, chocolate, and red wine), worry, bright sunlight, too much or too little sleep, and skipping meals. Try to avoid the things that you know trigger your migraines.

Can tolfenamic acid cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Important: if you experience any of the following, speak with your doctor immediately or go to your local accident and emergency department without delay:

• Any sign of bleeding in the stomach or intestine, such as blood in vomit or dark stools.
• Any shortness of breath, or swelling of the mouth or face.
• A severe skin rash.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store tolfenamic acid

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines