For the specific effect, in general, there is no implication that a contributory cause is necessary, though it may be so. In general, a factor that is a contributory cause is not sufficient, because it is by definition accompanied by other causes, which would not count as causes if it were sufficient. For the specific effect, a factor that is on some occasions a contributory cause might on some other occasions be sufficient, but on those other occasions it would not be merely contributory.J. L. Mackie argues that usual talk of "cause" in fact refers to INUS conditions (insufficient but non-redundant parts of a condition which is itself unnecessary but sufficient for the occurrence of the effect). An example is a short circuit as a cause for a house burning down. Consider the collection of events: the short circuit, the proximity of flammable material, and the absence of firefighters. Together these are unnecessary but sufficient to the houses burning down (since many other collections of events certainly could have led to the house burning down, for example shooting the house with a flamethrower in the presence of oxygen and so forth). Within this collection, the short circuit is an insufficient (since the short circuit by itself would not have caused the fire) but non-redundant (because the fire would not have happened without it, everything else being equal) part of a condition which is itself unnecessary but sufficient for the occurrence of the effect.
Tolmetin  is a nonsteroidal anti-inflammatory drug (NSAID) of the heterocyclic acetic acid derivative class. It is used primarily to reduce hormones that cause pain, swelling, tenderness, and stiffness in conditions such as osteoarthritis and rheumatoid arthritis, including juvenile rheumatoid arthritis. In the United States it is marketed as Tolectin and comes as a tablet or capsule. Clinical trials
Tolmetin is applicable in the treatment of rheumatoid arthritis, osteoarthrosis, pain, and ankylosing spondylitis. Mechanism of action
Although the mechanism of action of tolmetin is unknown, research involving humans and animals has shown that tolmetin does not achieve anti-inflammatory response by stimulation of the adrenal or pituitary gland, but it has shown tolmetin restrains prostaglandin synthetase in vitro and reduces plasma levels of prostaglandin E, possibly causing the anti-inflammatory response. When tested in rats, tolmetin prevented experimentally stimulated polyarthritis and reduced inflammation. In patients with rheumatoid arthritis or osteoarthritis tolmetin restrained disease activity as efficiently as aspirin and indometacin, although the occurrence of mild gastrointestinal adverse effects and tinnitus was lower in patients treated with tolmetin than it was with aspirin-treated patients and the occurrence of adverse effects of the central nervous system was lower with tolmetin than it was with indometacin. Side effects
Tolmetin can increase the risk of heart or circulatory conditions such as heart attacks and strokes. It should not be taken shortly before or after coronary artery bypass surgery. Tolmetin can also increase the risk of gastrointestinal conditions such as perforation or bleeding, which is fatal.