indomethacin, Indocin, Indocin-SR (Discontinued Brand in U.S.)

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GENERIC NAME: a

BRAND NAME: Indocin, Indocin-SR (Discontinued Brand in U.S.)

DRUG CLASS AND MECHANISM: Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that reduces fever, pain and inflammation. It is similar to ibuprofen (Motrin) and naproxen (Naprosyn, Aleve). Indomethacin works by reducing the production of prostaglandins. Prostaglandins are chemicals that the body produces and which cause the fever and pain that are associated with inflammation. Indomethacin blocks the enzymes that make prostaglandins (cyclooxygenase 1 and 2) and thereby reduces the levels of prostaglandins. As a result, fever, pain and inflammation are reduced. Indomethacin is available in an extended release form. The FDA first approved indomethacin in January 1965.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS:

  • Capsules: 25 and 50 mg
  • Capsules, extended release: 75 mg
  • Suspension: 25 mg/ml
  • Suppositories: 50 mg.
  • Injection (powder): 1 mg

STORAGE: Capsules should be kept at room temperature, 15 C to 30 C (59 F to 86 F). Oral suspension and suppositories should be kept below 30 C (86 F). The oral suspension should not be frozen.

PRESCRIBED FOR: Indomethacin is used for the treatment of inflammation caused by rheumatoid arthritis, ankylosing spondylitis, gouty arthritis, osteoarthritis, and soft tissue injuries such as tendinitis and bursitis.

DOSING:

  • The recommended adult dose of regular release indomethacin for treating inflammation or rheumatoid disorders is 50-200 mg per day split into 2-3 doses.
  • The dose for extended release indomethacin is 75-150 mg divided into two daily doses.
  • Bursitis or tendonitis are treated with a total dose of 75-150 mg daily of regular release indomethacin divided into 3 or 4 doses or 75-150 mg daily of extended release divided into two doses.
  • Acute gouty arthritis is treated with 50 mg every 8 hours for 3 to 5 days. I
  • Indomethacin should be taken with food and 8-12 ounces of water in order to reduce abdominal discomfort.

DRUG INTERACTIONS: Cholestyramine (Questran) and colestipol (Colestid) may decrease the absorption of indomethacin by binding to indomethacin in the intestine and preventing absorption into the body. Indomethacin and other NSAIDs may decrease the elimination of lithium (Eskalith, Lithobid) by the kidneys and, therefore, increase the blood level of lithium, which could lead to lithium toxicity.

Indomethacin may interfere with the blood pressure-lowering effects of drugs that are given to reduce blood pressure. This may occur because prostaglandins play a role in the regulation of blood pressure.

When indomethacin is used in combination with methotrexate (Rheumatrex, Trexall) or aminoglycosides (for example, gentamicin) the blood levels of the methotrexate or aminoglycoside may increase, presumably because their elimination from the body is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.

Indomethacin should be avoided by patients with a history of asthma attacks, hives or other allergic reactions to aspirin or other NSAIDs.

If aspirin is taken with indomethacin there may be an increased risk for developing an ulcer.

Persons who have more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking indomethacin or other NSAIDs.

Medically Reviewed by a Doctor on 12/5/2013



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