indomethacin, Indocin, Indocin-SR

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: indomethacin

BRAND NAME: Indocin, Indocin-SR

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 to cause 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 a sustained (slow) release form (Indocin-SR). The FDA first approved indomethacin in January 1965.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS:

• Capsules: 25 and 50 mg;
• Capsules, sustained release: 75 mg;
• Suspension: 25 mg/ml;
• Suppositories: 50 mg.

STORAGE: Capsules should be kept at room temperature 15-30 C (59-86 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 dose for adults is 50-200 mg per day split into 2-3 doses. Indomethacin should be taken with food 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 reduce 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 aminoglycoside antibiotics (for example, gentamicin) the blood levels of the aminoglycoside may increase, presumably because the elimination of aminoglycoside from the body is reduced. This may lead to aminoglycoside-related side effects.

Individuals taking oral blood thinners or anticoagulants [for example, warfarin (Coumadin)] should avoid indomethacin because indomethacin also thins the blood, and excessive blood thinning may lead to bleeding.

PREGNANCY: Use during pregnancy has not been adequately studied. Indomethacin may have adverse effects on the fetus.

NURSING MOTHERS: Indomethacin is excreted in breast milk and therefore should be avoided by nursing mothers.

SIDE EFFECTS: The most common side effects are nausea, vomiting, diarrhea, stomach discomfort, heartburn, rash, headache, dizziness and drowsiness.

Report Problems to the Food and Drug Administration You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088. Need help identifying pills and medications? Use the pill identifier tool on RxList.