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

  • Pharmacy Author:
    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.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    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.

What is the dosage for indomethacin?

  • 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.

Which drugs or supplements interact with indomethacin?

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.

Indomethacin increases the negative effect of cyclosporine on kidney function and reduces the effect of furosemide (Lasix) and thiazide diuretics because of prostaglandin inhibition.

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.

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