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What is indomethacin? How is indomethacin used?
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.
What brand names are available for indomethacin?
Indocin, Indocin-SR (Discontinued Brand in U.S.)
Is indomethacin available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for indomethacin?
What are the side effects of indomethacin?
Common side effects of indomethacin are:
Other important side effects are:
Some individuals are allergic to NSAIDs and may develop shortness of breath when an NSAID is taken. People with asthma are at a higher risk for experiencing serious allergic reaction to NSAIDs. Individuals with a serious allergy to one NSAID are likely to experience a similar reaction to a different NSAID.
Indomethacin may cause ulceration of the stomach or intestine, and the ulcers may bleed. Sometimes, ulceration may lead to perforation of the intestine and bleeding can occur without abdominal pain, and black tarry stools, weakness, and dizziness upon standing (orthostatic hypotension) may be the only signs of a ulceration.
NSAIDs can reduce the ability of blood to clot thereby increasing bleeding after an injury.
NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of NSAIDs in these patients should be done cautiously. Individuals who have nasal polyps or are allergic to aspirin or other NSAIDs should not use indomethacin because there is an increased risk of severe allergic reactions in these individuals.
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.
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.
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.
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Is indomethacin safe to take if I'm pregnant or breastfeeding?
Use during pregnancy has not been adequately studied. Indomethacin may have adverse effects on the fetus.
What else should I know about indomethacin?
What preparations of indomethacin are available?
- Capsules: 25 and 50 mg
- Capsules, extended release: 75 mg
- Suspension: 25 mg/ml
- Suppositories: 50 mg.
- Injection (powder): 1 mg
How should I keep indomethacin stored?
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.
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Stool Color, Changes in Color, Texture, and Form
Stool color changes can very from green, red, maroon, yellow, white, or black. Causes of changes of stool color can range from foods a person eats, medication, diseases or conditions, pregnancy, cancer, or tumors. Stool can also have texture changes such as greasy or floating stools. Stool that has a uncharacteristically foul odor may be caused by infections such as giardiasis or medical conditions.
Low Blood Pressure (Hypotension)
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, and fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Bursitis of the hip results when the fluid-filled sac (bursa) near the hip becomes inflamed due to localized soft tissue trauma or strain. Symptoms include stiffness and pain around the hip joint. If the hip bursa is not infected, hip bursitis can be treated with ice compresses, rest, and anti-inflammatory and pain medications.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disease resulting in chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Early RA signs and symptoms include anemia, both sides of the body affected (symmetric), depression, fatigue, fever, joint deformity, joint pain, joint redness, joint stiffness, joint swelling, joint tenderness, joint warmth, limping, loss of joint function, loss of joint range of motion, and polyarthritis.
Buildup of uric acid crystals in a joint causes gouty arthritis. Symptoms and signs include joint pain, swelling, heat, and redness, typically of a single joint. Gout may be treated with diet and lifestyle changes, as well as medication.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited. Treatment incorporates medications, physical therapy, and exercise.
Arthritis (Joint Inflammation)
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, and pseudogout.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Also known as degenerative arthritis, osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms and signs include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and anti-inflammatory and pain medications.
Ankle Pain (Tendonitis)
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
A bursa is a fluid-filled sac found in the joints that cushions them. Bursitis is an inflammation of the bursae, most commonly caused by repetitive motion. Bursitis can be caused by a bacterial infection and should be treated with antibiotics. Doctors also recommend icing and resting the joint.
Pericarditis (Symptoms, ECG, Types, Causes, Treatment)
Pericarditis is the inflammation of the pericardial sac that surrounds the heart. The causes of pericarditis include injury from heart attack, heart surgery, trauma, viral or fungal infection, HIV, tumors, mixed connective tissue disease, metabolic disease, medication reactions, or unknown reasons. Treatment for pericarditis is generally medication, however, sometimes surgery is necessary.
Nonsteroidal Anti-inflammatory Drugs and Ulcers
Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Shoulder bursitis is inflammation of the shoulder bursa. Bursitis may be caused by injury, infection, or a rheumatic condition. Symptoms include pain, swelling, tenderness, and pain with movement of the shoulder joint. Treatment may involve ice compresses, rest, and anti-inflammatory medications and depends on whether there is an infection.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms and signs include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves anti-inflammatory medications and exercise.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary, or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with anti-inflammatory medications.
Diabetes insipidus is a condition in which the patient has frequent urination. Symptoms of diabetes insipidus include irritable, listless, fever, vomiting, or diarrhea due to the loss of large volumes of urine. There are three types of diabetes insipidus, central, nephrogenic, dipsogenic, and gestational. Treatment depends upon the type of diabetes insipidus.
Calcific bursitis is the calcification of the bursa caused by chronic inflammation of the bursa. Calcific bursitis most commonly occurs in the shoulder. Calcific bursitis treatment includes medication for inflammation, ice, immobilization, cortisone injections, and occasionally surgical removal of the inflamed bursa.
Uveitis is inflammation of the eye. Symptoms include blurred vision, eye pain, eye redness, photophobia, and floaters. Treatment may involve prescription eyedrops, antibiotics, and wearing dark glasses.
What Is Weber-Christian Disease?
Weber-Christian disease is a rare inflammatory disease that affects the body's fat tissues. The disorder appears on the skin as red or purple tender, raised lumps usually on the thighs and lower legs. Other symptoms may include nausea, vomiting, weight loss, joint pain, and abdominal pain. There is no cure for the disease, but anti-inflammatory medications may help with inflammation.
Juvenile Rheumatoid Arthritis (JRA)
Juvenile rheumatoid arthritis (JRA) annually affects one child in every thousand. There are six types of JRA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Non-Radiographic Axial Spondyloarthritis (nr-axSpA)
Non-radiographic spondyloarthritis (nr-axSpA) is an inflammatory arthritis that mainly affects the joints of the spine. Morning stiffness and back pain are the usual symptoms of nr-axSpA. Nonsteroidal anti-inflammatory drugs, exercise, and biologics are treatments for nr-axSpA.
Treatment & Diagnosis
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Medications & Supplements
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- fenoprofen (Nalfon)
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