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- What is indomethacin, and how does it work (mechanism of action)?
- What brand names are available for indomethacin?
- Is indomethacin available as a generic drug?
- Do I need a prescription for indomethacin?
- What are the side effects of indomethacin?
- What is the dosage for indomethacin?
- Which drugs or supplements interact with indomethacin?
- Is indomethacin safe to take if I'm pregnant or breastfeeding?
- What else should I know about indomethacin?
What is indomethacin, and how does it work (mechanism of action)?
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 are the side effects of indomethacin?
: Common side effects of indomethacin are:
- stomach discomfort,
- dizziness and
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.PREGNANCY Use during pregnancy has not been adequately studied. Indomethacin may have adverse effects on the fetus.
Is indomethacin safe to take if I'm pregnant or breastfeeding?
Indomethacin is excreted in breast milk and therefore should be avoided by nursing mothers.
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.
Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment
indomethacin; Indocin, Indocin-SR (Discontinued Brand in U.S.) is a nonsteroidal anti-inflammatory (NSAID) drug prescribed for the treatment of inflammation caused by gouty arthritis, osteoarthritis, soft tissue injuries such as bursitis and tendinitis, rheumatoid arthritis, and ankylolsing spondylitis. Side effects, drug interactions, pregnancy safety, and dosage information should be reviewed prior to taking this medication.
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Medications & Supplements
- flurbiprofen (Ansaid is a discontinued brand)
- sulindac, Clinoril
- oxaprozin, Daypro
- piroxicam, Feldene
- etodolac, Lodine (Discontinued)
- ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, and others)
- fenoprofen, Nalfon
- naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
- ketoprofen (Discontinued brands: Nexcede, Orudis, Oruvail, Actron)
- nabumetone, Relafen (Discontinued)
- tolmetin, Tolectin (Discontinued Brand)
- Tramadol: for Pain (Ultram, Ultram ER, Conzip)
- bromfenac, Duract
- baclofen (Gablofen, Lioresal)
- celecoxib (Celebrex)
- Nonsteroidal Antiinflammatory Drugs (NSAIDs)
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- valdecoxib, Bextra
- Aspirin vs. NSAIDs (Side Effect and Use Differences)
Prevention & Wellness
Rheumatoid Arthritis Resources
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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.