Indomethacin
Anti-rheumatic, Systemic · NSAID: Indole
Indications
Pain syndromes. Biliary & renal colics. Post-operative pain. Cancer pain. Chronic pain, rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, musculoskeletal pain syndromes, acute gout and uretic rheumatism. Post-traumatic pain. Sport injuries.
Dosage
ORAL: Adults & Children: > 14 yr: Rheumatoid Arthritis/Osteoarthritis: Initial: 25 mg every 8 or 12 hr. Titrate: increase by 25-50 mg/day weekly. Max: 200 mg/day. Bursitis/Tendinitis: 75-150 mg/day given every 8 or 12 hr for 7-14 days. Acute Gouty Arthritis: 50 mg 3 times daily. SUPPOSITORY: Adults: 100-200 mg daily or 100 mg at night. Total 200 mg daily. Children: Not recommended.
Adverse Effects
Gastro-intestinal bleeding, persistent headache (discontinue if occur). Corneal deposits, retinal disturbances (perform periodic eye tests on long term use), melaena, haematemesis, dizziness, CNS effects, blood dyscrasias.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Active peptic ulcer, history of GIT lesions, aspirin or anti-inflammatory induced allergy. Severe cardiac, hepatic or renal failure. Nasal polyps. Precautions: Renal or hepatic impairment, monitor on long term therapy. Mild to moderate heart failure, hypertension, ischaemic heart, peripheral arterial or cerebrovascular disease, cardiac risk factors, diabetes, volume depletion. History of GI disease. SLE, mixed connective tissue disorders, epilepsy, bleeding disorders, psychiatric disorders, parkinsonism, infection, surgery. Asthma. Monitor haematological, hepatic and GI effects. Use lowest effective dose for shortest duration.
Interactions
Salicylates, anticoagulants, lithium, corticosteroids, diuretics, beta-blockers, probenecid, quinolones, other NSAIDs, antiplatelets, cyclosporin, methotrexate, digoxin, antihypertensives, nephrotoxic drugs, SSRIs, live vaccines, antidiabetics, mifepristone, baclofen, triamterene, vasodilators, tacrolimus, phenytoin, haloperidol, cyclophosphamide, desmopressin.
Advice to Patient
Take with meals. Do not crush, break or chew capsules. Swallow whole with a glass of water. Do not lie down for 15-30 minutes after taking medication. Discontinue medication and inform prescriber if there is constant abdominal pain, cramps, indigestion, blood in stool. Contact prescriber if there is chest pain, palpitations, fast heartbeat, difficulty in breathing, unusual cough, unusual bruising or bleeding, blood in urine/gums/vomitus, acute fatigue, skin rash, itching, irritation, blisters, swelling in ankles/hands/feet, change in vision, change in hearing, ringing in ears, difficulty in speaking. Avoid alcohol during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Check your weight every week and report unusual weight gain (3-5 lb per week). Avoid direct sunlight during therapy, wear sunscreen, proper eyewear…
Pharmacokinetics
Onset of action: Approx. 30 minutes. Duration: 4 to 6 hours. Absorption: Oral: Immediate release: Neonates: Formulation specific; Adults: Prompt and extensive; Extended release: Adults: 90% Over 12 hours. Metabolism: Hepatic; significant enterohepatic recirculation. Bioavailability: Neonates, premature: Percent bioavailability reported in the literature is highly variable and may be influenced by formulation components. Some have suggested that aqueous formulations are less bioavailable compared to ethanol based formulations; aqueous suspension ( in saline): 13% to 20%; ethanol based suspension: 98.6%. Adults: Oral: 100%; rectal: 80% to 90% (than that absorbed from capsule form) Half-life elimination: Neonates: Postnatal age (PNA) >2 weeks: Approx. 11 hours. Adults: 2.6-11.2 hours; 7.6 hours. Time to peak: Oral: Immediate release: 2 hours. capsules: 1.67 hours. Excretion: Urine (60%,…
Unlicensed Use
Children: Relief of pain and inflammation in rheumatic diseases including juvenile idiopathic arthritis: 1 mth-18 yr, 0.5-1 mg/kg twice daily; higher doses may be used under specialist supervision.
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Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.