INDOMETHACIN

Non-steroidal anti-inflammatory drug

Dosage Forms

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Capsule

25 mg

Uses

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  • Pyogenic (septic) arthritis
  • Rheumatoid arthritis
  • Gout arthritis
  • Osteoarthritis
  • Osteomyelitis
  • Nociceptive or somatic pain
  • Dysmenorrhoea

Dose and Duration

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All uses
  • Adult: 50–200 mg daily in 2–3 divided doses (maximum dose in dysmenorrhoea, 75 mg in 2–3 divided doses a day)
  • Child 1 month–18 years: 0.5–1 mg/kg every 12 hours

Contraindications

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  • Hypersensitivity to aspirin or other NSAIDs
  • History of or active peptic ulcer disease
  • Nasal polyps associated with angioneurotic oedema
  • Coagulation defects
  • Severe heart failure

Side Effects

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  • Headache, dizziness, depression, vertigo, fatigue
  • Nausea, anorexia, vomiting, epigastric distress, abdominal pain, constipation, diarrhoea
  • Angioneurotic oedema
  • Angiitis (inflammation of small blood vessels)
  • Erythema nodosum, pruritus, urticaria, skin rash, photosensitivity, Stevens-Johnson syndrome
  • Rapid fall in blood pressure resembling a shock-like state
  • Acute respiratory distress
  • Tinnitus, hearing disturbances

Interactions

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  • Haloperidol (possible severe drowsiness)
  • Triamterene (reduced renal function)
  • Methotrexate (excretion of methotrexate reduced hence increased risk of toxicity)
  • Probenecid (reduced excretion of indomethacin, increased plasma concentration of indomethacin)
  • Aspirin and other NSAIDs (increased risk of side effects)

Patient Instructions

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  • Take with or immediately after food

Pregnancy

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  • Do not use

Breast-feeding

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  • Do not use

⚠️ Caution

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  • Start with lower doses and increase gradually to reduce incidence of headache
  • Use with caution in patients with history of bronchial asthma, psychiatric disorders, epilepsy or parkinsonism
  • Increased risk of gastrointestinal bleeding and fluid retention if used in hepatic failure
  • In renal failure, use the lowest possible dose for the shortest possible duration. If acute interstitial nephritis occurs, withdraw the medicine
  • Withdraw medicine if eye changes are observed in patients with chronic rheumatoid disease
  • Indomethacin may mask signs and symptoms of infection