Find Singapore: Indomethacin

Generic Name: indomethacin (in doe METH a sin)

Brand Names: Indocin, Indocin SR

What is indomethacin?

Indomethacin is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Indomethacin works by reducing hormones that cause inflammation and pain in the body.

Indomethacin is used to treat pain or inflammation caused by many conditions such as arthritis, gout, ankylosing spondylitis, bursitis, or tendinitis.

Indomethacin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about indomethacin?

This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use indomethacin. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking indomethacin. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Do not drink alcohol while taking indomethacin. Alcohol can increase the risk of stomach bleeding caused by indomethacin. Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar to indomethacin (such as ibuprofen, ketoprofen, or naproxen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen.

What should I discuss with my healthcare provider before taking indomethacin?

Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Do not use this medication if you are allergic to indomethacin, or if you have a history of allergic reaction to aspirin or other NSAIDs.

Before taking indomethacin tell your doctor if you are allergic to any drugs, or if you have:

a history of heart attack, stroke, or blood clot;

heart disease, congestive heart failure, high blood pressure;

a history of stomach ulcers or bleeding;

liver or kidney disease,

a seizure disorder such as epilepsy;

asthma;

polyps in your nose;

a bleeding or blood clotting disorder; or

if you smoke.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take indomethacin.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking indomethacin during the last 3 months of pregnancy may harm the unborn baby. Do not take indomethacin during pregnancy unless your doctor has told you to. Indomethacin passes into breast milk and may affect a nursing baby. Do not take indomethacin without first talking to your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 14 years old without the advice of a doctor.

How should I take indomethacin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take indomethacin with food or milk to lessen stomach upset. Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

If you take indomethacin for a long period of time, your doctor may want to check you on a regular basis to make sure this medication is not causing harmful effects. Do not miss any scheduled visits to your doctor.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using indomethacin.

Store indomethacin at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

See also: Indomethacin dosage (in more detail)

What happens if I miss a dose?

If you are taking indomethacin on a regular schedule, take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose.

If you are taking indomethacin as needed, take the missed dose if it is needed, then wait the recommended or prescribed amount of time before taking another dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of an indomethacin overdose may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, fainting, or coma.

What should I avoid while taking indomethacin?

Indomethacin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking indomethacin and seek medical attention or call your doctor at once if you have any of these serious side effects:

chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

black, bloody, or tarry stools;

coughing up blood or vomit that looks like coffee grounds;

swelling or rapid weight gain;

urinating less than usual or not at all;

nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or

bruising, severe tingling, numbness, pain, muscle weakness.

Less serious side effects may include:

upset stomach, mild heartburn, diarrhea, constipation;

bloating, gas;

dizziness, nervousness, headache;

skin rash, itching;

blurred vision; or

ringing in your ears.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Indomethacin Dosing Information

Usual Adult Dose for Ankylosing Spondylitis:

Immediate-release: 25 mg orally every 8 to 12 hours. Dosage may be increased by 25 or 50 mg increments every week to a maximum daily dose of 150 to 200 mg. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Extended-release: 75 mg orally once a day. Dosage may be increased to 75 mg orally twice a day.

Rectal: 50 mg rectally every 8 to 12 hours.

Usual Adult Dose for Osteoarthritis:

Usual Adult Dose for Rheumatoid Arthritis:

Usual Adult Dose for Acute Gout:

50 mg orally or rectally 3 times a day until the gouty attack has resolved, usually 2 to 3 days. Indomethacin should be given with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Adult Dose for Bursitis:

75 to 150 mg daily in 3 to 4 divided doses. Give with food, immediately after meals, or with antacids to reduce gastric irritation. The usual course of therapy is 7 to 14 days.

Usual Adult Dose for Tendonitis:

75 to 150 mg daily in 3 to 4 divided doses. Give with food, immediately after meals, or with antacids to reduce gastric irritation. The usual course of therapy is 7 to 14 days.

Usual Adult Dose for Cluster Headache:

Immediate-release: 25 to 50 mg orally 3 times a day. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Extended-release: 75 mg orally once or twice a day.

Rectal: 50 mg rectally 2 to 3 times a day.

Usual Pediatric Dose for Patent Ductus Arteriosus:

Indomethacin IV:

Less than 48 hours:
First dose: 0.2 mg/kg IV.
Second dose: 0.1 mg/kg IV.
Third dose: 0.1 mg/kg IV.
Doses are given at 12 to 24 hour intervals.

2 to 7 days:
First dose: 0.2 mg/kg IV.
Second dose 0.2 mg/kg IV.
Third dose: 0.2 mg/kg IV.
Doses are given at 12 to 24 hour intervals.

Greater than 7 days:
First dose: 0.2 mg/kg IV.
Second dose: 0.25 mg/kg IV.
Third dose: 0.25 mg/kg IV.
Doses are given at 12 to 24 hour intervals.

Usual Pediatric Dose for Rheumatoid Arthritis:

2 to 14 years: 2 mg/kg/day given in divided doses. Titrate dose upward to a maximum of 4 mg/kg/day or 200 mg per day. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Pediatric Dose for Pain:

1 to 2 mg/kg/day in 2 to 4 divided doses. Maximum daily dose 4 mg/kg. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Pediatric Dose for Bartter Syndrome:

0.5 to 2 mg/kg/day in divided doses, given with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Pediatric Dose for Gitelman Syndrome:

Case Report (n=3): 1 to 2 mg/kg/day given in three divided doses. Maximum doses of 4 mg/kg/day have been used if poor growth observed.

Usual Pediatric Dose for Langerhans' Cell Histiocytosis:

Study (n=10)
Greater than 2 years: 1 to 2.5 mg/kg/day given in 2 to 3 divided doses for an average time of 6 weeks (range: 2 to 16 weeks).

What other drugs will affect indomethacin?

Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs with indomethacin may cause you to bruise or bleed easily.

Before taking indomethacin, tell your doctor if you are taking any of the following drugs:

a blood thinner such as warfarin (Coumadin);

cyclosporine (Gengraf, Neoral, Sandimmune);

digoxin (digitalis, Lanoxin);

diuretics (water pills) such as furosemide (Lasix);

lithium (Eskalith, Lithobid);

methotrexate (Rheumatrex, Trexall);

probenecid (Benemid);

steroids (prednisone and others);

aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others; or

a beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others.

This list is not complete and there may be other drugs that can interact with indomethacin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More indomethacin resources

Indomethacin Side Effects (in more detail)
Indomethacin Dosage
Indomethacin Use in Pregnancy & Breastfeeding
Drug Images
Indomethacin Drug Interactions
Indomethacin Support Group
35 Reviews for Indomethacin - Add your own review/rating

indomethacin Advanced Consumer (Micromedex) - Includes Dosage Information

Indomethacin Prescribing Information (FDA)

Indomethacin Professional Patient Advice (Wolters Kluwer)

Indomethacin Monograph (AHFS DI)

Indomethacin MedFacts Consumer Leaflet (Wolters Kluwer)

Indocin MedFacts Consumer Leaflet (Wolters Kluwer)

Indocin SR Sustained-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

Indocin SR Prescribing Information (FDA)

Compare indomethacin with other medications

Ankylosing Spondylitis
Back Pain
Bartter Syndrome
Bursitis
Cluster Headaches
Frozen Shoulder
Gitelman Syndrome
Gout, Acute
Langerhans' Cell Histiocytosis
Osteoarthritis
Pain
Patent Ductus Arteriosus
Rheumatoid Arthritis
Sciatica
Tendonitis

Where can I get more information?

Your pharmacist can provide more information about indomethacin.

See also: indomethacin side effects (in more detail)

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Thursday, October 13, 2016

Indomethacin