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indomethacin, Indocin: Drug Facts, Side Effects and Dosing

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indomethacin

  • 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?
  • Pharmacy Author:

    Omudhome Ogbru, PharmD

    Omudhome Ogbru, PharmD

    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor:

    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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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 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?

Yes

What are the side effects of indomethacin?

: Common side effects of indomethacin are:

  • nausea ,
  • vomiting ,
  • diarrhea ,
  • stomach discomfort,
  • heartburn ,
  • rash ,
  • headache ,
  • dizziness and
  • drowsiness.

Other important side effects are:

  • Fluid retention,
  • blood clots ,
  • heart attacks,
  • hypertension ( high blood pressure ), and
  • heart failure .

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.

Indomethacin should be avoided by patients with a history of asthma attacks, hives or other allergic reactions to
aspirin or other NSAIDs.

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.

Indomethacin increases the negative effect of cyclosporine on kidney function and reduces the effect of furosemide
( Lasix ) and thiazide diuretics because of prostaglandin inhibition.

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.

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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.

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Summary

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

FDA Drug Labels on RxList.com

    • Nonsteroidal Antiinflammatory Drugs (NSAIDs)
    • Tramadol: for Pain (Ultram, Ultram ER, Conzip)
    • naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
    • ibuprofen (Advil, Children’s Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, and others)
    • celecoxib (Celebrex)
    • Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
    • Drug Interactions
    • nabumetone, Relafen (Discontinued)
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    • piroxicam, Feldene
    • Aspirin vs. NSAIDs (Side Effect and Use Differences)
    • etodolac, Lodine (Discontinued)
    • flurbiprofen (Ansaid is a discontinued brand)
    • oxaprozin, Daypro
    • sulindac, Clinoril
    • fenoprofen, Nalfon
    • ketoprofen (Discontinued brands: Nexcede, Orudis, Oruvail, Actron)
    • tolmetin, Tolectin (Discontinued Brand)
    • valdecoxib, Bextra
    • bromfenac, Duract
    • Indocin
    • Uloric
    • Zyloprim

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FDA Logo

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.

See more info: indomethacin on RxList
References
Reference: FDA Prescribing Information



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Indocin Capsule

GENERIC NAME(S): Indomethacin

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WARNINGS:

Nonsteroidal anti-inflammatory drugs (including indomethacin ) may rarely increase the risk for a heart attack or stroke . This effect can happen at any time while taking this drug but is more likely if you take it for a long time. The risk may be greater if you have heart disease or increased risk for heart disease (for example, due to smoking , family history of heart disease , or conditions such as high blood pressure or diabetes ). Do not take this drug right before or after heart bypass surgery (CABG).

Also, this drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines . This effect can occur without warning symptoms at any time while taking this drug. Older adults may be at higher risk for this effect. (See also Precautions and Drug Interactions sections.)

Stop taking indomethacin and get medical help right away if you notice any of the following rare but serious side effects: bloody or black/tarry stools, persistent stomach / abdominal pain , vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating , weakness on one side of the body, sudden vision changes, slurred speech.

Talk with your doctor or pharmacist about the risks and benefits of treatment with this medication .

Who should not take Indocin Capsule?

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  • Uses
  • Side Effects
  • Precautions
  • Interactions
  • Overdose
  • Images
Uses

Uses

Indomethacin is used to relieve pain, swelling, and joint stiffness caused by arthritis , gout , bursitis , and tendonitis . It is also used to relieve pain from various other conditions. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body’s production of certain natural substances that cause inflammation . This effect helps to decrease swelling and pain.

If you are treating a chronic condition such as arthritis , ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.

How to use Indocin Capsule

Read the Medication Guide provided by your pharmacist before you start using indomethacin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually 2 to 3 times a day with a full glass of water (8 ounces or 240 milliliters). Do not lie down for at least 10 minutes after taking this drug. If stomach upset occurs while taking this medication, take it with food, milk, or an antacid.

The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight . To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose or use this drug more often or for longer than prescribed. For ongoing conditions such as arthritis , continue taking this medication as directed. Discuss the risks and benefits with your doctor or pharmacist.

In certain conditions (such as arthritis ), it may take up to 4 weeks when this drug is taken regularly before you notice the full benefits.

If you are taking this drug on an “as needed” basis (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.

Tell your doctor if your condition worsens.

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Side Effects

Side Effects

See also Warning section.

Upset stomach , heartburn , headache , drowsiness, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure . Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if any of these unlikely but serious side effects occur: hearing changes (such as ringing in the ears ), mental/mood changes, difficult/painful swallowing, symptoms of heart failure (such as swelling ankles /feet, unusual tiredness, unusual/ sudden weight gain ).

Get medical help right away if any of these rare but very serious side effects occur: signs of kidney problems (such as change in the amount of urine), unexplained stiff neck .

This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: dark urine, persistent nausea / vomiting /loss of appetite, severe stomach / abdominal pain , yellowing eyes or skin .

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction , including: rash , itching /swelling (especially of the face/ tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

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Precautions

Precautions

Before taking indomethacin , tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen , naproxen , celecoxib ); or if you have any other allergies . This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication , tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, growths in the nose ( nasal polyps ), heart disease (such as previous heart attack ), high blood pressure , liver disease, stomach /intestinal/ esophagus problems (such as bleeding, ulcers, recurring heartburn ), stroke .

Kidney problems can sometimes occur with the use of NSAID medications , including indomethacin. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease , are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana.

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco , especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking . Consult your doctor or pharmacist for more information.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs , nonprescription drugs, and herbal products).

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters /redness.

Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially stomach bleeding and kidney problems.

Children may be more sensitive to the side effects of this drug, especially serious liver problems. Caution is advised when this drug is used in children. Discuss the risks and benefits of treatment with your doctor.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage , trouble getting pregnant ). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy , this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.

This drug passes into breast milk and may have undesirable effects on a nursing infant . Consult your doctor before breast -feeding.

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Interactions

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions . Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist . Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: aliskiren , ACE inhibitors (such as captopril , lisinopril ), angiotensin II receptor blockers (such as valsartan , losartan ), cidofovir , corticosteroids (such as prednisone ), lithium , methotrexate , ” water pills ” ( diuretics such as furosemide ).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti- platelet drugs such as clopidogrel , ” blood thinners ” such as dabigatran / enoxaparin / warfarin , among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers ( aspirin , NSAIDs such as celecoxib , diflunisal , ibuprofen , or ketorolac ). These drugs are similar to indomethacin and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

This medication can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug.

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Overdose

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach pain , vomit that looks like coffee grounds, extreme drowsiness, slow or shallow breathing, confusion, seizures .

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as blood pressure , complete blood count , liver and kidney function tests) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Non-drug treatment for arthritis that is approved by your doctor (such as weight loss if needed, strengthening and conditioning exercises) may help improve your flexibility, range of motion, and joint function. Consult your doctor for specific instructions.

Missed Dose

If you are prescribed this drug on a regular schedule (not just “as needed”) and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.Information last revised July 2018. Copyright(c) 2018 First Databank, Inc.

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    Indomethacin 50 Mg Is It A Narcotic

    Indomethacin 50 Mg Is It A Narcotic

    Indomethacin 50 Mg Is It A Narcotic

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