Rosch would have challenged Lundbeck's (then named Ovation) acquisition of
Indocin even apart from its subsequent acquisition of NeoProfen.
Cluster headaches are usually relieved by prescription drugs such as verapamil, lithium carbonate, indomethacin (
Indocin), and ergotamine (in combination with verapamil) is reputed to be effective, but not to be used by patients at risk for cardiovascular disease.
For example, the nonsteroidal anti-inflammatory drug
Indocin is 10 times more expensive in the Netherlands than in Greece.
Joint pain and stiffness caused by inflammation can usually be alleviated by a variety of anti-inflamitory drugs such as aspirin,
Indocin and Naprosyn.
In 2005, Lundbeck, then named Ovation Pharmaceuticals, purchased the rights to
Indocin IV (
Indocin),4 an off-patent drug, from Merck & Co.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as
Indocin and Naprosyn, decrease inflammation and pain.
Acute, mild attacks respond to over-the-counter NSAIDs such as ibuprofen, but faster relief is possible through a prescription NSAID called indomethacin (
Indocin).
The company added that Indomethacin will be introduced in the second quarter of 2010 and is therapeutically equivalent to the reference-listed drug
INDOCIN I.V., by Lundbeck Inc.
Of the medications listed on the Beers Criteria, some of those most commonly prescribed for older people include benzodiazepines (for insomnia); older tricyclic antidepressants, such as amitriptyline (Elavil, sometimes used for pain); prescription-strength nonsteroidal antiinflammatory drugs (NSAIDs), such as indomethacin (
Indocin) prescribed for pain and inflammation; and stronger analgesics, such as propoxyphene (Darvon).
Treatment might be nothing more than anti-inflammatory medicines, such as
Indocin, or it might be medicines that act on the immune system, such as cortisone or cyclephosphamide.
For example, oral terbutaline, oral calcium channel blockers, and oral
Indocin have been well-studied and widely used, with varying levels of success.
Pain Medications to Use and Avoid with Older Adults Type of Drug Preferred Avoid Opioids Acetaminophen-Codeine Pentazocine (Talwin [R]) phosphate (Tylenol Meperidine (Demerol [R]) with codeine [R]) Oxycodone Propoxyphene (Darvon-N [R]) (Oxycontin [R]) Hydromorphone (Dilaudid [R]) NSAIDs Ibuprofen (Motrin [R]) Indomethacin (
Indocin [R]) Salsalate (Salsitab [R]) Piroxicam (Feldene [R]) Diflunisal (Dolobid [R]) Phenylbutazone Acetaminophen (Tylenol [R]) (Cotylbutazones [R]) Adjuvant Trazadone (Desyrel [R]) Aspirin (Bayer [R]) Fluoxetine (Prozac [R]) Amitriptyline (Elavil [R]) Desipramine (Norpramin [R]) Phenothiazine (Thorazine [R]) Note: The Pain: Geriatric Self-Learning Module is based on module developed by Sally Scott, Nancy Eksterowicz, and Beth White.