indometacin


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Related to indometacin: gout

indomethacin (indometacin (UK))

Apo-Indomethacin (CA), Flexin, Indameth (CA), Indocid-R (UK), Indomax SR (UK), Indocid (CA), Indocid PDA (UK), Indocin SR, Indolar SR (UK), Indotec (CA), Novo-Methacin (CA), Nu-Indo (CA), Pardelprin (UK), Pro-Indo (CA), Ratio-Indomethacin (CA), Rheumacin (CA), Rhodacine (CA), Rimacid (UK), Sandoz Indomethacin (CA), Slo-Indo (UK)

Pharmacologic class: Nonsteroidal anti-inflammatory drug (NSAID)

Therapeutic class: Anti-inflammatory, analgesic, antipyretic

Pregnancy risk category B (third trimester: D)

FDA Box Warning

• Drug may increase risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke (which can be fatal). Risk may increase with duration of use, and may be greater in patients who have cardiovascular disease or risk factors for it.

• Drug is contraindicated for perioperative pain in setting of coronary artery bypass graft surgery.

• Drug increases risk of serious GI adverse events, including bleeding, ulcers, and stomach or intestinal perforation, which can be fatal. These events can occur at any time during therapy and without warning. Elderly patients are at greater risk.

Action

Unknown. Thought to inhibit cyclo-oxygenase, an enzyme needed for prostaglandin synthesis.

Availability

Capsules: 25 mg, 50 mg

Capsules (sustained-release): 75 mg

Oral suspension: 25 mg/5 ml

Indications and dosages

Rheumatoid arthritis; osteoarthritis; ankylosing spondylitis

Adults: 25 to 50 mg P.O. two or three times daily, not to exceed 200 mg daily; or one 75-mg sustained-release capsule P.O. once or twice daily

Acute gouty arthritis

Adults: 50 mg P.O. t.i.d. until pain is tolerable; then reduce dosage rapidly and, finally, discontinue drug. Don't give sustained-release form.

Acute bursitis or tendinitis of shoulder

Adults: 75 to 150 mg P.O. daily in three or four divided doses. Discontinue once inflammation is controlled.

Off-label uses

• Bartter's syndrome

• Pericarditis

Contraindications

• Hypersensitivity to drug, its components, or other NSAIDs

• Active GI bleeding

• Concurrent diflunisal use

Precautions

Use cautiously in:

• severe cardiovascular, renal, or hepatic disease

• history of ulcer disease

• elderly patients

• pregnant or breastfeeding patients

• children ages 14 and younger (efficacy not established).

Administration

• Give with food, full glass of water, or antacids to reduce GI upset.

• Don't open or crush capsules.

• For arthritis, give up to 100 mg of daily dose at bedtime as needed to reduce nighttime pain and morning stiffness.

• Don't give sustained-release form to patients with gouty arthritis.

Adverse reactions

CNS: headache, dizziness, drowsiness, fatigue, vertigo, depression, seizures

EENT: tinnitus

GI: nausea, vomiting, diarrhea, constipation, abdominal pain or cramps, dyspepsia, ulcers, GI bleeding

Other: allergic reactions including anaphylaxis

Interactions

Drug-drug. Antihypertensives, diuretics: decreased efficacy of these drugs

Corticosteroids, other NSAIDs: additive adverse GI reactions

Cyclosporine: increased risk of nephrotoxicity

Diflunisal: potentially fatal GI hemorrhage

Lithium, methotrexate, zidovudine: increased risk of toxicity from these drugs

Probenecid: increased risk of indomethacin toxicity

Drug-diagnostic tests. Dexamethasone suppression test: false-negative result

Drug-herbs. Anise, arnica, chamomile, clove, dong quai, feverfew, garlic, ginger, ginkgo, ginseng: increased bleeding risk

Patient monitoring

• Assess for dizziness, drowsiness, headache, fatigue, and exacerbation of depression, epilepsy, or parkinsonism.

• Monitor for drug efficacy, indicated by improved joint mobility, pain relief, and decreased inflammation.

• Monitor urine output for marked reduction.

• Watch for signs and symptoms of GI bleeding and ulcers.

Patient teaching

• Tell patient to take with food, full glass of water, or antacid to reduce GI upset.

• Advise patient not to open or crush capsules.

• Inform breastfeeding patient that indomethacin enters breast milk and may cause seizures in infant. Advise her to use a different infant feeding method during therapy.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, balance, and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

indometacin

(ĭn′dō-mĕt′ə-sĭn)
References in periodicals archive ?
Control group treated without LPS and FBL; model group treated with only 1 [micro]g/mL LPS for 24 h; positive group treated with 44.70 mg/mL indometacin for 6 h and 1 [micro]g/mL LPS for 24 h; and FBL groups treated with 62.50, 15.62, and 3.91 [micro]g/ mL FBL for 6h, respectively, and 1 [micro]g/mL LPS for 24 h.
Hydrochlorothiazide (HCTZ; thiazide diuretic), acetazolamide (ACTZ; carbonic anhydrase inhibitor), ouabain octahydrate (sodium potassium ATPase inhibitor), N-[omega]-Nitro-L-arginine methyl ester (L-NAME; NO synthase inhibitor), icatibant acetate (HOE-140; [B.sub.2] bradykinin receptor antagonist), indometacin (cyclooxygenase inhibitor), atropine (muscarinic receptor antagonist), and captopril (angiotensin converting enzyme inhibitor), were obtained from Sigma-Aldrich Chemical Co.
One hour after drug administration, each animal received orally 30 mg/kg of Indometacin. All animals were sacrificed five hours later by overdose of ether.
Testing hyptis crenata, or Brazilian mint, on mice, the team led by Graciela was able to show that when prepared as a "tea" the mint was as effective as the synthetic aspirin-style drug Indometacin.
Testing hyptis crenata, or Brazilian mint, on mice, the team led by Graciela was able to show that when prepared as a "tea" - the traditional way to administer the medicine - the mint was as effective as the synthetic aspirin-style drug Indometacin.
Effect of indometacin on blood pressure in the normotensive unanesthetized rabbit: Posible relation to prostaglandin synthesis inhibition.
(1.) These include etodolac, phenylbutazone, floctafenine, mefenamic, the SR, and enteric coated (other than 650 mg) forms of ASA, 1 g SR form of naproxen, as well as the injectable and/or suppository forms of indometacin, naproxen, ketoprofen, diclofenac, and piroxicam.
Leung et al., "Routine pre-procedural rectal indometacin versus selective post-procedural rectal indometacin to prevent pancreatitis in patients undergoing endoscopic retrograde cholangio-pancreatography: a multicentre, single-blinded, randomised controlled trial," The Lancet, vol.
Neven et al., "Effects of nimesulide and indometacin on COX-1 and COX-2: a comparative study," Journal de Pharmacie de Belgique, vol.
The studies performed on iPSC-derived neurons from AD patients have shown that indometacin, ibuprofen, diclofenac, and flurbiprofen significantly reduced the A[beta]42/A[beta]40 ratio [46].
Adipogenic differentiation was stimulated using three cycles of induction medium A (stimulatory supplements including dexamethasone, 3-isobutyl-1-methylxanthine, insulin, and indometacin) for 3 days and maintenance medium B (stimulatory supplements including insulin) for 24 hours.