indomethacin


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Related to indomethacin: gout

indomethacin

 [in″do-meth´ah-sin]
a nonsteroidal antiinflammatory drug used in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and various other rheumatic and nonrheumatic inflammatory conditions, dysmenorrhea, and vascular headache. The trihydrated sodium salt is used to induce closure in certain cases of patent ductus arteriosus.

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.

in·do·meth·a·cin

(in'dō-meth'ă-sin),
A potent analgesic, antipyretic, and nonsteroidal antiinflammatory agent used to treat acute exacerbations of various joint diseases. It is also used to produce closure of a patent ductus arteriosus in infants.

indomethacin

(ĭn′dō-mĕth′ə-sĭn)
n.
A nonsteroidal anti-inflammatory, antipyretic, and analgesic drug, C19H16ClNO4, used especially in the treatment of some forms of arthritis. Also called indometacin.

in·do·meth·a·cin

(in'dō-meth'ă-sin)
A potent analgesic, antipyretic, and nonsteroidal antiinflammatory agent used to treat acute exacerbations of various joint diseases.

indomethacin

Indometacin, a non-steroidal painkilling (analgesic) and anti-inflammatory drug (NSAID) of the indole acetic acid group. Brand names are Flexin Continus, Indocid, Indocid PDA and Indomod.

antiinflammatory drug 

A drug which inhibits or suppresses most inflammatory responses of an allergic, bacterial, traumatic or anaphylactic origin, as well as being immunosuppressant. They include the corticosteroids (e.g. betamethasone, dexamethasone, fluorometholone, hydrocortisone acetate, loteprednol etabonate, prednisolone, rimexolone, triamcinolone). They are sometimes combined with an antibiotic drug (e.g. betamethasone combined with neomycin or sulfacetamide, dexamethasone combined with neomycin or polymyxin B). Corticosteroids have side effects, such as enhancing the activity of herpes simplex virus, fungal overgrowth, raising intraocular pressure or cataract formation.There are other antiinflammatory drugs that are non-steroidal (NSAID) and have little toxicity. They act mainly by blocking prostaglandin synthesis. These include diclofenac sodium, flurbiprofen sodium, indomethacin, ketorolac, nepafenac and oxyphenbutazone. See immunosuppressants; steroid.
References in periodicals archive ?
This expression was significantly inhibited by indomethacin, a NSAID that was used as positive control.
In uncomplicated case, indomethacin therapy proved effective.
There was a significant decrease in mRNA expression of MMP-3 in the indomethacin and tetrandrine groups compared to the control group (p<0.05).
Two different types of NSAIDs were used in the selected trials, including diclofenac [11-14] and indomethacin [6, 8, 10, 15-18].
DYING Baby Junior Wilson after doctors at the Queen Elizabeth University Hospital gave him indomethacin
This study was done to study the effect of aloe vera when given in higher doses especially on sodium and water retention in the body and comparing with that of indomethacin effect.
Systemic administration of Curcumin was more beneficial than Indomethacin or Propranolol administration regarding the decrease of the oxidative stress parameters and nociceptive process.
In addition, this activity was dose-dependent and comparable to that presented by indomethacin (10 mg/kg; p.o.) in the time points of 1 and 2 hours.
During a 2-hour period at the emergency department, 100-mm visual analog scale (VAS) pain scores at rest declined by 6.54 mm/hour with indomethacin and by 5.05 mm/hour with prednisolone, and with activity, the declines were 11.69 mm/hour and 11.38 mm/hour, respectively.
Rats were divided randomly into four groups: Group A; received intramuscular injection of indomethacin in male rat, Group B; was received intramuscular injection of indomethacin in female rat, Group C; received intramuscular injection of indomethacin and thyme volatile oils in male rat and Group D; received intramuscular injection of indomethacin and thyme volatile oils in female rat.