Drug information of Indomethacin

Mechanism of effect

Although the exact mechanism of action through which indomethacin causes closure of a patent ductus arteriosus is not known, it is believed to be through inhibition of prostaglandin synthesis.

Pharmacodynamic

Indomethacin, a NSAIA, with analgesic and antipyretic properties exerts its pharmacological effects by inhibiting the synthesis of prostaglandins involved in pain, fever, and inflammation.

Pharmacokinetics

Bioavailability is approximately 100% following oral administration and 80–90% following rectal administration. Protein binding:97% Metabolism: Hepatic. Indomethacin is eliminated via renal excretion, metabolism, and biliary excretion. Half life:4.5 hours.

Drug indications

Rheumatoid arthritis , ankylosing spondylitis , Osteoarthritis , Acute Gout , Bursitis , Tendonitis , Cluster Headache

Dosage

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.

Drug contraindications

hypersensitivity to drug or its components.

Side effects

abdominal pain , vomiting , Bradycardia , Hypertension , fluid retention , hemorrhage , GI perforation , hyponatremia , renal failure , Weight increase , Hypoglycemia , GI bleeding

Interactions

Atenolol , Allium- S , Amitriptyline , Amikacin , Adefovir , Streptokinase , Expectorant , Furosemide , Labetalol , Losartan , Warfarin , Voriconazole , Prazosin , Propranolol , Penicillin G , Tanacetum parthenium , Feverfew , Gentamicin , Drospirenone , Sotalol , Sulfadiazine , C-lax , Cyclosporine , Metoprolol , Carvedilol , Cotrimoxazole , probenecid , Donepzil , Doxazosin , Meglumine Compound , Apixaban , Phenindione , Desirudin , Travoprost , Ginkgo biloba , Bumetanide , Eprosartan , Peginterferon alfa-2b , Trandolapril , Glucagon , Pemetrexed , Telmisartan , Tositumomab , Ibritumomab tiuxetan , Benazepril , aminolevulinic acid oral , Aminolevulinic acid topical , Diatrizoate (Amidotrizoic acid) , Bendroflumethiazide , Betrixaban , tiludronate , Ramucirumab , Bromfenac , Moexipril , Ioxaglate , Cordyceps , Netonal , Iothalamate Meglumine , Urokinase , Sulfamethoxazole , Dasatinib , Remdesivir , macimorelin , vortioxetine , Bremelanotide , Aminohippurate Sodium

Alerts

1-minor gastrointestinal bleeding (i.e., chemical detection of blood in the stool) was more commonly noted in those neonates treated with indomethacin. Severe gastrointestinal effects have been reported in adults with various arthritic disorders treated chronically with oral indomethacin. 2-Prematurity per se, is associated with an increased incidence of spontaneous intraventricular hemorrhage. Because indomethacin may inhibit platelet aggregation, the potential for intraventricular bleeding may be increased. 3-(Indomethacin) may mask the usual signs and symptoms of infection.

Points of recommendation

1-Severe hepatic reactions have been reported in adults treated chronically with oral indomethacin for arthritic disorders 2-The drug should be administered carefully to avoid extravascular injection or leakage as the solution may be irritating to tissue. 3-If indomethacin is used in pediatric patients 2 years of age or older, such patients should be monitored closely and periodic assessment of liver function is recommended. 4-Safety and effectiveness have not been established in pediatric patients less than 14 years of age.

Pregnancy level

C

Related drugs

Ibuprofen , Piroxicam , Tolmetin , Naproxen , Ketorolac , Tolfenamic Acid , Aceclofenac , Celecoxib , Acemetacin , Sulindac , Azapropazone