Indomethacin is an indoleacetic acid derivative and belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). It has a pronounced anti-inflammatory effect, which is much higher than that of Phenylbutazone and acetylsalicylic acid. The drug has analgesic activity comparable to that of Metamizole. It has antipyretic action. Indomethacin medication has a strong inhibitory effect on prostaglandin synthesis by inhibiting cyclooxygenase.
Indomethacin tablets reduce: platelet aggregation (sticking), inflammation, leukotriene activity, and also reduce the release of endogenous pyrogens, inactivate lysosomal enzymes, inhibit the activity of neutral proteases.
Indomethacin: Side effects
Use the Indomethacin pill as prescribed by your doctor to avoid side effects:
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Gastrointestinal disorders. Peptic ulcer, perforation or gastrointestinal bleeding (sometimes fatal) may occur, mainly in elderly patients.
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Blood and lymphatic system. Leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia (including hemolytic and aplastic), disseminated intravascular coagulation.
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Immune system. Bronchospasm, asthmatic attacks, anaphylactic reactions, fever, vasculitis, pulmonary or cerebral edema.
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Metabolism and nutrition. Elevated urea levels, increased body weight, increased liver enzymes, increased sweating, accelerated cartilage degeneration, fluid retention, hyperglycemia, glucosuria, and hyperkalemia.
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Nervous system: agitation, seizures, muscle weakness, spontaneous muscle movements, mental disorders, increased epilepsy and parkinsonism, impaired consciousness, coma, dysarthria, aseptic meningitis, hallucinations, fear, dizziness, headache.
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Respiratory system: nasal bleeding, dyspnea, acute respiratory distress.
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Organs of vision: optic neuritis, conjunctivitis, periocular pain, diplopia, blurred vision.
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Hearing and labyrinthine organs: deafness, tinnitus.
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Cardiac disorders: tachycardia, angina pectoris, palpitations, arrhythmias, edema.
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Renal and urogenital system disorders: impaired renal function, edema, vaginal bleeding, enlarged and strained mammary glands, gynecomastia, proteinuria, hematuria, nephrotic syndrome, interstitial nephritis, papillary necrosis.
Side effects can be reduced by using the lowest effective therapeutic dose of the drug for a short period of time to control symptoms.
Indomethacin for gout
Indomethacin is a drug that is used for mild to moderate acute pain in joint disease as well as gout.
Indomethacin tablet relieves inflammation, swelling, stiffness, and pain in the joints. To relieve an acute attack of gout, an initial dose of 100 mg (4 tablets) is prescribed, followed by continuing treatment with a dose of 50 mg (2 tablets) 3 times a day until the pain is reduced.
Interaction of Indomethacin
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Concomitant use of Zidovudine and Indomethacin increases the risk of hematologic toxicity.
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The risk of Indomethacin toxicity is increased when used with Ritonavir.
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Caution should be exercised when concomitantly used with antiepileptic drugs, due to increased effect of Phenytoin.
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Concomitant use with Haloperidol increases drowsiness.
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Concomitant use with benzodiazepines increases the risk of dizziness.
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Non-steroidal anti-inflammatory drugs should be avoided for 8-12 days after Mifepristone administration.
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Indomethacin may decrease the excretion rate of Baclofen and thus increase its toxic effects.
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Simultaneous administration with vasodilators increases the risk of bleeding.
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Digoxin: Indomethacin may increase the plasma concentration of Digoxin (reduces its excretion by the kidneys), which requires dose adjustment and monitoring of Digoxin levels.
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Lithium salts: Indomethacin prolongs and potentiates the effects of lithium salts and increases the toxicity of lithium.
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Immunosuppressants: concomitant use of Indomethacin and immunosuppressants such as Methotrexate and Cyclosporine leads to an increase in their toxicity.
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Diuretics (diuretics): NSAIDs decrease the therapeutic efficacy of diuretics (due to decreased tubular secretion). There may be an increased risk of hyperkalemia when concomitant use with potassium-saving diuretics and decreased renal function. Diuretics may increase nephrotoxicity of Indomethacin.
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Antihypertensive agents: Indomethacin may weaken the antihypertensive effect of ACE inhibitors and beta-adrenoceptors when used simultaneously.
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Antidiabetic agents: Indomethacin does not alter the therapeutic effectiveness of oral antidiabetic agents and insulin.
Dosage of Indomethacin
The drug should be used orally after meals. Indomethacin’s pill should be swallowed whole with water.
For adults and children over 14 years of age, the initial dose is 25-50 mg (1-2 tablets) 2-4 times per day. If the therapeutic effect is not enough, the dose should be increased to 150 mg (6 tablets) per day, divided into 3 doses.
The maximum daily dosage is 200 mg (8 tablets). In long-term treatment, the daily dose should not exceed 75 mg (3 tablets).
Indomethacin: Uses
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Generic Indomethacin is effective for Inflammatory and degenerative diseases of the musculoskeletal system:
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Ankylosing spondylitis (Bechterew's disease)
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Rheumatism with manifestation of joint pain;
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Gout in aggravated form;
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Osteoarthritis;
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Radiculitis;
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Inflammatory affection of ligaments and tendons;
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Bursitis;
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Sciatica (pain in the sciatic nerve area);
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As a result of injuries (injuries and tears of ligaments, tendons, various bruises).
Before deciding to use Indomethacin, the potential benefits and risks of use should be carefully evaluated and contraindications should be excluded.
Indomethacin: contraindications
Before using Indomethacin 100 mg, consult your doctor because the drug has various contraindications:
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Hypersensitivity to the components of the drug;
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Hypersensitivity to Acetylsalicylic acid or other non-steroidal anti-inflammatory drugs with clinical manifestation of asthmatic attack, angioedema, urticaria or rhinitis;
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Active peptic ulcer of the stomach and duodenum or frequent recurrences;
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Ulcerative colitis or enterocolitis;
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A history of gastrointestinal bleeding or perforations associated with the use of NSAIDs;
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Concomitant use of other non-steroidal anti-inflammatory drugs;
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Severe heart failure;
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Severe hepatic and renal insufficiency.
Patients taking the drug for a long time should have periodic blood, liver, or stomach function tests to detect the adverse effects of Indomethacin as early as possible. If necessary, the doctor will replace or reduce the dosage of the drug.
Indomethacin and alcohol
Indomethacin affects the mucosa of the stomach and intestines, so it is strictly forbidden to combine this drug with alcohol. Ethanol itself corrodes the mucosa of the walls of the stomach, burning it. And if you consider that Indomethacin inhibits the production of protective mucus, the risk of gastrointestinal bleeding increases by 50%. That is, if you drink alcohol against the background of NSAID therapy, an ulcer, or erosion occurs with a high probability. Internal bleeding can occur with a 50-70% probability. In addition, alcohol with various drugs of the group of non-steroidal anti-inflammatory drugs can enter into other reactions, having a negative impact on the body and its systems, depending on the drug itself.
Indomethacin and pregnancy
Indomethacin is contraindicated during pregnancy. Breastfeeding should be stopped during treatment with this drug because the active substance penetrates into breast milk in small amounts.
Indomethacin for headaches
Indomethacin is considered the drug of choice for treating chronic paroxysmal and prolonged hemicrania, also for emergency treatment of migraines and various types of primary headaches.
Remember, painkillers should not be used too often, it provokes abusive headaches. Do not use the drug more than nine days a month, and consult a neurologist if the headache cannot be controlled.
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