Indomethacin[ (Indocin) ] Drug Information

Contains Indomethacin drug information and provides Indomethacin drug indication, contraindication, special concerns, side effects, overdose management and dosage
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Not a simple analgesic; use only for the conditions listed. Moderate to severe rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis (drug of choice). Acute gouty arthritis and acute painful shoulder (tendinitis, bursitis). IV: Pharmacologic closure of persistent patent ductus arteriosus in premature infants. Investigational: Topically to treat cystoid macular edema (0.5% and 1% drops), sunburn, primary dysmenorrhea, prophylaxis of migraine, cluster headache, polyhydramnios.
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Pregnancy and lactation. PO indomethacin in children under 14 years of age. GI lesions or history of recurrent GI lesions. IV use: GI or intracranial bleeding, thrombocytopenia, renal disease, defects of coagulation, necrotizing enterocolitis. Suppositories: Recent rectal bleeding, history of proctitis.
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Special Concerns:
Restrict use in children to those unresponsive to or intolerant of other anti-inflammatory agents; efficacy has not been determined in children less than 14 years of age. Geriatric clients are at greater risk of developing CNS side effects, especially confusion. Use with caution in clients with history of epilepsy, psychiatric illness, or parkinsonism and in the elderly. Use with extreme caution in the presence of existing, controlled infections.
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Side Effects:
Reactivation of latent infections may mask signs of infection. More marked CNS manifestations than for other drugs of this group. Aggravation of depression or other psychiatric problems, epilepsy, and parkinsonism.
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Overdose Management:
No Available information
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Drug Interactions:
Captopril / Captopril effect, probably R/T inhibition of prostaglandin synthesis Diflunisal / Plasma levels of indomethacin; also, possible fatal GI hemorrhage Diuretics (loop, potassium-sparing, thiazide) / May reduce antihypertensive and natriuretic action of diuretics Lisinopril / Possible lisinopril effect Prazosin / Antihypertensive drug effects
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Capsules, Oral Suspension Moderate to severe arthritis, osteoarthritis, ankylosing spondylitis.

Adults, initial: 25 mg b.i.d.-t.i.d.; may be increased by 25-50 mg at weekly intervals, according to condition and, if tolerated, until satisfactory response is obtained. With persistent night pain or morning stiffness, a maximum of 100 mg of the total daily dose can be given at bedtime. Maximum daily dosage: 150-200 mg. In acute flares of chronic rheumatoid arthritis, the dose may need to be increased by 25-50 mg/day until the acute phase is under control.

Acute gouty arthritis.

Adults, initial: 50 mg t.i.d. until pain is tolerable; then, reduce dosage rapidly until drug is withdrawn. Pain relief usually occurs within 2-4 hr, tenderness and heat subside in 24-36 hr, and swelling disappears in 3-4 days.

Acute painful shoulder (bursitis/tendinitis).

75-150 mg/day in three to four divided doses for 1-2 weeks.

Sustained-Release Capsules Antirheumatic, anti-inflammatory.

Adults: 75 mg, of which 25 mg is released immediately, 1-2 times/day.

Suppositories Anti-inflammatory, antirheumatic, antigout.

Adults: 50 mg up to q.i.d. Pediatric: 1.5-2.5 mg/kg/day in three to four divided doses (up to a maximum of 4 mg/kg or 250-300 mg/day, whichever is less).

IV Only Patent ductus arteriosus.

3 IV doses, depending on age of the infant, are given at 12-24-hr intervals. Infants less than 2 days: first dose, 0.2 mg/kg, followed by two doses of 0.1 mg/kg each; infants 2-7 days: three doses of 0.2 mg/kg each; infants more than 7 days: first dose, 0.2 mg/kg, followed by two doses of 0.25 mg/kg each. If patent ductus arteriosus reopens, a second course of one to three doses may be given. Surgery may be required if there is no response after two courses of therapy.
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