Monograph Details
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Musculoskeletal Disorders
> Arthritis/rheumatic disorders
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Indomethacin |
| Manufacturer |
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Various generic manufacturers |
| Legal Classification |
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Rx
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| Pharmacological Class |
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NSAID (indole deriv.). |
| Generic Name |
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Indomethacin 25mg, 50mg; caps. |
| Also |
• INDOCIN SUSPENSION
• Indomethacin Suppositories
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| Indications |
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Moderate to severe rheumatoid arthritis, osteoarthritis, ankylosing spondylitis. Acute painful shoulder. Gouty arthritis. |
| Children |
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<14 yrs: usually not recommended. If risk warranted, give with food or antacids; ≥2 yrs: 1–2mg/kg/day in divided doses; max 3–4mg/kg/day (or 150–200mg/day whichever less). |
| Adults |
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Give with food or antacids. Use lowest effective dose. Acute painful shoulder: 75–150mg/day in 3–4 divided doses until inflammation controlled (usually 7–14 days). Acute gouty arthritis: 50mg 3 times daily until pain tolerable; then rapidly reduce dose to discontinue. Other conditions: initially 25mg 2–3 times daily. Increase if needed at weekly intervals by 25–50mg daily; max 200mg daily. |
| Contraindications |
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Aspirin allergy. Coronary artery bypass graft surgery. Supp: history of proctitis or recent rectal bleeding. |
| Precautions |
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Advanced renal disease: not recommended. History of GI lesions. Impaired renal or hepatic function. Heart failure. Hypertension. Edema. Sepsis. Volume depletion. Preexisting asthma. Epilepsy. Depression. Parkinsonism. Bleeding disorders. Monitor blood, hepatic, renal, and ocular function in chronic use; monitor hepatic function in children. Discontinue if liver dysfunction occurs. Elderly. Debilitated. Pregnancy (Cat.C); avoid in late pregnancy. Nursing mothers: not recommended. |
| Interactions |
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Avoid salicylates, other NSAIDs, triamterene. Potentiated by diflusinal. Potentiates digoxin (monitor). Probenecid increases plasma levels. Increases serum lithium levels. Diuretics, β-blockers, ACE inhibitors (eg, captopril), angiotensin II antagonists (eg, losartan): reduced antihypertensive effect. Caution with cyclosporine, oral anticoagulants, methotrexate; monitor. |
| Adverse Reactions |
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GI ulcers, bleeding or perforation, headache, nausea, dyspepsia, drowsiness, dizziness, edema, rash (discontinue if occurs), corneal deposits, retinopathy, hepatotoxicity, nephritis, nephrotic syndrome. See literature re: risk of cardiovascular events. Supp: rectal irritation, tenesmus. |
| How Supplied |
Caps, supps—contact supplier.
Susp—237mL |
| Additional Resources |
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• Related Prescribing Note |
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