WARNING

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to reduce pain, inflammation, and fever. While it can be effective for various conditions, it is important to be aware of the potential risks associated with its use. Here are some of the risks of taking Indomethacin:

• Gastrointestinal Effects: One of the most common side effects of Indomethacin is gastrointestinal irritation. It can cause stomach pain, indigestion, nausea, vomiting, and even ulcers or bleeding in the digestive tract. Individuals with a history of stomach ulcers or gastrointestinal bleeding are at higher risk.
• Cardiovascular Risks: NSAIDs, including Indomethacin, may increase the risk of cardiovascular events such as heart attack or stroke, particularly with long-term use or in individuals with existing cardiovascular conditions. This risk may be higher in older adults and those with preexisting heart disease.
• Kidney Effects: Indomethacin can potentially cause kidney problems, including reduced kidney function, fluid retention, and increased blood pressure. It is important to stay well-hydrated while taking this medication, and individuals with kidney disease should use it with caution.
• Allergic Reactions: Some individuals may experience allergic reactions to Indomethacin, which can range from mild skin rashes to more severe symptoms such as difficulty breathing, swelling, or anaphylaxis. If you experience any signs of an allergic reaction, seek immediate medical attention.
• Central Nervous System Effects: Indomethacin may cause dizziness, drowsiness, or blurred vision. It can also affect mental alertness and coordination, so it’s important to use caution while performing tasks that require focus or physical coordination.
• Pregnancy and Lactation: Indomethacin is generally not recommended during pregnancy, particularly in the third trimester, as it may harm the unborn baby. It can also pass into breast milk and may affect a nursing infant, so it’s important to consult a healthcare professional if you are pregnant or breastfeeding.

It’s crucial to discuss the potential risks and benefits of Indomethacin with your healthcare provider before starting or stopping the medication. They can evaluate your individual circumstances, medical history, and any other medications you may be taking to determine the best course of treatment for you.

Why is this medication prescribed?

Indomethacin is prescribed for several reasons due to its anti-inflammatory, analgesic (pain-relieving), and antipyretic (fever-reducing) properties. Here are some common conditions for which indomethacin may be prescribed:

• Arthritis: Indomethacin is frequently used to manage symptoms associated with various types of arthritis, including rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. It helps reduce joint pain, stiffness, swelling, and inflammation.
• Gout: Indomethacin is often prescribed for acute gouty arthritis, a painful condition caused by the buildup of uric acid crystals in the joints. It helps relieve the pain and inflammation associated with gout attacks.
• Tendonitis and Bursitis: These are inflammatory conditions affecting tendons and bursae (small fluid-filled sacs that cushion joints). Indomethacin can be used to reduce pain and inflammation in these conditions.
• Pain and Inflammation: Indomethacin may be prescribed for acute pain and inflammation caused by various injuries or conditions, such as strains, sprains, and postoperative pain.
• Patent Ductus Arteriosus (PDA): In newborn babies with PDA, a condition where a blood vessel fails to close after birth, indomethacin can be given to help close the ductus arteriosus and improve blood circulation.

How should this medicine be used?

Here are some general guidelines for using indomethacin:

• Follow the prescribed dosage and schedule strictly. Do not take more or less than recommended unless instructed by your doctor.
• Take indomethacin with a full glass of water, preferably with food or milk to reduce the risk of stomach upset.
• Do not crush, chew, or break sustained-release capsules. Swallow them whole.
• If using the suppository form, carefully follow the instructions provided with the medication.
• It’s important to take indomethacin regularly to experience its full benefits. If you miss a dose, take it as soon as you remember. However, if it’s close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to compensate for a missed one.
• It’s advisable to avoid alcohol while taking indomethacin, as it can increase the risk of stomach bleeding.
• Inform your healthcare provider about any other medications, supplements, or medical conditions you have, as certain drugs or health conditions may interact with indomethacin.

Remember, it’s essential to consult your healthcare provider before starting or making any changes to your medication regimen, as they can provide personalized advice based on your specific situation.

Other uses for this medicine

There are other off-label uses for indomethacin as well. Here are a few examples:

• Patent ductus arteriosus (PDA) closure: Indomethacin is sometimes used to close a persistent opening between two major blood vessels in the heart, known as a patent ductus arteriosus, in premature infants.
• Cluster headaches: Indomethacin may be prescribed for the management of cluster headaches, a type of headache that occurs in cyclical patterns.
• Hemicrania continua: This medication can also be used to treat hemicrania continua, a chronic and continuous headache that is usually localized to one side of the head.
• Bursitis and tendonitis: Indomethacin may be used for the treatment of bursitis (inflammation of the fluid-filled sacs that cushion joints) and tendonitis (inflammation of tendons).

What special precautions should I follow?

As for special precautions, it is essential to consider the following:

• Allergic reactions: Individuals who are allergic to indomethacin or other NSAIDs should avoid taking this medication.
• Gastrointestinal effects: Indomethacin can cause gastrointestinal side effects such as stomach ulcers, bleeding, and perforation. It is recommended to take the medication with food or milk to help reduce these risks. Additionally, individuals with a history of gastrointestinal disorders should use indomethacin with caution.
• Cardiovascular risks: NSAIDs, including indomethacin, have been associated with an increased risk of cardiovascular events like heart attack and stroke. People with pre-existing heart conditions, high blood pressure, or a history of cardiovascular disease should use indomethacin with caution and consult their healthcare provider.
• Kidney function: Indomethacin can affect kidney function and may cause fluid retention or worsen pre-existing kidney problems. Individuals with kidney disease or impaired renal function should be closely monitored while taking this medication.
• Pregnancy and breastfeeding: Indomethacin should be used with caution during pregnancy, particularly during the third trimester, as it may cause harm to the unborn baby. It is not recommended for use during breastfeeding.

It is crucial to consult a healthcare professional or pharmacist for specific advice and guidance regarding the use of indomethacin, as they can provide personalized information based on your medical history and current health condition.

What special dietary instructions should I follow?

When taking indomethacin, there are no specific dietary restrictions that need to be followed. However, it is generally recommended to take this medication with food or milk to help reduce the risk of stomach upset. Avoid consuming alcohol while taking indomethacin as it can increase the risk of stomach bleeding.

What should I do if I forget a dose?

If you forget to take a dose of indomethacin, take it as soon as you remember. However, if it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is primarily used to reduce inflammation, pain, and fever. While it can be effective for various conditions, it may also have some side effects. The most common side effects of indomethacin include:

• Gastrointestinal Effects: Indomethacin can irritate the lining of the stomach and intestines, leading to symptoms such as stomach pain, heartburn, indigestion, nausea, vomiting, and diarrhea. It may also increase the risk of developing stomach ulcers and gastrointestinal bleeding, which can be serious.
• Cardiovascular Effects: Indomethacin may increase the risk of heart-related problems, including high blood pressure, heart attack, and stroke. These risks may be higher in individuals with existing cardiovascular conditions or those taking indomethacin for long periods.
• Renal Effects: Indomethacin can affect kidney function, particularly in individuals with pre-existing kidney disease. It may cause fluid retention, decreased urine output, and increased blood pressure. In rare cases, it can lead to kidney damage or failure.
• Central Nervous System Effects: Some individuals may experience drowsiness, dizziness, headache, or confusion while taking indomethacin. These effects are usually mild but can be more pronounced in certain individuals.
• Skin Reactions: Indomethacin can rarely cause allergic skin reactions such as rash, hives, itching, and swelling. In some cases, severe allergic reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis may occur, although this is extremely rare.
• Hematological Effects: Indomethacin may affect blood clotting and increase the risk of bleeding. It can also rarely cause anemia or decrease the number of white blood cells.
• Respiratory Effects: In rare cases, indomethacin may cause bronchospasm, which can lead to breathing difficulties, particularly in individuals with a history of asthma or allergies.

It’s important to note that this list does not cover all possible side effects. Some people may experience different or more severe side effects. If you are prescribed indomethacin and experience any concerning symptoms, it is advisable to consult your healthcare provider.

What should I know about storage and disposal of this medication?

Storage:

• Keep indomethacin in its original container, tightly sealed, and away from moisture and heat.
• Store the medication at room temperature, typically between 68°F and 77°F (20°C and 25°C).
• Avoid exposing indomethacin to direct sunlight or extreme temperature fluctuations.
• Keep the medication out of reach of children and pets.

Disposal:

• Do not flush indomethacin down the toilet or pour it into a drain unless instructed to do so.
• If you have specific instructions from your healthcare provider or local guidelines on medication disposal, follow those instructions.
• If you are uncertain about the appropriate method of disposal, consult with your pharmacist or local waste management authorities for guidance.

In case of emergency/overdose

In case of emergency or overdose, it is crucial to seek immediate medical assistance. Here are some steps to take:

• Contact your local emergency services or poison control center immediately.
• If the person is conscious, provide them with water or milk to drink, unless advised otherwise by medical professionals.
• Do not induce vomiting unless directed by medical professionals.
• If possible, provide information about the medication taken, dosage, and the time of ingestion to the medical professionals.
• Follow the guidance provided by healthcare professionals or poison control experts.

What other information should I know?

• Indomethacin may cause stomach or intestinal bleeding, particularly in older adults. If you experience symptoms like black, bloody, or tarry stools or vomit that resembles coffee grounds, seek medical attention.
• Inform your healthcare provider about any existing medical conditions, allergies, or medications you are taking before starting indomethacin.
• It is important to take indomethacin exactly as prescribed by your healthcare provider. Do not exceed the recommended dosage or duration of treatment unless instructed to do so.
• Common side effects of indomethacin may include stomach upset, headache, dizziness, and rash. If you experience severe side effects or an allergic reaction, seek medical attention.

Remember, the information provided here is a general guideline. Always consult your healthcare provider or pharmacist for specific instructions and advice regarding the storage, disposal, and management of indomethacin.