Indomethacin (Oral)

Overview

Indomethacin is a nonsteroidal anti-inflammatory drug that is used to treat both mild and moderate acute pain and relieve the symptoms of gout and specific types of arthritis (rheumatoid and arthritis), such as swelling, inflammation, stiffness and joint pain. However, this medication doesn't cure arthritis and it will only help you for as long as you're taking the medication.

Indomethacin is also used in the treatment of ankylosing spondylitis, which is a type of arthritis that affects the spine and its joints. This medication can also be used to treat painful shoulder caused by tendinitis or bursitis.

You cannot obtain this medication on your own. It can only be obtained by prescription from your doctor. This product is available in the following dosage forms.

  • Suspension

Conditions treated

  • Rheumatic Disease causing Pain & Stiffness in Backbone

Type of medicine

  • Oral medication

Side effects

Along with the intended effects of this medication, it can produce some unwanted side effects. Not all of these may be present, but if they are, you may need to seek medical attention.

Inform your doctor or healthcare professional right away if you suffer from any of the following side effects whilst taking this drug.

Less common

  • Acid or sour stomach

Rare

  • Crawling, burning, itching, numbness, prickling, "pins and needles", or tingling feelings

Seek emergency help right away if you suffer from any of the signs of overdose:

Symptoms of overdose

  • Confusion about identity, place, and time

Some side effects that occur that occur don't typically require medical attention as they aren't serious. You usually find that these side effects begin to disappear as your body begins adjusting to the medication. However, if you are finding these side effects bothersome, you can seek advice from your pharmacist or doctor on ways to reduce or prevent these side effects. Seek advice from your doctor or healthcare professional if any of the following side effects are lingering or bothersome.

More common

  • A mild headache

Less common

  • Continuing buzzing or ringing or other unexplained noise in the ears

Rare

  • Anxiety

You may suffer from other side effects that are not listed above. If you notice anything unusual seek advice from your doctor. Remember you can report side effects to the FDA.

Dosage

The final dose of this medication will be different for different patients. Your final dose will depend on a variety of factors. Your doctor will consider your weight, height, and age, any other medical conditions you suffer from alongside any corresponding medications you take for treatment. They will also take into account the strength of the medication, the number of doses you are required to take each day, the specific condition you are being treated for and how you react to the first dose. Do not change your doses without consultation with a doctor or healthcare professional and do not share your medication with anyone else.

The following dosing recommendations are guidelines. Do not be alarmed if your dosing schedule is different.

For oral dosage forms (suspension or capsules) for acute gouty arthritis:

Adults: 50 milligrams three times daily. Your doctor may decrease your dose as necessary.

Children 15 and older: The dose is based on body weight and will be determined by your healthcare professional or doctor.

Children younger than 14 years old: The dose and specific use will be determined by your doctor.

For acute painful shoulder (tendinitis or bursitis):

Adults: 75 to 150 milligrams daily, divided into three or four equal doses, and taken for one to two weeks as determined by your doctor.

Children 15 years old and older: The final dose is dependent on body weight and will be determined by your doctor.

Children younger than 14 years of age: The dose and specific use will be determined by a doctor.

For mild to moderate acute pain:

Adults: 20 milligrams three times daily, or 40 mg two or three times daily.

Children: The final use and dose will be determined by your doctor.

For moderate to severe osteoarthritis, ankylosing spondylitis or rheumatoid arthritis:

Adults: 25milligrams two to three times daily. Your doctor may increase your dose by 25 or 50 mg each day, as required. However, typically, the total dose does not exceed more than 200 mg each day.

Children 15 years old and older: The final dose is based on body weight and will, therefore, be determined by your doctor.

Children younger than 14 years old: The final dose and use will be determined by your doctor.

Missed Dose

If you find you have missed a dose of this medication, you should take it as soon as you remember. The exception is, if its close to your next scheduled dose, then skip the dose you have missed and returned to your normal dosing schedule. Don't double your doses to make up for a missed dose.

Proper use

For effective and safe use of this medication, you should not take more of it than directed from your doctor, or take it more frequently or for a longer duration of time. If you take too much of this medication, you could increase your risk of severe side effects. Alternatively, if you take too little, it may reduce your treatment.

This medication will come with a Medication Guide. You should follow and read these instructions and if you have any concerns or questions, then contact your doctor or healthcare professional for advice.

When used for continuing or severe arthritis, this medication must be taken regularly as ordered by your healthcare professional or doctor in order for it to effectively help your treatment and condition. This medication usually begins to work within one week of consumption, but in severe cases, up to 2 weeks or even longer may pass before you start feeling improvements. Also, it may take several weeks before you feel the full effects of this medication.

Swallow this capsule whole. Don't crush, open, break or chew it.

Ensure you shake the oral suspension well before you use it each time. Measure the medication with an oral syringe, marked measuring spoon or medicine cup. Don't use the average household teaspoon as it may not hold the required amount of liquid.

It is best to take this medication alongside the consumption of food.

You should check with your doctor before you switch to a different form of dosage (eg, suspension, capsules.) These different forms are different from each other so may required different dosing schedules.

Interactions

Interactions can occur with this medication which could lead to severe side effects or reduce the effectiveness of either drug. To help limit the risk of interactions you should give your doctor a full list of all medications you are currently taking any medications you have taken in the past. This should include all prescription, non-prescription drugs, vitamin supplements and herbal products. You should also make your doctor aware of any other medical conditions you suffer from as these too can increase your risk of interactions.

The use of this medication is not recommended with any of the following drugs. Your doctor may decide to avoid treating you with this medication altogether or alter some of the other medications you are taking.

  • Ketorolac

The use of this medication alongside any of the following medications is not typically recommended. However, in some cases, it may be necessary. If you are given both medications together, your doctor may alter the dose or frequency of either medication.

  • Dalteparin

The use of this medication with any of the following medications can increase your risk of some side effects, however, in some cases, this may be the best treatment for you. If you are prescribed both medications together your doctor may alter the dose or frequency in which you use either medication.

  • Benazepril

This list is not exclusive, so it's important that you inform your doctor or healthcare professional of all medications you are taking.

Other Medical Problems

The presence of other medical conditions can affect the use of this medication. Ensure you inform your doctor or healthcare professional about any other medical conditions you may suffer from including:

  • Bleeding problems

Warnings

Before you commit to taking any medication, you need to consider a number of different factors to determine how your body will react to it and that it is safe for you to take. Some of these precautions are listed below.

Allergies

Let your doctor know if you have ever suffered from an allergic or unusual reaction to this medication or similar medications. You should also let your doctor or healthcare professional know about any other allergies including to animals, dyes, preservatives or foods.

Pediatric population

Appropriate studies have not been conducted on the relationship of age to the effects of indomethacin capsules, suppositories and, suspension in children younger than fourteen years old. Therefore efficacy and safety have not yet been established.

Appropriate studies have not been conducted on the relationship of age to the effects of Tivorbex® capsules in the younger population. Therefore efficacy and safety have not yet been established.

Geriatric population

Appropriate studies conducted to date have not indicated a geriatric-specific problem that could limit the effectiveness of indomethacin in the older population. However, older patients may be more sensitive to the effects of indomethacin than younger adults and could be more likely to suffer from unwanted side effects (eg, psychosis and confusion) and stomach/kidney related problems, which requires adjustments in dosage and caution to be exercised.

Pregnancy and breastfeeding

The use of this drug is different for different stages of pregnancy.

1st Trimester: This is under FDA pregnancy category C
2nd Trimester: This is under FDA pregnancy category C.
3rd Trimester: This is under FDA pregnancy category D

Taking Indocin during the last three months of pregnancy can harm the unborn child. You should tell your doctor if you are currently pregnant or intend on becoming pregnant whilst using this medication. This drug can pass into breast milk and could harm a nursing child. You should avoid breastfeeding whilst using medication.

It's extremely important that your doctor monitors your progress at a regular appointment. This will help your doctor to check if this medication is working as it should do and determine whether you should continue taking it. They can also monitor for unwanted side effects via blood and urine tests.

Your doctor may recommend you monitor your blood pressure while using this medication.

This medication can raise your risk of having a stroke or heart attack. This is more likely to occur in those who already suffer from heart disease. People who use this medication for long periods of time are also at higher risk. You should check with your doctor right away if you suffer from any of the following symptoms:

  • Trouble speaking or breathing

This medication could cause bleeding in your intestines or stomach. These problems can occur without warning signs. This is more likely if you have previously suffered from a stomach ulcer, you drink alcohol or smoke regularly, are in poor health, are over sixty years of age, or you are using certain other medications (eg, a blood thinner or steroid medicine).

Seek medical attention from a doctor immediately if you have any symptoms of liver problems including:

  • Pale stools or dark-colored urine

Serious skin reactions may occur during treatment with this medication. Consult with your doctor immediately if you suffer from any of the following signs whilst taking this medication.

  • Unusual weakness or tiredness

Possible warning signs of some serious side effects that can occur during treatment with this medication can include:

  • Skin rash

Also, symptoms of a serious heart problem may occur such as:

  • Slurring of the speech

Seek medical attention right away if you experience any of these signs.

This medication can also cause a serious type of allergic reaction known as anaphylaxis. Despite this being a rare reaction, it can occur more in patients who have an allergy to any other NSAIDs (nonsteroidal anti-inflammatory drugs) or to aspirin. This condition is intentionally life-threatening and requires urgent medical attention. The most serious signs of this are listed below:

  • Very fast but irregular pulse or heartbeat

If you notice any of these signs, seek urgent medical attention.

The use of this medication during the last trimester of a pregnancy can harm your unborn infant. If you think you have fallen pregnant whilst using this medication, you should inform your doctor immediately.

This medication can cause a delay in ovulation for women and can affect their ability to conceive children. You should speak with your doctor before using this medication if you plan to have children.

Check with your doctor right away if difficulty in reading, blurred vision or any other change in vision occurs during or after you have received this drug. Your doctor may request you to see an eye doctor for eye tests.

This medication can cause some people to feel lightheaded, drowsy, experience dizziness or feel less alert in general than they normally are. Even if you take this drug at bedtime, it can cause some people to feel less alert or drowsy when they wake up. Ensure you know how this medication reacts with your body before you use machinery, drive or do any other activities that require you to be alert.

Before you have any kind of medical tests or surgery, you should let your doctor know you are taking this medication. You may need to halt your treatment for a short time or switch to a different type of NSAID before your procedure.

Storage

This medication should be stored in a closed container and kept away from moisture, light and heat at room temperature. You should prevent this medication from freezing. Keep this medication out of the reach of children. Don't keep medication that has passed its expiry date or you no longer require. You should seek advice from your local pharmacist on the best way to dispose of medication you no longer require.

Summary

When used as directed, this Indomethacin is successful in the treatment of a variety of different strands of arthritis among other uses. However, due to a large number of interactions possible with this drug, it is vital that you let your doctor or healthcare professional know about all the current medications you are taking. This drug can produce some serious side effects, you should seek medical advice right away if you notice anything unusual.

You should let your doctor know if you are pregnant or intend to becoming pregnant whilst using this medication. This drug cannot be used in the third trimester of pregnancy as it could bring harm to an unborn child. You should also avoid breastfeeding whilst using this medication. Do not change your dose of this medication without consulting with your doctor. This drug does not cure arthritis. If you require any further information about the practical uses of Indomethacin, or you have further questions, then get in touch with your local healthcare professional or doctor for advice.