Indomethacin

💊 What is Indomethacin used for?

• •Moderate to severe rheumatoid arthritis, including acute flares of the disease
• •Moderate to severe ankylosing spondylitis
• •Moderate to severe osteoarthritis
• •Acute painful shoulder (bursitis and/or tendinitis)
• •Acute gouty arthritis

How it works

The label describes indomethacin as a nonsteroidal anti-inflammatory drug. It is used to treat pain and the redness, swelling and heat (inflammation) caused by conditions such as arthritis. The label does not describe the exact mechanism in the text provided.

How it is usually taken

• •Indomethacin is taken by mouth as a capsule. The label says to use the lowest effective dose for the shortest time that fits the person's treatment goals. The dose and how often it is taken are adjusted by the prescriber based on how the person responds. The label says that side effects generally become more likely as the dose goes up. Follow the instructions from your prescriber or pharmacist.

Comes as

• •25 mg capsules: opaque green hard capsules with white to off-white powder inside
• •50 mg capsules: opaque green hard capsules with white to off-white powder inside

⚠️ Indomethacin side effects

🛑 Who should not take Indomethacin, and who should be careful

The label says not to take it if

• 🚨You have had an asthma attack, hives, or another allergic reaction after taking aspirin or any other NSAID.
• 🚨You have a known allergy to indomethacin or any ingredient in the capsule.
• 🚨You are having heart bypass surgery (CABG), either right before or right after it.
• 🚨You are at about 30 weeks of pregnancy or later. The label says you should not take NSAIDs after 30 weeks of pregnancy.
• 🚨You have had a recent heart attack. The label says to avoid NSAIDs in this case unless your healthcare provider tells you to take them.

Tell your doctor before taking it if

• •Tell your healthcare provider about all your medical conditions, including liver or kidney problems, high blood pressure, asthma, and heart problems.
• •Tell your provider if you are pregnant or plan to become pregnant, or if you are breastfeeding or plan to breastfeed.
• •Tell your provider about a history of stomach ulcers, stomach or intestinal bleeding, or bleeding problems.
• •Tell your provider about all medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
• •The label says the risk of ulcers and bleeding is higher with older age, poor health, smoking, advanced liver disease, drinking alcohol, and use of corticosteroids, anticoagulants, SSRIs or SNRIs.
• •The label says NSAIDs should be used exactly as prescribed, at the lowest dose possible, for the shortest time needed.
• •The label says that after a recent heart attack, NSAIDs should be avoided unless the healthcare provider says otherwise.

🔀 Indomethacin with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Anticoagulants such as warfarin: the label says indomethacin and anticoagulants together increase the risk of serious bleeding.
• •Antiplatelet drugs such as aspirin, and SSRIs or SNRIs: these can increase bleeding risk when used with indomethacin.
• •Aspirin for pain: the label says using indomethacin with analgesic doses of aspirin is not generally recommended because of increased bleeding risk. The label also says indomethacin is not a substitute for low-dose aspirin for heart protection.
• •ACE inhibitors, angiotensin receptor blockers (ARBs) and beta-blockers: NSAIDs may reduce how well these blood pressure medicines work. In some people, including those who are older, dehydrated, on diuretics or have kidney problems, kidney function may worsen.
• •Corticosteroids: the label lists these as increasing the risk of ulcers and bleeding when taken with NSAIDs.

Alcohol and food

The label text provided does not say whether to take indomethacin with food. The label lists drinking alcohol as a factor that increases the risk of ulcers and stomach bleeding.

🤰 Indomethacin in pregnancy and breastfeeding

Pregnancy

The label says NSAIDs, including indomethacin, can cause early closure of the baby's ductus arteriosus and kidney problems in the baby that can lead to low amniotic fluid. The label says to limit use between about 20 and 30 weeks of pregnancy and to avoid use at about 30 weeks and later. Tell your healthcare provider if you are or may become pregnant.

Breastfeeding

The label text provided does not give specific guidance on breastfeeding. It lists breastfeeding as a reason to tell your healthcare provider before taking the medicine.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20°C to 25°C (68°F to 77°F) and to protect the capsules from light.

If a dose is missed

The label does not say.

If too much is taken

The label says symptoms of an NSAID overdose are typically lethargy, drowsiness, nausea, vomiting and stomach pain, which are generally reversible with supportive care. Stomach bleeding has occurred. Less often, high blood pressure, acute kidney failure, slowed breathing and coma have occurred. There are no specific antidotes. If you take too much, call your healthcare provider or get medical help right away.

🗒️ Questions to ask about Indomethacin

• Is my heart or stroke risk higher because of my health history, and is this medicine a good fit for me?
• How long do I need to take this medicine, and when should I check in about whether it is still needed?
• Should I take this with food or alcohol, and what should I avoid while taking it?
• Which of my current medicines, including over-the-counter pain relievers and supplements, could interact with indomethacin?
• What warning signs of stomach bleeding or allergic reaction should I watch for, and who should I call?
• If I am pregnant or planning a pregnancy, what should I know about this medicine?

❓ Indomethacin: frequently asked questions