Indomethacin is indicated in:

• Rheumatoid arthritis
• Ankylosing spondylitis
• Osteoarthritis (degenerative joint disease)
• Gout
• Acute non-articular rheumatism (bursitis, synovitis, tendinitis)

Indomethacin is an NSAID having antipyretic and analgesic effects. A great number of pharmacological studies have proved that Indomethacin has strong anti-inflammatory, analgesic, and antipyretic properties. Unlike corticosteroids, the effect of Indomethacin is not related to the pituitary gland or the adrenals. Indomethacin is absorbed promptly following oral administration, and peak plasma levels occur within 2 hours. Approximately two-thirds of this amount is excreted in the urine, and the remainder is excreted in the feces. About 90% of a single dose is excreted in 24-48 hours. In a number of controlled clinical trials, Indomethacin has proved to be of great value in the treatment of rheumatic diseases. It relieves pain, reduces joint swelling and edema, and improves joint mobility.

75 mg sustained-release capsule:

• Rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis (degenerative joint disease): The initial dose is one 75 mg sustained-release capsule once daily. If severe, then twice daily is required.
• Acute attacks of gout: May be controlled with a dose of one 75 mg sustained-release capsule twice daily.
• Acute non-articular rheumatism (bursitis, synovitis, tendinitis): 1-2 sustained-release capsules daily according to the severity of the condition.

25 mg capsule:

• Rheumatic diseases: 50-200 mg daily in divided doses
• Acute gout: 150-200 mg daily in divided doses
• Dysmenorrhea: up to 75 mg daily

It may interact with anticoagulants, lithium, diuretics, antihypertensive drugs, diflunisal and sulfonylureas.

Indomethacin is contraindicated in patients with ulcer, gastritis, or active ulcerative colitis, and it should be used with caution in patients with a history of these disorders. In these cases, administration of Indomethacin suppositories should be preferred. It is also contraindicated in previously hypersensitive patients.

Headaches, usually in the morning, and mild vertigo may occur during the early weeks of therapy. These symptoms are transient and usually disappear with continued use or by reduction of the dose. Rare cases of mild psychic disturbances have also been reported, which subsided after a few days of treatment. Gastrointestinal reactions such as nausea, vomiting, diarrhea, epigastric and abdominal pain are often due to large doses of the drug and disappear when the dose is reduced. Administration of the capsule immediately after meals with an antacid, if necessary, minimizes the frequency and severity of these untoward effects.

Indomethacin capsules should be used with caution in patients with psychiatric problems, epilepsy or parkinsonism, since the drug may aggravate these conditions. It is not recommended for pregnant women because, at the present time, clinical studies are insufficient. Indomethacin is not normally given to neonates except when used to assist closure of a patent ductus arteriosus.

Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Store in a cool and dry place protected from light. Keep out of the reach of children.