Indomethacin Pharmacology


About Indomethacin
NSAID, Indole derivative, Anti-inflammatory, potent antipyretic and analgesic.
Mechanism of Action of Indomethacin
Indomethacin acts by inhibition of Prostaglandin (PGs) synthesis and their release at the site of injury. Prostaglandins cause tenderness and amplify the action of other algesics. Indomethacin does not affect the tenderness induced by PGs but block the pain producing mechanism induced by inflammatory mediators by inhibiting the enzyme cyclo-oxygenase.
Pharmacokinets of Indomethacin
Absorption: Indomethacin is well absorbed after oral administration. Distribution: It is distributed in protein bound form. Metabolism: Indomethacin is metabolised to inactive metabolites in the liver. Excretion: Drug and metabolites are primarily excreted in urine and some amount in the faeces.
Onset of Action for Indomethacin
Analgesic action: with in 30 minutes and Antirheumatic action with in 1 week
Duration of Action for Indomethacin
6 - 8 hours
Half Life of Indomethacin
2-5 hours
Side Effects of Indomethacin
5.Gastrointestinal bleeding
6.Abdominal distress
8.Peptic ulcer
Contra-indications of Indomethacin
1.Hypersensitivity to Indomethacin and other Non steroidal anti inflammatory drugs(NSAID)
2.Peptic ulcer
3.Severe renal impairment
4.Suppositories in patients with proctitis and hemorrhoids.
Special Precautions while taking Indomethacin
1.Hepatic impairment
2.Renal impairment
3.Cardiovascular diseases
4.Gastrointestinal diseases
7.Psychiatric illness
8.Cautioned against driving, operating or activities requiring concentration
9.Avoid alcohol
Pregnancy Related Information
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Children Related Information
CHILDREN below 14 years: contraindicated
NEONATES: used only to close the patent ductus arteriosus as IV form only
Indications for Indomethacin
1.Rheumatoid arthritis
2.Ankylosing spondylitis
4.Gouty arthritis
6.Painful shoulder
8.Closure of patent ductus arteriosus in premature infants
Interactions for Indomethacin
Anticoagulants: May prolong prothrombin time. Instruct patients to watch for signs & symptoms of bleeding.
Beta-Blockers: Antihypertensive effect may be blunted.
Cyclosporine: Nephrotoxicity of both agents may be increased.
Digoxin: Serum digoxin levels may be increased by ibuprofen and indomethacin.
Hydantoins: Serum hydantoin levels increased resulting in increased pharmacological and toxic effects.
Lithium: Serum lithium levels may be increased.
Loop diuretics: Decreased effects.
Methotrexate: Risk of methotrexate toxicity (bone marrow suppression, nephrotoxicity, stomatitis) may be increased.
Salicylates: Displaces NSAIDs from serum binding sites resulting in decreased plasma concentrations of NSAIDs and increased incidence of GI effects.
Sympathomimetics: Indomethacin coadministration may result in increased blood pressure.
Thiazide diuretics: Naproxen and indomethacin may cause decreased antihypertensive and diuretic action.
Typical Dosage for Indomethacin
Adult: 50 - 200 mg / day in 2 - 4 divided doses.
Rheumatoid arthritis, ankylosing spondylitis and Osteoarthritis: 50 - 75 mg / day in 2 - 3 divided doses with food or antacids. Dose can be gradually increased every week until sufficient response is obtained.
Maximum dose: 200 mg / day
Gouty arthritis: 150 mg / day in 3 divided doses until pain is tolerable. Then reduce the dose and suddenly stop the drug.
Dysmenorrhoea: 75 mg / day in 3 divided doses with food or antacids.
Painful shoulder: 75 -150 mg / day in 3 - 4 divided doses for 1 - 2 week
Migraine: 50mg 3 - 4 times daily

Children: 1 mg / kg / day in divided doses.
Maximum dose: 4 mg / kg / day in divided doses.
Children below 14 years: not recommended

Schedule of Indomethacin
Storage Requirements for Indomethacin
Store Indomethacin at room temperature in a tightly closed light resistant container.
Effects of Missed Dosage of Indomethacin
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.

Effects of Overdose of Indomethacin
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal.

Home Delivery for Indomethacin in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including indomethacin.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for indomethacin and other medicines and health products. Home delivery services for indomethacin may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take indomethacin only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for indomethacin before they complete the sale. You can get this information while placing the order for indomethacin with the pharmacy.

Indomethacin is a generic medicine name and there are several brands available for it. Some of the brands for indomethacin might be better known than indomethacin itself. If the pharmacy that's willing to deliver medicines to your home doesn't have indomethacin in stock, you can ask for one of the branded alternatives for indomethacin.