Uses of Indomethacin SR: - Pain relief Rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis (degenerative joint disease), gout, acute non-articular rheumatism (bursitis, synovitis, tendinitis). Indomethacin SR is contraindicated in patients with ulcer, gastritis, active ulcerative colitis, and should be used with caution in patients with a history of these disorders. It is also contraindicated in previously hypersensitive patient.

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

Indomethacin is a non-steroidal anti-inflammatory drug (NSAID) having properties of antipyretic and analgesic effects. A great number of pharmacological studies have proved that Indomethacin has strong anti-inflammatory, analgesic and antipyretic properties. Unlike the corticosteroids, the effect of Indomethacin is not related to the pituitary gland or the adrenals.

How to use Indomethacin: Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Indomethacin is to be taken with food. Administration: Take with food to avoid gastrointestinal (GI) effects Adult Dose: Oral Inflammatory/Rheumatoid Disorders Immediate release: 25-50 mg PO q8-12hr; not to exceed 200 mg/day Extended release: 75-150 mg/day PO in single daily dose or divided q12hr; not to exceed 150 mg/day Bursitis/Tendinitis Immediate-release: 75-150 mg/day PO divided q6-8hr Extended-release: 75-150 mg/day PO in single daily dose or divided q12hr Acute Gouty Arthritis 50 mg PO q8hr for 3-5 days; reduced once pain is under control Rectal Pain and inflammation associated with musculoskeletal and joint disorders Adult: As supp: 100 mg to be inserted at night and repeated in the morning if necessary. Child Dose: Inflammatory/Rheumatoid Disorders <2 years: Safety and efficacy not established 2-14 years: 1-2 mg/kg/day PO divided q6-12hr; not to exceed 4 mg/kg/day or 150-200 mg/day >14 years: 25-50 mg IR PO q8-12hr; not to exceed 200 mg/day; 75-150 mg/day ER PO in single daily dose or divided q12hr; not to exceed 150 mg/day

May increase plasma levels of methotrexate. Increased risk of GI bleeding w/ warfarin. May reduce hypotensive effects of hydralazine, furosemide, ?-blockers (e.g. atenolol, propranolol, oxprenolol), or thiazide diuretics. Increased risk of hyperkalaemia w/ K-sparing diuretics, ACE inhibitors, K supplements. May increase nephrotoxic effects of ciclosporin or triamterene. Increase plasma concentration w/ probenecid. May increase plasma levels of aminoglycoside (e.g. amikacin, gentamicin) in premature neonates. May enhance antipsychotic effect (e.g. severe drowsiness and confusion) of haloperidol. Al- or Mg-containing antacids may reduce GI disorders of indometacin. Potentially Fatal: Diflunisal decreases renal clearance and increases plasma concentrations of indometacin which leads to fatal GI haemorrhage.

Indomethacin is contraindicated in patients with ulcer, gastritis, active ulcerative colitis, and should be used with caution in patients with a history of these disorders. It is also contraindicated in previously hypersensitive patient.

Common - Vomiting - Stomach pain/epigastric pain - Nausea - Indigestion - Diarrhea - Heartburn - Loss of appetite >10% Transient renal insufficiency (40%),Jaundice (<15%),Elevated liver function test values (≤15%),Headache (12%) 1-10% Dizziness (3-9%),Dyspepsia (3-9%),Epigastric pain (3-9%),Indigestion (3-9%),Nausea (3-9%) Symptomatic upper GI ulcers, gross bleeding/perforation (4% of patients treated for 1 year; 1% of patients treated for 3-6 months). Abnormal pain/cramps/distress (<3%),Constipation (1-3%),Depression (1-3%),Diarrhea (1-3%),Fatigue (1-3%),Somnolence (1-3%),Tinnitus (1-3%),Vertigo (1-3%) <1% Acute interstitial nephritis with hematuria/proteinuria,Acute respiratory distress,Agranulocytosis,Angioedema,Aplastic anemia,Asthma,Bone marrow depression,Congestive heart failure (CHF),Hemolytic anemia,Leukopenia,Macular and morbilliform eruptions,Pulmonary edema,Thrombocytopenia,Thrombocytopenic purpura,Ulcerative stomatitis,Urticaria

Use in pregnancy: Not recommended for pregnant women, because at the present time clinical studies are insufficient. Use in children: Not recommended for children.

Precaution: Patient w/ known CV disease or risk factors for CV disease, fluid retention, history of GI disease (e.g. bleeding or ulcers), history of mental depression or other psychiatric disorder, epilepsy, or parkinsonian syndrome; existing infection that is adequately controlled. May mask signs and symptoms of infection. Hepatic and renal impairment. Elderly, childn. Pregnancy and lactation. Lactation: Drug enters breast milk; use not recommended (American Academy of Pediatrics committee states that drug is compatible with nursing)

Should be stored in cool and dry place

Indometacin, an indole acetic acid derivative has anti-inflammatory, analgesic and antipyretic actions. It reversibly inhibits cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, thus resulting in reduced synthesis of prostaglandin precursors.