Moderate to severe rheumatoid arthritis including acute flares of chronic disease. Moderate to severe ankylosing spondylitis. Moderate to severe osteoarthritis.
Indomethacin is NSAID having property of antipyretic and analgesic effect. A great number of pharmacological studies have proved that Indomethacin has strong anti-inflammatory, analgesic, and antipyretic properties. Unlike the corticosteriods, 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 joints swelling edema and improves joint mobility.
ORAL Pain & inflammation associated w/ musculoskeletal & joint disorders: Adult: Initially, 25 mg bid-tid, increased if necessary by 25-50 mg daily at wkly intervals to 150-200 mg daily. Acute gout: Adult: 150-200 mg daily in divided doses until signs & symptoms disappear. Dysmenorrhoea: Adult: 75 mg daily. Night pain & morning stiffness: Adult: Up to 100 mg/day, on retiring. May also be given as rectal suppository. Total combined oral & rectal doses should not exceed 200 mg/day. Juvenile rheumatoid arthritis: Child: 2-14 yr: start w/ 1-2 mg/kg/day in divided doses. Max: 3 mg/kg/day or 150-200 mg/ day, whichever is lower.
It may interact with anticoagulants, Lithium, diuretics, antihypertensive drugs, diflunisal and sulfonylureas.
Active peptic ulcer; pregnancy (3rd trimester), hypersensitivity to aspirin & other NSAIDs; treatment of perioperative pain in CABG surgery; severe renal impairment; rectal admin in patients w/ proctitis & haemorrhoids; neonates w/ necrotizing enterocolitis, active bleeding, thrombocytopenia, coagulation defects & untreated infections. SP: Hypertension; congestive heart failure; fluid retention; epilepsy, parkinsonism, psychiatric disorders; may affect performance of skilled tasks. Prolonged treatment duration may increase risk of CV thrombotic events. Monitor ophthalmologic, blood, electrolytes & renal tunction regularly; lactation.
Gl upsets, headache, dizziness, tinnitus, lightheadedness, depression, insomnia, psychiatric disturbances, peripheral neuropathy, blurred vision, confusion; hyperglycaemia, hyperkalaemia. Renal failure.
PREGNANCY Avoid unless the potential benefit outweighs the risk. Avoid during the third trimester (risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn); onset of labour may be delayed and duration may be increased. BREAST FEEDING Amount probably too small to be harmful?manufacturers advise avoid. Use with caution during breast-feeding.
Store in a cool and dry place protected from light. Keep out of the reach of children.
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