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Indocin (indomethacin) 

Indications

Indocin is a nonsteroidal anti-inflammatory drug indicated for: 

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

Dosage and Administration

• Take Indocin at the lowest effective dose for the shortest possible time. 
• Take Indocin with a full glass of water (8 ounces or 240 milliliters), usually 2 to 3 times a day. 
• Use Indocin as the first signs of pain occur if taken on an “as needed” basis. 
• Continue taking Indocin as directed for ongoing conditions such as arthritis. 
• Do not lie down for at least 10 minutes after taking Indocin. 
• Do not take two doses at one time if a dose is missed. 
• Do not exceed the prescribed dosage. 
• Do not take Indocin if you are allergic to indomethacin or any components of the drug product. 
• Do not take in the setting of CABG surgery. 

Mechanism of Action

Indocin, the active ingredient in Indocin, works by inhibiting the production of prostaglandins, which are substances in the body that play a key role in inflammation, pain, and fever. 

Contraindications

• Known hypersensitivity to indomethacin or any components of the drug product. 
• History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. 
• In the setting of CABG surgery. 

Side Effects of Indocin

Common Side Effects: 

• Indigestion 
• Nausea 
• Dizziness 

Serious Side Effects of Indocin: 

• Signs of stomach bleeding 
• Kidney problems 
• Low red blood cells (anemia) 
• Hearing changes 
• Mental/mood changes 
• Difficult/painful swallowing 
• Symptoms of numbness, pricking, burning, or creeping on the skin 
• Seizures 
• Other serious side effects may include heart attack, stroke, skin changes, weight gain, swelling, shortness of breath, tachycardia, unusual bleeding, jaundice, stomach pain, and pain with urination. 

Precautions

• Hepatotoxicity: Monitor for signs and symptoms of liver damage. 
• Hypertension: Monitor blood pressure. 
• Heart Failure and Edema: Avoid use in patients with severe heart failure unless benefits outweigh risks. 
• Renal Toxicity: Monitor renal function in patients with renal or hepatic impairment. 
• Anaphylactic Reactions: Seek emergency help if an anaphylactic reaction occurs. 
• Exacerbation of Asthma Related to Aspirin Sensitivity: Monitor patients with preexisting asthma. 
• Serious Skin Reactions: Discontinue at first appearance of skin rash or other signs of hypersensitivity. 
• Premature Closure of Fetal Ductus Arteriosus: Avoid use in pregnant women starting at 30 weeks gestation. 
• Hematologic Toxicity: Monitor hemoglobin or hematocrit in patients with any signs or symptoms of anemia. 

Storage Instructions of Indocin

Store Indocin at room temperature 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F). 

References 

Indocin (indomethacin) package insert