Indomethacin
About
Indomethacin belongs to the group of pain killers known as NSAID's (Non-Steroidal Anti-Inflammatory Drugs) used to relieve symptoms caused by osteoarthritis, ankylosing spondylitis, and rheumatoid arthritis such as stiffness, swelling and joint pain. Indomethacin is also used to treat acute gouty arthritis, musculoskeletal pain, lower back pain, period pain, pain following joint and bone surgery.
Indomethacin works by blocking the effect of a chemical messenger in your body, known as cyclo-oxygenase (COX) enzymes that make another chemical 'prostaglandins' (PG). These prostaglandins are produced at injury sites and cause pain and swelling. By blocking the effect of COX enzymes, lesser PGs are produced, which reduces mild to moderate pain and inflammation at the injured or damaged site.
You are advised to take Indomethacin for as long as your doctor has prescribed it for you depending on your medical condition. In some cases, you may experience certain common side-effects such as headache, dizziness, diarrhoea, vomiting, and constipation. Most of these side-effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side-effects persistently.
Indomethacin can increase your risk of fatal heart attack or stroke. So, if you have had any recent heart surgery, do not use Indomethacin. Indomethacin increases the chances of stomach ulcers and bleeding. To treat your condition effectually, continue taking Indomethacin for as long as your doctor has prescribed. To avoid recurring symptoms, do not stop it midway. Do not take Indomethacin if you are pregnant or breastfeeding unless prescribed. Indomethacin causes drowsiness and dizziness, so drive with caution. Indomethacin should not be given to children as safety and efficacy have not been established. Avoid consuming alcohol along with Indomethacin as it could lead to increased drowsiness and dizziness; it might also increase the risk of stomach bleeding. Keep your doctor informed about your health condition and medicines to rule out any side-effects.
Uses of Indomethacin
Medicinal Benefits
Indomethacin belongs to the group of pain killers known as NSAID's (Non-Steroidal Anti-Inflammatory Drugs). Indomethacin is used to relieve symptoms caused by osteoarthritis, ankylosing spondylitis, and rheumatoid arthritis such as stiffness, swelling and joint pain. Indomethacin is also used to treat acute gouty arthritis, musculoskeletal pain, lower back pain, period pain, pain following joint and bone surgery. Indomethacin works by blocking the effect of a chemical messenger in your body, known as cyclo-oxygenase (COX) enzymes that make another chemical 'prostaglandins' (PG). These prostaglandins are produced at injury sites and cause pain and swelling. By blocking the effect of COX enzymes, lesser PGs are produced, which reduces mild to moderate pain and inflammation at the injured or damaged site.
Directions for Use
Storage
Side Effects of Indomethacin
- Headache,
- Dizziness
- Diarrhoea
- Vomiting
- Constipation
In-Depth Precautions and Warning
Drug Warnings
Indomethacin can increase your risk of having a fatal heart attack, chest pain (angina) or stroke. So, tell your doctor that you are using Indomethacin before undergoing heart bypass surgery (CABG) or graft surgery. Do not take Indomethacin if you are allergic to Indomethacin, have severe heart failure, have suffered bleeding problems such as bleeding from stomach or bowels while taking any pain killers or you have liver or kidney problems. Do not take Indomethacin if you are pregnant or breastfeeding unless prescribed. Indomethacin causes drowsiness and dizziness, so drive only if you are alert. Indomethacin should not be given to children as the safety have not been established. Avoid consuming alcohol along with Indomethacin as it could lead to increased drowsiness and can increase the risk of stomach bleeding. Stop taking Indomethacin and consult your doctor immediately if you have stomach pain or any signs of bleeding in intestine or stomach like blood in stools.
Drug Interactions
Drug-Drug Interactions: Indomethacin may have interaction with ibuprofen, naproxen, and aspirin (used to relieve pain), duloxetine (used to treat depression), metoprolol (used to treat high blood pressure), celecoxib, and prednisone (used to treat arthritis).
Drug-Food Interactions: Avoid consuming alcohol along with Indomethacin as it could lead to increased drowsiness and dizziness. It could also elevate the risk of stomach bleeding.
Drug-Disease Interactions: Indomethacin should not be given in patients with heart failure, fluid retention (oedema), asthma, gastrointestinal toxicity, high blood pressure, hyperkalemia (high levels of potassium), thrombosis (formation of clots), anaemia (low red blood cells), rash, platelet aggregation inhibition, CNS problems, kidney and liver toxicity.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou are recommended to avoid alcohol consumption while taking Indomethacin. Alcohol intake, along with Indomethacin, may cause increased dizziness and drowsiness. It may also elevate the risk of stomach bleeding.
Pregnancy
unsafeIt is not recommended to take Indomethacin while you are pregnant. Please consult your doctor if you are pregnant or if you are having any concerns regarding this.
Breast Feeding
unsafeIt is not recommended to take Indomethacin while you are breastfeeding. Please consult your doctor if you are breastfeeding or if you are having any concerns regarding this.
Driving
cautionIndomethacin may cause drowsiness, dizziness, tiredness and vision disturbances, do not drive or operate heavy machinery if you feel dizzy.
Liver
cautionDose adjustment may be needed. Indomethacin should be taken with caution in patients with liver impairment/liver disease. Please consult your doctor if you have liver problems with symptoms of yellowing of skin/eyes, difficulty in peeing or feeling exhausted all the time.
Kidney
cautionDose adjustment may be needed. Indomethacin should be taken with caution in patients with kidney impairment/kidney disease. Please consult your doctor if you have kidney impairment or any concerns regarding this.
Children
unsafeIndomethacin should not be used by children, as the efficacy and safety have not been established.
Habit Forming
Diet & Lifestyle Advise
- Physical activity helps in strengthening muscles and relieves joint stiffness. Gentle activities like 20-30minutes of walking or swimming would be helpful.
- Performing yoga may also help in improving joint flexibility and pain management.
- Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
- Get adequate sleep as resting the muscles can help in reducing inflammation and swelling.
- Follow heat or cold therapy, apply a cold or hot compress on the joints for 15-20minutes regularly.
- De-stress yourself by meditating, reading books, taking a warm bubble bath or listen to soothing music.
- Acupuncture, massage and physical therapy may also be helpful.
- Eat food rich in antioxidants such as berries, spinach, kidney beans, dark chocolate, etc.
- Foods containing flavonoids help in reducing inflammation. These include soy, berries, broccoli, grapes and green tea.
- Avoid smoking and alcohol consumption.
Special Advise
- Your doctor may advise you to undergo tests for monitoring liver and kidney functioning, blood cell levels, effect on stomach and intestine.
- Regular monitoring of eye-sight via eye tests is advised if you have rheumatoid arthritis.
- Monitoring of blood pressure levels and heart functioning is recommended.
Patients Concern
Disease/Condition Glossary
Osteoarthritis: It is a degenerative joint disease in which the two ends of the joints come together due to breakdown of a protective covering of cartilage. Due to the absence of this protective covering, the joints rub against each other, leading to pain and stiffness. Symptoms of osteoarthritis include pain, inflammation, stiffness, and tenderness. The main reason for osteoarthritis is age, the older you are, the more likely you could get osteoarthritis, thus known as degenerative disease, meaning that the joints wear-out as a person ages. Other reasons include a past injury such as torn cartilage, dislocated joints and ligament injuries.
Rheumatoid arthritis: It is an auto-immune disease (body's immune system attacks its tissue) which leads to joint pain and damage. Symptoms of rheumatoid arthritis include stiffness, pain, swelling, deformities and loss of joint function.
Ankylosing spondylitis: It causes pain and stiffness in the spine, which starts in the lower back and can spread to the neck, damaged joints or other parts of the body. Symptoms of ankylosing spondylitis include decreased flexibility which usually leads to hunched-forward posture, pain and back and joints.
FAQs
Indomethacin works by blocking the effect of chemical messengers (prostaglandin), thereby helps in reducing joint pain, stiffness, swelling and inflammation.
Indomethacin causes drowsiness, dizziness, tiredness and vision disturbances. So, drive only if you are alert and omit driving or operating machinery if you feel dizzy or drowsy.
Diarrhoea might be a side-effect of Indomethacin. Drink lots of fluids and eat food rich in fibre if you experience diarrhoea. If you find blood in stools (tarry stools) or if you experience excess diarrhoea consult your doctor. Do not take anti-diarrheal medicine on your own.
Do not take Indomethacin for longer durations or high doses as it may cause a heart attack or stroke. Do not exceed the dose and duration prescribed by your doctor.
Indomethacin may increase the risk of heart attack or stroke. Do not use Indomethacin immediately before or after heart surgery. Consult your doctor before taking Indomethacin if you have/ had heart problems.
Avoid or limit consumption of alcohol with Indomethacin as it increases the chances of stomach ulcers and bleeding.
Indomethacin may affect laboratory test results. Inform the person doing the tests that you are taking Indomethacin.
Indomethacin may affect fertility. However, the effect is reversible on stopping Indomethacin. Consult your doctor before taking Indomethacin if you are planning to become pregnant. It is important not to become pregnant while using Indomethacin and for at least 1 month after stopping Indomethacin as it can cause harm to the unborn baby or fetus. Women can be given a reminder card from the doctor about this.
The common side effects of Indomethacin include skin becoming more sensitive to sunlight, dry eyes, dry throat, dry nose and nosebleeds, headaches and general aches and pains. Besides this, in the rare case, it can cause depression and even make people feel suicidal.
