- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Oral formulations of indometacin.
Acute musculoskeletal disorders
Chronic rheumatic conditions
Control of pain/inflammation after orthopaedic surgery
25mg two to four times daily (maximum daily dose 200mg).
50mg three to four times daily until symptoms subside.
Up to 75mg daily until symptoms subside.
Relief of pain and inflammation in rheumatic diseases (unlicensed)
0.5mg/kg to 1mg/kg twice daily.
Asthma, urticaria or acute rhinitis associated with NSAIDS
History of gastrointestinal haemorrhage
History of gastrointestinal perforation
History of peptic ulcer
Nasal polyps, angioedema, and bronchospastic reactivity to NSAIDs
Severe cardiac failure
Severe hepatic impairment
Severe renal impairment
Third trimester of pregnancy
Precautions and Warnings
Children under 18 years
Females attempting to conceive
Predisposition to fluid retention
Risk factors for cardiovascular disorder
Connective tissue disorder
First trimester of pregnancy
Glucose-galactose malabsorption syndrome
History of asthma
History of gastrointestinal disorder
Ischaemic heart disease
Peripheral arterial circulatory disorder
Second trimester of pregnancy
Systemic lupus erythematosus
If renal function impaired, reduce dose to lowest to maintain control
May mask symptoms or signs of infections
May precipitate bronchospasm in patients with asthma or allergy
Advise ability to drive/operate machinery may be affected by side effects
Discontinue if signs of gastro-intestinal bleeding occur
During prolonged therapy eye and blood examinations advisable
Elderly: Monitor for gastrointestinal bleeding
May inhibit platelet aggregation - observe for signs of bleeding
Monitor patients on prolonged therapy
Monitor renal function in patients with cardiac impairment
Monitor renal function in patients with hepatic impairment
Discontinue if signs of gastro-intestinal ulceration occur
High dose/long term use may increase risk of arterial thrombotic events
Risk of gastro-intestinal bleeding increased in the elderly
Severe gastro-intestinal side effects may occur without warning
May affect results of some laboratory tests
Discontinue if patient is attempting to conceive
Discontinue treatment if skin rash or other allergic reaction occurs
Maintain treatment at the lowest effective dose
May cause impaired fertility
Advise patient to take after food to reduce gastro-intestinal disturbances
Prostaglandins are important in maintaining renal perfusion. NSAID drugs may precipitate renal failure in patients with renal impairment by reducing prostaglandin formation.
Headache, dizziness and lightheadedness can occur during the initiation of treatment. The symptoms normally disappear when therapy is continued or upon dosing reduction. Discontinue treatment if headache continues despite dosage reduction.
In rheumatoid arthritis patients, eye changes may occur due to the underlying condition or indometacin treatment. Discontinue therapy if eye changes observed.
Pregnancy and Lactation
Indometacin is contraindicated during the 3rd trimester of pregnancy. Use with caution during the 1st and 2nd trimester.
Use of indometacin during the 3rd trimester of pregnancy is contraindicated by the manufacturer. The manufacturer does not recommend using indometacin during the 1st and 2nd trimester.
Animal studies have shown teratogenic effects. Human data is limited, however the effects of NSAIDs in pregnancy pose a potential risk that cannot be ruled out. The risks include premature closure of the ductus arteriosus and delayed and prolonged labour with increasing risk of bleeding. Congenital abnormalities have been reported.
Use indometacin with caution during breastfeeding.
The manufacturer does not recommend breastfeeding whilst taking indometacin.
Available data indicates indometacin is present in human breast milk in very low concentrations.
Effects on exposed infants are unknown.
Aggravation of existing asthma
Altered liver function tests
Blood urea increased
Bone marrow depression
Congestive cardiac failure
Exacerbation of Crohn's disease
Exacerbation of epilepsy
Exacerbation of psoriasis
Gastro-intestinal ulceration and bleeding
Increase in serum ALT/AST
Intravascular coagulation (disseminated)
Involuntary movement disorders
Non-specific allergic reactions
Peptic ulceration with perforation and haemorrhage
Toxic epidermal necrolysis
Effects on Laboratory Tests
False-negative results in the dexamethasone suppression test (DST) in patients being treated with indometacin have been reported. The results of this test should be used with caution in these patients.
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full Review Date: October 2021
Summary of Product Characteristics: Indometacin 25mg capsules. Almus. Revised July 2017
Summary of Product Characteristics: Indometacin 50mg capsules. Almus. Revised July 2017
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 14 October 2021
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.