- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Rectal formulation of indometacin.
Acute musculoskeletal disorders
Chronic rheumatic conditions
Control of pain/inflammation after orthopaedic surgery
The dosage should be carefully adjusted according to the needs of the individual patient.
Undesirable effects may be minimised by using the lowest effective dose for the shortest possible duration.
One suppository (100mg) to be inserted at night and repeated in the morning, if necessary.
Children under 18 years
Gastric mucosa lesion
History of gastrointestinal perforation
History of peptic ulcer
History of proctitis
History of rectal bleeding
Nasal polyps, angioedema, and bronchospastic reactivity to NSAIDs
Third trimester of pregnancy
Precautions and Warnings
Females attempting to conceive
Predisposition to fluid retention
First trimester of pregnancy
History of asthma
History of gastrointestinal disorder
Second trimester of pregnancy
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
May inhibit platelet aggregation - observe for signs of bleeding
Monitor for gastrointestinal toxicity
Monitor patients on prolonged therapy
Monitor renal function in patients with cardiac impairment
Monitor renal function in patients with hepatic impairment
Severe gastro-intestinal side effects may occur without warning
May affect results of some laboratory tests
Discontinue if patient is attempting to conceive
Maintain treatment at the lowest effective dose
Female: May cause infertility
Headache can occur in early treatment. Start therapy with a low dosage and gradually increase it to minimise the occurrence of headache. Symptoms will frequently disappear as the therapy progresses or during the reduction of dosage. Withdraw indometacin if headache persists despite dosage reduction.
Renal prostaglandins are important in maintaining renal perfusion in patients with reduced renal blood flow therefore non-steroidal anti-inflammatory drugs may precipitate overt renal decompensation on administration.
Eye changes may occur in patients with rheumatoid arthritis which may be related to the underlying condition or due to indometacin therapy. The manufacturer recommends regular ophthalmological examinations and discontinue therapy if eye changes detected.
Pregnancy and Lactation
Indometacin is contraindicated during the 3rd trimester of pregnancy but may be used with caution during the 1st and 2nd trimester.
The manufacturer advises that indometacin should not be given unless clearly necessary during the 1st and 2nd trimester of pregnancy. The dose should be kept as low and duration of treatment as short as possible. Use of indometacin during the 3rd trimester of pregnancy is contraindicated by the manufacturer.
Animal studies have shown reproductive toxicity.
Data from epidemiological studies suggest an increased risk of miscarriage and of cardiac malformation and gastroschisis after use of a prostaglandin synthesis inhibitor in early pregnancy.
Indometacin is contraindicated during breastfeeding.
The manufacturer does not recommend breastfeeding whilst taking indometacin.
Indometacin is present in human breast milk.
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 epilepsy
Gastro-intestinal ulceration and bleeding
Increase in serum ALT/AST
Inhibition of ovulation (reversible)
Intravascular coagulation (disseminated)
Involuntary movement disorders
Non-specific allergic reactions
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: Indocid Suppositories 100mg. Aspen. Revised December 2020.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 13 October 2021
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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