Indomethacin - instructions for use, reviews, analogs and formulations (candles 50 mg and 100 mg Sopharma, tablets and capsules 25 mg and 50 mg, 5% gel, 10% ointment) for the treatment of inflammation in adults, children and pregnancy
In this article, you can read the instructions for using the drug Indomethacin. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Indomethacin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of indomethacin in the presence of existing structural analogues. Use to treat inflammation in rheumatology and gynecology in adults, children,as well as during pregnancy and lactation.
Indomethacin - Non-steroidal anti-inflammatory agent, indoleacetic acid derivative. Has anti-inflammatory, analgesic and antipyretic effect. The mechanism of action is associated with inhibition of the enzyme COX, which leads to inhibition of the synthesis of prostaglandins from arachidonic acid.
Suppresses the aggregation of platelets.
When administered orally and parenterally contributes to the weakening of the pain syndrome, especially joint pain at rest and during movement, a decrease in morning stiffness and swelling of the joints, an increase in the volume of movements. The anti-inflammatory effect develops by the end of the first week of treatment.
With topical application removes pain, reduces swelling and erythema.
With external application, in addition, helps reduce morning stiffness, increase the volume of movements.
Pharmacokinetics
After ingestion indomethacin is rapidly absorbed from the digestive tract. Metabolised in the liver. Undergoes intestinal-hepatic recirculation. It is excreted in urine - 60% in the form of unchanged substance and metabolites, and with feces - 33% mainly in the form of metabolites.
Indications
For systemic use:
- articular syndrome (incl.Rheumatoid arthritis, arthrosis or osteoarthritis, ankylosing spondylitis, gout);
- pain in the spine;
- neuralgia;
- myalgia;
- traumatic inflammation of soft tissues and joints;
- rheumatism;
- diffuse connective tissue diseases;
- dysmenorrhea.
As an auxiliary agent for infectious and inflammatory diseases of the ENT organs, adnexitis, prostatitis, cystitis.
For topical application:
- prevention of inflammation in surgical interventions for cataracts and in the anterior segment of the eye;
- inhibition of miosis during surgery.
For external use:
- articular syndrome (including rheumatoid arthritis, arthrosis or osteoarthritis, ankylosing spondylitis, gout);
- pain in the spine;
- neuralgia;
- myalgia;
- traumatic inflammation of soft tissues and joints.
Forms of release
Candles for rectal administration 50 mg and 100 mg.
Tablets, coated with a shell, soluble in the intestine 25 mg.
Capsules 25 mg and 50 mg.
Ointment for external use 10%.
Gel for external use 5%.
Instructions for use and dosing regimen
Established individually taking into account the severity of the course of the disease. For adults with oral administration, the initial dose is 25 mg 2-3 times a day.If the clinical effect is inadequate, the dose is increased to 50 mg 3 times a day. Medicinal forms of prolonged action are applied 1-2 times a day. The maximum daily dose: 200 mg.
When the effect is achieved, treatment is continued for 4 weeks at the same or reduced dose. With prolonged use, the daily dose should not exceed 75 mg. Take after meals.
For the treatment of acute conditions or relief of an exacerbation of a chronic process, intramuscularly administered 60 mg 1-2 times a day. The duration of the IM is 7-14 days. Indomethacin is then administered orally or rectally at 50-100 mg twice a day, with the maximum daily dose not exceeding 200 mg. For maintenance treatment, rectally apply 50-100 mg once a day at night.
For topical application in ophthalmology dose, the frequency and duration of application are determined individually.
External apply 2 times a day.
Side effect
- nausea, vomiting;
- anorexia;
- pain and discomfort in the abdomen;
- constipation or diarrhea;
- erosive and ulcerative lesions;
- bleeding and perforation of the gastrointestinal tract;
- intestinal stricture;
- stomatitis;
- flatulence;
- bleeding from the sigmoid colon or from the diverticulum;
- dizziness;
- headache;
- depression;
- feeling tired;
- anxiety;
- fainting;
- drowsiness;
- convulsions;
- peripheral neuropathy;
- muscle weakness;
- involuntary muscular movements;
- sleep disorders;
- mental disorders (depersonalization, psychotic episodes);
- paresthesia;
- edema;
- increased blood pressure;
- tachycardia;
- pain in the chest;
- arrhythmia;
- arterial hypotension;
- congestive heart failure;
- itching;
- hives;
- erythema nodosum;
- skin rash;
- hair loss;
- a sharp drop in blood pressure;
- anaphylactic reactions;
- angioedema;
- pulmonary edema;
- leukopenia;
- DIC syndrome;
- hearing impairment;
- deafness;
- interstitial nephritis;
- impaired renal function;
- hyperglycemia;
- glucosuria;
- vaginal bleeding;
- tides;
- increased sweating;
- nose bleed;
- increase and tension of mammary glands;
- gynecomastia;
- the formation of an infiltrate, an abscess (with local and intramuscular injection);
- itching, redness, rash at the place of application.
Contraindications
- increased sensitivity to indomethacin;
- erosive and ulcerative lesions of the gastrointestinal tract in the phase of exacerbation;
- "aspirin triad";
- disorders of hematopoiesis;
- severe violations of the liver and / or kidney function;
- severe forms of chronic heart failure, arterial hypertension, pancreatitis;
- 3 trimester of pregnancy;
- children's age till 14 years;
- for rectal administration: proctitis, recent bleeding from the rectum.
Application in pregnancy and lactation
Indomethacin is contraindicated in the third trimester of pregnancy. In 1 and 2 trimesters of pregnancy, as well as during lactation (breast-feeding), the use is not recommended.
Indomethacin in small amounts excreted in breast milk.
special instructions
They are used with caution in elderly patients, as well as in cases of liver, kidney, gastrointestinal disease history, dyspeptic symptoms at the time of application, arterial hypertension, heart failure, immediately after serious surgical interventions, with parkinsonism, epilepsy.
In case of anamnesis, allergic reactions to NSAIDs are used only in urgent cases.
During the period of treatment, systematic monitoring of liver and kidney function, a picture of peripheral blood is necessary.
It is not recommended simultaneous use with Acetylsalicylic acid and other NSAIDs.
Do not use indomethacin concomitantly with diflunizole.
When concomitant use of indomethacin with lithium preparations should be borne in mind the possibility of the appearance of symptoms of toxic effects of lithium.
When topical application should not be applied to the wound surface of the skin, and avoid contact with eyes or mucous membranes.
Impact on the ability to drive vehicles and manage mechanisms
During treatment should refrain from potentially dangerous activities associated with the need for concentration and increased speed of psychomotor reactions.
Drug Interactions
With simultaneous use of indomethacin can reduce the effects of saluretics, beta-blockers; intensify the effects of indirect anticoagulants.
With the simultaneous use of indomethacin and diflunizala there is a danger of severe bleeding from the gastrointestinal tract.
With simultaneous application with probenecid, an increase in the concentration of indomethacin in the blood plasma is possible.
Indomethacin can reduce tubular secretion of methotrexate, which leads to an increase in its toxicity.
With simultaneous use with NSAIDs, the toxicity of cyclosporine increases.
Indomethacin in a dose of 50 mg 3 times a day increases the concentration of lithium in blood plasma and reduces the clearance of lithium from the body in patients with mental illness.
With the simultaneous use of indomethacin with digoxin, an increase in Digoxin concentration in the blood plasma and an increase in the half-life of digoxin are possible.
Analogues of the medicinal product Indomethacin
Structural analogs for the active substance:
- Indoene;
- Indowis EU;
- Indocollar;
- Indomethacin (Moivide);
- Indomethacin 100 Berlin-Chemie;
- Indomethacin 50 Berlin-Chemie;
- Indomethacin Sopharma;
- Indomethacin-Acry;
- Indomethacin-Altpharm;
- Indomethacin-Biosynthesis;
- Indotard;
- Indocide;
- Metindol retard;
- Metindol.
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