Indomethacin tablets, injections. Indications for use, reviews

The drug Indomethacin relieves inflammation, lowers body temperature and relieves pain. The drug is available in the form of tablets, suppository and solution for intramuscular injection. Indications for use are diseases that are characterized by symptoms in the form of severe pain syndrome.

Composition and form of release

Round tablets, biconvex, covered with a white film shell.

1 tablet contains:

Active ingredient:

• indomethacin - 25 mg

Additional substances	Content in mg
lactose mohydrate	41,6
seen	25
microcrystalline cellulose	16
potato starch	10
magnesium stearate	0,9
Shell components	Content in mg
acryl-EZE White 93А18597	3,6
talc	0,594
titanium dioxide	0,540
triethyl citrate	0,40
sodium hydrogen carbonate	0,036
colloidal silicon dioxide	0,036
sodium liuryl sulfate	0,018

The drug is also available in the form of a solution for injections.

Terms of sale, prices

The medication is sold in pharmacy chains only with a prescription from the attending doctor.

The cost of Indomethacin in tablets and solution for injections varies from 50 to 200 rubles. depending on the volume of the package and the manufacturer.

Pharmacological properties

The active ingredient is a substance that is part of indoleacetic acid. The drug has a strong anti-inflammatory and analgesic effect, the mechanism of which is associated with the suppression of the production of prostaglandins, provoking a decrease in their amount in the blood. Prevents the interaction of tissue receptors with bradykinin, reducing pain in the inflammation focus. By inhibiting cyclooxygenase, it inhibits prostaglandin synthesis. Reduces the formation of blood clots in the area of ​​inflammation.

The content in plasma reaches a maximum within 1-2 hours.

Pharmacodynamics and pharmacokinetics

Indomethacin has antiaggregatory, anti-inflammatory, febrifugal and analgesic effects. The tablets reduce platelet aggregation. The indication for use is severe painful sensations provoked by inflammation or infection. Reduces stiffness and swelling of the joints in the morning, reduces or completely relieves non-rheumatic pain and of a rheumatic nature, as well as swelling:

• in joints at rest or in motion;
• with inflammation after injury and surgery.

Bioavailability 80-90% when taken orally. Penetrates all tissues, systems and organs. By binding to blood plasma proteins in 90%, it enhances the medicinal effect of other medicines with simultaneous therapy.

The half-life of the active substance varies from 2.6 to 11 hours. The kidneys excrete 60-75%, of which 10-20% in its original form, the rest - with feces and bile.

Indications for use

Indomethacin tablets (indications for use are due to the medicinal properties of the active ingredient).

It is prescribed for short-term therapy of pain syndrome of a chronic course and during an exacerbation, accompanying the following conditions:

• pathology of the musculoskeletal system of an inflammatory nature;
• sports injuries;
• diseases of the tissues around the joints;
• inflammatory and infectious diseases of the ENT organs;
• discopathy, pathology of the nerve plexuses, neuritis.

The drug does not affect the development of pathology.

Indomethacin is not prescribed during gestation. The active substance is excreted in breast milk. During medication therapy, breastfeeding is stopped.
The use can negatively affect fertility, in this regard, it is not prescribed to women at the stage of pregnancy planning.

Contraindications

Indomethacin has contraindications.

These conditions include:

• attacks of rhinitis, respiratory failure, urticaria, provoked by taking aspirin;
• duodenal ulcer and stomach, intense bleeding in the digestive system;
• dysfunction of the heart;
• inflammatory bowel ailments;
• lactose intolerance;
• Congenital heart defect;
• recovery period after coronary artery bypass grafting;
• disorders of the functioning of the liver and kidneys;
• insufficient blood clotting;
• disorders of hematopoiesis;
• hyperkalemia;
• the patient's age is up to 14 years.

Assign carefully:

• cerebrovascular pathology;
• ischemia of the heart;
• hyper and dyslipidemia;
• disorders of the functions of the heart of a chronic course;
• diabetes;
• low platelet count;
• peripheral vascular disease;
• hypertension;
• smoking;
• cirrhosis of the liver;
• long-term use of NSAIDs;
• hyperbilirubinemia;
• alcohol abuse;
• severe somatic pathologies.

Method of administration and dosage

Indomethacin tablets (indications for use affect the dosage). The dose and duration of therapy is determined by a specialist for each patient individually, taking into account the general condition and course of the pathology.

The daily dose for adults is 1.5-2.5 mg / kg, the maximum is 150 mg.

Elderly patients

It is recommended to take 1 or 2 tablets throughout the day.

Primary dysmenorrhea

Take 1 tablet a day. The duration of therapy is 1-2 weeks. To reduce the likelihood of developing adverse reactions in the digestive system, the medication is recommended to be taken together with antacids during or after a meal, drinking plenty of water or milk.

With prolonged therapy, the dose per day should not be higher than 75 mg. It is strictly forbidden to combine with the use of alcoholic beverages.

Side effects

Indomethacin can provoke the development of the following adverse reactions:

Systems and organs	Possible violations
Liver, digestive organs	The following symptoms may appear: digestive disorders; loss of taste; inflammatory pathologies of the oral cavity. In rare cases, it may develop; stomach and intestinal ulcers; bleeding from the sigmoid colon and its perforation; increased serum aminotransaminases; toxic hepatitis; a transient increase in the concentration of bilirubin; fulminant hepatitis.
Nervous system.	The following violations are possible: dizziness, blurred consciousness and migraines; drowsiness; disorientation in space; fever; swelling of the brain; aseptic meningitis; sensitivity disorders; decreased concentration and memory disorders; convulsions; peripheral neuropathy. Rarely: depressive conditions, sleep disorders, increased anxiety; in patients with mental disorders, epilepsy, or a history of Parkinson's disease, the condition may worsen.
Genitourinary system	Isolated cases of occurrence: exacerbation of kidney dysfunction; nephrotic syndrome, leukopenia and polyuria; bleeding from the vagina; pain and breast enlargement in women; renal necrotizing papillitis.
Hematopoiesis.	Rarely occur: anemia of aplastic and hemolytic type; agranulocytopenia; suppression of bone marrow functions; microangiopathy; DIC syndrome and petechiae provoked by it; ecchymosis.
The cardiovascular system.	Against the background of admission, you may experience: cardiopalmus; hypertension; arrhythmia; swelling; increase or decrease in blood pressure; vasculitis; palpitations; angina pectoris.
Skin and subcutaneous tissue	The following symptoms may appear: itching sensation; exacerbation of psoriasis; angioedema; hair loss; hives; dermatitis; redness; eczema.
Hearing organs, vestibular apparatus	Sometimes there are: deafness; hearing disorders; vertigo.
Orans of view	The following disorders may occur: blurred vision; pain in the area around the eyes; conjunctivitis; damage to the optic nerve of an inflammatory nature. Long-term therapy causes: retinal abnormalities; deposits on the cornea.
Immunity.	Sometimes there are: nonspecific allergies; bronchospasm; anaphylaxis; skin reactions in the form of angioedema, itching, rashes, urticaria, dermatosis.
Metabolism.	The following reactions may occur: retinal lesions; glucosuria; increased content of urea and liver enzymes; violation of fluid excretion; weight gain; intense sweating.
Respiratory system	There are: bleeding from the nose; bronchospasm; asthma attacks.
Connective tissue and musculoskeletal system	There may be: muscle weakness; intense degeneration of cartilage.

Overdose

When taking an increased dose of the medication, migraine, nausea, dizziness, vomiting, disorientation in space, drowsiness, memory loss may occur.

Symptomatic therapy is used to ensure the normal functioning of the body. It is recommended to induce vomiting and gastric lavage. Then take activated charcoal. If the condition worsens, hospitalization and supervision of specialists for several days is necessary.

special instructions

Indomethacin tablets (indications for use require compliance with certain instructions). Adverse reactions can be reduced by taking the lowest effective dose.

Negative manifestations from the liver and digestion are reduced if the medication is combined with food. Patients with severe pathologies of the stomach and intestines are recommended to start NSAID therapy with the lowest possible dosage.

Clinical trials have shown that the use of certain NSAIDs can cause arterial thrombotic events.

Assign with special care to patients with drug hypersensitivity. When symptoms of this disorder appear, the reception is stopped.

There is a likelihood of hyperkalemia, especially in elderly patients with disorders of kidney function, taking 3-blockers, ACE inhibitors and diuretics that save potassium.

Caution is indicated for patients with mental disorders, epilepsy, Parkinson's disease, disorders work of the heart of a chronic course, hypertension, hemorrhagic syndromes and an increased tendency to bleeding. Indomethacin provokes a violation of fluid withdrawal, therefore it is carefully used in therapy for patients with diseases that are characterized by the appearance of puffiness.

In patients with low blood flow, it can provoke the development of severe renal hypoglycemia. They need to control the functioning of the kidneys during drug therapy.

The medication can provoke bronchospasm, therefore, patients suffering from bronchial asthma are prescribed it with caution.

Taking indomethacin can cause visual impairment and retinal abnormalities, therefore, with prolonged use, it is necessary to regularly undergo examination by an ophthalmologist. In addition, it is recommended to periodically examine the blood, liver and stomach function in order to identify negative reactions at the initial stage of development.

It is recommended to use the medication with caution in patients after surgery, as it can increase the duration of bleeding.

The use of indomethacin reduces fertility. Reception is not recommended for women who are planning to conceive.

Patients with SWR and connective tissue pathologies significantly increase the likelihood of viral meningitis.

The medication contains lactose, therefore it is categorically contraindicated in patients with intolerance to this substance of a hereditary nature.

Negatively affects the speed of reactions when driving a car or working with potentially dangerous mechanisms. It is not recommended to take medication for drivers and people whose professional activities require increased attention.

Drug interactions

Indomethacin tablets (indications for use include the possibility of interaction with other medicines). It is strongly not recommended to take 2 or more NSAIDs due to the high likelihood of developing negative reactions.

Medication	Possible consequences when taken together with indomethacin
Aspirin	Simultaneous reception is contraindicated. In addition to side effects, acetylsalicylic acid can lower the concentration of the active ingredient in plasma.
Antibacterial drugs	The likelihood of seizures is high.
Zalcitabine	Provokes changes in their pharmacodynamics.
Zidovudine	The likelihood of hematologic toxicity is high.
Ritonavir	The risk of indomethacin toxicity is significantly increased.
Cyclophosphamide	Use with caution, as there is a high likelihood of developing water intoxication.
Antidepressants	There is a high likelihood of bleeding.
Metformin	In rare cases, it can provoke metabolic acidosis.
Antiepileptic medicines	Use with caution.
Haloperidol	Increases drowsiness.
Indirect anticoagulants	Increases the effect of warfarin, and therefore, there is a need to control the prothrombin index.
Clopidogrel	There is a high likelihood of bleeding.
Probenecid	The content of indomethacin in the blood may increase, as a result of which a dose reduction is required.
Diuretics of different types	Indomethacin reduces the diuretic and antihypertensive effect.
Corticosteroids	Increases the likelihood of bleeding and ulceration in the digestive system.
Diflunisal	May cause bleeding in the stomach and intestines.
Tacrolimus	There is a high likelihood of developing nephrotoxicity.
Benzodiazepines	Dizziness may occur.
Mifepristone	Indomethacin is contraindicated for at least 8 days after taking this medication.
Muromonab-SBZ	The likelihood of psychosis and encephalopathy is high.
Vasodilator drugs	High risk of bleeding.
Quinolines	Increases the likelihood of seizures.

The active substance may show incorrect test results:

• increase the concentration of one or more liver enzymes;
• may give a falsely negative dexamethasone test result.

Analogs

Analogues in composition and therapeutic effect include the following drugs:

• Indomethacin: DS, Biosynthesis, Altpharm;
• Metindol

Storage conditions

The manufacturer recommends storing Indomethacin at a temperature not exceeding 25 C. Keep the tablets out of the reach of small children. The shelf life when the medication is indicated for use is 3 years. Taking an expired medication is categorically contraindicated.

Indomethacin indications for use: