Brand name:

Indocin

Generic name: Indomethacin

Why is Indocin prescribed?

Indocin, a nonsteroidal anti-inflammatory drug, is used to relieve the inflammation, swelling, stiffness and joint pain associated with moderate or severe rheumatoid arthritis and osteoarthritis (the most common form of arthritis), and ankylosing spondylitis (arthritis of the spine). It is also used to treat bursitis, tendinitis (acute painful shoulder), acute gouty arthritis, and other kinds of pain.

Most important fact about Indocin

You should have frequent checkups with your doctor if you take Indocin regularly. Ulcers or internal bleeding can occur without warning.

Like other NSAIDs, Indocin may increase the risk of heart attack and stroke, both of which can be fatal. If you already have heart disease, the risk may be even greater.

How should you take Indocin?

Indocin should be taken with food or an antacid, and with a full glass of water. Never take on an empty stomach.

Take this medication exactly as prescribed by your doctor.

If you are using Indocin for arthritis, it should be taken regularly.

If you are taking the liquid form of this medicine, shake the bottle well before each use.

Indocin SR capsules should be swallowed whole, not crushed or broken.

Do not lie down for about 20 to 30 minutes after taking Indocin. This helps prevent irritation that could lead to trouble in swallowing.

If you are using the suppository form of this medicine:

1. If the suppository is too soft to insert, hold it under cool water or chill it before removing the wrapper
2. Remove the foil wrapper and moisten your rectal area with cool tap water.
3. Lie down your side and use your finger to push the suppository well up into the rectum. Hold your buttocks together for a few seconds.
4. Indocin suppositories should be kept inside the rectum for at least 1 hour so that all of the medicine can be absorbed by your body.

• If you miss a dose...
  Take the forgotten dose as soon as you remember. If it is time for your next dose, skip the one you missed and return to your regular schedule. Never take a double dose.

• Storage instructions...
  The liquid and suppository forms of Indocin may be stored at room temperature. Keep both forms from extreme heat, and protect the liquid from freezing.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Indocin.

• Side effects may include:
  Abdominal pain, constipation, depression, diarrhea, dizziness, fatigue, headache, heartburn, indigestion, nausea, ringing in the ears, sleepiness or excessive drowsiness, stomach pain, stomach upset, vertigo, vomiting

Why should Indocin not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Indocin, aspirin, or similar drugs, or if you have had asthma attacks caused by aspirin or other drugs of this type, you should not take this medication. Make sure that your doctor is aware of any drug reactions that you have experienced.

Do not use Indocin suppositories if you have a history of rectal inflammation or recent rectal bleeding.

Special warnings about Indocin

Indocin prolongs bleeding time. If you are taking blood-thinning medication, this drug should be taken with caution.

Like other NSAIDs, Indocin may cause serious skin reactions such as rash, blisters, and itching. If you experience these symptoms, contact your doctor immediately.

Your doctor should prescribe the lowest possible effective dose. The incidence of side effects increases as dosage increases.

Peptic ulcers and bleeding can occur without warning, especially in people over 65.

This drug should be used with caution if you have kidney or liver disease, and it can cause liver inflammation in some people. Signs of a liver problem include nausea, fatigue, itchy spots, flu-like symptoms, and jaundice (yellowing of the eyes or skin). If you experience these symptoms, contact your doctor immediately.

Do not take aspirin or any other anti-inflammatory medications while taking Indocin, unless your doctor tells you to do so.

If you have heart disease or high blood pressure, this drug can increase water retention.

This drug can mask the symptoms of an existing infection.

Indocin may cause you to become drowsy or less alert; therefore, driving or operating dangerous machinery or participating in any hazardous activity that requires full mental alertness is not recommended. Indocin may also cause confusion and, rarely, psychosis, especially in older adults.

Possible food and drug interactions when taking Indocin

If Indocin is taken with certain other drugs, the effects of either could be increased, decreased or altered. It is especially important to check with your doctor before combining Indocin with the following:

Aspirin

Blood pressure medications, including beta blockers, ACE inhibitors, and angiotensin II receptor antagonists

Blood-thinning medicines such as warfarin

Captopril

Cyclosporine

Diflunisal

Digoxin

Lithium

Loop diuretics

Other nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen

Potassium-sparing water pills such as spironolactone

Probenecid

The anticancer drug methotrexate

Thiazide-type water pills such as chlorothiazide

Triamterene

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Special information if you are pregnant or breastfeeding

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The effects of Indocin during pregnancy have not been adequately studied. If taken late in pregnancy, this drug may cause prenatal heart problems. Indocin may also slow contractions, leading to a delayed delivery. If you are pregnant or plan to become pregnant inform your doctor immediately. Indocin appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with this medication is finished.

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Recommended dosage for Indocin

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ADULTS

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This medication is available in liquid, capsule, and suppository form. The following dosages are for the capsule form. If you prefer the liquid form ask your doctor to make the proper substitution. Do not try to convert the medication or dosage yourself.

Moderate to Severe Rheumatoid Arthritis, Osteoarthritis, Ankylosing Spondylitis

The usual dose is 25 milligrams 2 or 3 times a day, increasing to a total daily dose of 150 to 200 milligrams. Your doctor should monitor you carefully for side effects when you are taking this drug.

Your doctor may prescribe a single daily 75-milligram capsule of Indocin SR in place of regular Indocin.

Bursitis or Tendinitis

The usual dose is 75 to 150 milligrams daily divided into 3 to 4 small doses for 1 to 2 weeks, until symptoms disappear.

Acute Gouty Arthritis

The usual dose is 50 milligrams 3 times a day until pain is reduced to a tolerable level (usually 3 to 5 days). Your doctor will advise you when to stop taking this drug for this condition. Keep him informed of its effects on your symptoms.

CHILDREN

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The safety and effectiveness of Indocin have not been established in children under 14 years of age. However, your doctor may decide that the benefits of this medication outweigh any potential risks.

OLDER ADULTS

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Your doctor will adjust the dosage as needed.

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Overdosage

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Any medication taken in excess can cause symptoms of overdose. If you suspect an overdose seek medical attention immediately.

• The symptoms of Indocin overdose may include:
  Convulsions, disorientation, dizziness, intense headache, lethargy, mental confusion, nausea, numbness, tingling or pins and needles, vomiting