Indocin

Generic name: Indomethacin

What is Indocin?

Indocin 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 (inflammation and pain around joints), tendinitis (acute painful shoulder), acute gouty arthritis, and other kinds of pain.

What is the most important information I should know about Indocin?

Indocin may increase the chance of a heart attack or stroke that can lead to death. This chance increases with longer use of Indocin or if you have heart disease. Symptoms include chest pain, shortness of breath, weakness, and slurred speech.

Indocin can cause ulcers and bleeding in the stomach and intestines at any time during treatment. Ulcers and bleeding can happen without warning symptoms and may cause death. Symptoms include abdominal pain or blood in the stool. The risk of getting an ulcer or bleeding increases the longer you use the medication; if you smoke or drink alcohol; are older, or in poor health; or if you take corticosteroids such as prednisone or blood thinners such as warfarin.

Who should not take Indocin?

Do not take Indocin if you are sensitive to any component of the drug. Also, do not take Indocin if you have asthma, hives, or allergic reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), or right before or after a heart surgery called a coronary artery bypass graft.

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

What should I tell my doctor before I take the first dose of Indocin?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Indocin. Also, talk to your doctor about your complete medical history, especially if you drink more than 3 alcoholic beverages a day or if you have:

A bleeding disorder,An allergy to aspirin or any other NSAIDs,An ulcer or bleeding in the stomach,Chronic heart failure,Fluid retention,Heart disease,High blood pressure,Kidney or liver disease

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: This medication is available in capsule, liquid, 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 Indocin or dosage yourself.

Acute Gouty Arthritis

The usual dose is 50 milligrams (mg) taken 3 times a day until pain is reduced to a tolerable level (usually 3-5 days). Your doctor will advise you when to stop taking Indocin for this condition.

Bursitis or Tendinitis

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

Moderate to Severe Rheumatoid Arthritis, Osteoarthritis, Ankylosing Spondylitis

The usual dose is 25 mg taken 2-3 times a day, increasing to a total daily dose of 150-200 mg.

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

Children: Safety and effectiveness in children 14 years of age and younger have not been established.

How should I take Indocin?

Take Indocin exactly as prescribed by your doctor. You should take Indocin with food or an antacid, and with a full glass of water. Never take Indocin on an empty stomach.

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 20-30 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:

If the suppository is too soft to insert, hold it under cool water or chill it before removing the wrapper

Remove the foil wrapper and moisten your rectal area with cool tap water

Lie down on your side and use your finger to push the suppository well up into the rectum. Hold your buttocks together for a few seconds

Indocin suppositories should be kept inside the rectum for at least 1 hour so that your body can absorb all the medicine.

What should I avoid while taking Indocin?

Indocin may increase the sensitivity of the skin to sunlight. Avoid prolonged exposure to natural and artificial sunlight. Use a sunscreen and wear protective clothing when exposed to the sun.

Avoid alcohol or use it with moderation. If you drink more than 3 alcoholic beverages a day, Indocin may increase the risk of dangerous stomach bleeding.

Many over-the-counter cough, cold, allergy, and pain medications contain aspirin or other NSAIDs such as ibuprofen or naproxen. These medications may interact with Indocin.

What are possible food and drug interactions associated with 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 (atenolol, propranol), ACE inhibitors (enalapril, monopril), and angiotensin II receptor antagonists (losartan, valsartan),Blood-thinners such as warfain,Captopril,Cyclosporine,Diflunisal,Digoxin,Lithium,Loop diuretics such as furosemide,Methotrexate,Other NSAIDs such as ibuprofen or naproxen,Potassium-sparing water pills such as spironolactone,Probenecid,Thiazide-type water pills such as hydrochlorothiazide,Triamterene

What are the possible side effects of Indocin?

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

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

Can I receive Indocin if I am pregnant or breastfeeding?

The effects of Indocin during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding. If taken late in pregnancy, Indocin may cause prenatal heart problems. It may also slow contractions and lead to a delayed delivery. Do not breastfeed while you are taking Indocin.

What should I do if I miss a dose of Indocin?

Take the forgotten dose as soon as you remember. If it is time for your next dose, skip the missed dose and return to your regular schedule. Never take 2 doses at once.

How should I store Indocin?

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.