Indomethacin
- Atc Codes:C01EB03#M01AB01#M02AA23#S01BC01
- CAS Codes:53-86-1
- PHARMGKB ID:53-86-1
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Indobene, Indocid, Indocollyre, Indomelan, Luiflex; Belgium: Dolcidium, Indocid, Indocollyre, Sportflex; Bulgaria: Indocollyre, Indometacin; Cyprus: Elmetacin, Fortathrin; Indorem, Indylon; Czech Republic: Elmetacin, Indobene, Indocollyre, Indometacin, Vonum Cutan; Denmark: Confortid; Estonia: Elmetacin, Indomet; Finland: Indalgin, Indometin; France: Chrono-Indocid, Dolcidium, Indobiotic, Indocid, Indocollyre; Germany: Confortid, Elmetacin, Indo, Indocolir, Indomet, Indometacin, Inflam, Mobilat, Reusin, Rheubalmin, Rheumasan, Sigadoc, Sjoebo; Greece: Dolcispray, Fortathrin, Hastel, Intobutaz, Intomin, Reumacid, Reumadolor, Reumastop; Hungary: Elmetacin, Indobene, Indocollyre, Indometacinum; Ireland: Inocid; Italy: Indocid, Indocollirio, Indom, Indoxem, Metacen; Latvia: Elmetacin, Indomet, Indometacin, Metindol; Lithuania: Elmetacin, Indomet, Indometacin, Metindol; Luxembourg: Dolcidium, Indocid, Indomet; Malta: Indorem; Netherlands: Indocid, Indocollyre, Indometacin; Poland: Elmetacin, Indocid, Indocollyre, Metindol; Portugal: Autritis, Dolovin, Elmetacin, Indocollyre, Reumacide; Romania: Indocollyre, Indometacin, Indosin; Slovakia: Elmetecin, Indometacin; Slovenia: Indometacin; Spain: Aliviosin, ArtriNovo, Flogoter, Inacid, Indolgina, Indonilo, Reusin; Sweden: Confortid; UK: Indometacin, Pardelprin MR.
North America
Canada: Indomethacin, Indocid, Indocollyre, Novo-Methacin, Rhodacine; USA: Indocin, Indomethacin.
Latin America
Argentina: Agilex, I.M. 75 Montpellier, Indogesic, Indometacina, Indotex, Klonametacina; Brazil: Agilisin, Indocid; Mexico: Antalgin-Medix, Artaxol, Biometacin, Draxil, Indaflex, Indocarsil, Indocid, Indoman, Indometacina, Indotrin, Italon, Malival, Mefazil, Soltacina, Stratasin.
Asia
Japan: Aconip, Asmo ID, Catlep, Hapstar-ID, Hibit, Idomethine, Indacin, Inderanic, Inderapollon, Indome, Indomelol, Indometacin, Indomethine, Indonol, Inmecin, Inmetan, Innamit, Inside, Inteban, Intedaru, Intenacin, Intenurse, Korifumecin, Laction, Mikametan, Proarisin, Salodan, Serastar, Tenporal, Trap-On, Zempack.
Drug combinations
Indomethacin and Gentamicin
Chemistry
Indomethacin: C~19~H~16~ClNO~4~. Mw: 357.79. (1) 1H-Indole-3-acetic acid, 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-; (2) 1-(p-Chlorobenzoyl)-5-methoxy-2-methylindole-3-acetic acid. CAS-53-86-1 (1963).
Pharmacologic Category
Analgesics and Antipyretics; Other Nonsteroidal Anti-inflammatory Agents. Antigout Agents. (ATC-Code: C01EB03; M01AB01; M02AA23; S01BC01).
Mechanism of action
Inhibits cyclooxygenase-1 (COX-1/PTGS1) and COX-2/PTGS2. Exhibits anti-inflammatory, analgesic, and antipyretic activity. Permits closure of ductus arteriosus in premature neonates by inhibiting prostaglandin synthesis.
Therapeutic use
Symptomatic treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Symptomatic relief of acute gout and acute painful shoulder (i.e. bursitis and/or tendinitis). Treatment of patent ductus arteriosus in premature neonates.
Pregnancy and lactiation implications
Avoid use in third trimester due to possible premature closure of ductus arteriosus. Use not recommended during lactation.
Unlabeled use
Contraindications
Hypersensitivity to indomethacin, aspirin, other NSAIDs, or any component of the formulation. Perioperative pain in setting of CABG surgery. History of proctitis or recent rectal bleeding (suppositories). In neonates: necrotizing enterocolitis, impaired renal function, active bleeding (including intracranial hemorrhage and GI bleeding), thrombocytopenia, coagulation defects, untreated infection, congenital heart disease where patent ductus arteriosus is necessary.
Warnings and precautions
Anaphylactoid reactions might occur (avoid use in bronchospasm, asthma, rhinitis, or urticaria with NSAID or aspirin therapy). Possible decreased platelet adhesion and aggregation. Might prolong bleeding time. Anemia might occur. Increased risk of adverse cardiovascular thrombotic events, including MI, stroke, and new onset or worsening of pre-existing hypertension (use caution with fluid retention, heart failure, or hypertension). Increased risk of GI irritation, inflammation, ulceration, bleeding, and perforation (use caution with history of GI disease (bleeding or ulcers), concurrent therapy with aspirin, anticoagulants and/or corticosteroids, smoking, use of alcohol, elderly or debilitated patients). Risk of serious skin adverse events including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Prolonged use may cause corneal deposits and retinal disturbances. Do not administer in aspirin-sensitive asthma (severe bronchospasm might occur). Use caution in other forms of asthma. Risk of MI and stroke may be increased with use following CABG surgery. Use caution with depression (might aggravate depression or other psychiatric disorders). Use caution with epilepsy (may be aggravated). Use with caution in decreased hepatic function. Use caution with Parkinson’s disease (might be aggravated). NSAID use may compromise existing renal function. Not recommended for use in advanced renal disease. Long-term NSAID use may result in renal papillary necrosis. The elderly are at increased risk for adverse effects (especially peptic ulceration, CNS effects, renal toxicity). Hepatotoxicity reported in younger children treated for juvenile rheumatoid arthritis. Withhold for at least 4-6 half-lives prior to surgical or dental procedures. Should not be used in children 2-14 years of age unless toxicity or lack of efficacy with other drugs justifies risk. Use not recommended in advanced renal disease.