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BackIndomethacin Data - Uses, Dosage, Drug class, Brand name, Warnings, etc
| Pharmacology |
Indomethacin is an indoleacetic acid NSAID, a potent nonselective cyclo-oxygenase inhibitor with prominent anti-inflammatory, analgesic, and antipyretic properties. It is also used to suppress uterine activity and prevent premature labor. |
|---|---|
| Adult Dosage |
PO for rheumatoid arthritis, rheumatoid (ankylosing) spondylitis, osteoarthritis of the hip: - Initial: 25 mg bid or tid - Increase by 25 mg/day weekly until satisfactory response or max 150–200 mg/day - Alternative: Up to 100 mg of daily dose at bedtime for night/morning stiffness PO for acute gouty arthritis: - Initial: 100 mg, then 50 mg tid until resolved SR Capsule (75 mg): - 1–2 times/day for all uses except gouty arthritis, based on non-SR dosage |
| Pediatric Dosage |
IV for pharmacologic closure of patent ductus arteriosus in premature infants: - Initial: 0.2 mg/kg - Followed by 2 doses of 0.1–0.25 mg/kg (age-dependent) at 12–24 hr intervals Alternative: - Single dose: 0.3 mg/kg - Or ≥1 doses of 0.1 mg/kg via retention enema/orogastric tube |
| Dosage Forms |
- Capsule: 25 mg, 50 mg - Sustained-Release Capsule: 75 mg - Suppository: 50 mg - Suspension: 5 mg/mL - Injection: 1 mg |
| Pharmacokinetics |
Absorption: Rapid, well absorbed from GI tract; bioavailability 98% Peak Levels: Within 2 hr; effective concentrations 0.3–3 mg/L (0.8–8 µmol/L) Protein Binding: 90% Metabolism: Extensive O-demethylation, N-deacylation to inactive metabolites Distribution: Vd = 0.29 ± 0.04 L/kg Clearance: Cl = 0.084 ± 0.012 L/hr/kg; lower in premature infants, neonates, aged Excretion: 15 ± 8% unchanged in urine Half-life: 2.4 ± 0.4 hr; higher in premature infants, neonates, aged |
| Adverse Reactions |
Frequent (~20% intolerance): - Frontal lobe headache, drowsiness, dizziness, mental confusion, GI distress (especially >100 mg/day) Occasional: - Peripheral neuropathy, occult bleeding, peptic ulcer Rare: - Pancreatitis, corneal opacities, hepatotoxicity, aplastic anemia, agranulocytosis, thrombocytopenia, aggravation of psychiatric disorders, allergic reactions Other: May provoke asthma, angioedema, nasal polyps in susceptible patients Precautions, drug interactions, monitoring similar to other NSAIDs (see Ibuprofen). |
References
Hand of Clinical Drug Data