Indometacin

Indications

• Patent ductus arteriosus^[1]

• retinopathy of prematurity

• ankylosing spondylitis

• rheumatoid arthritis

• arthritic gout

• osteoarthritis

• juvenile arthritis

• psoriatic arthritis

• Reactive arthritis (ReA)

• Paget's disease of bone

• Bartter syndrome

• Exertion headaches

• pseudogout

  • dysmenorrhea (menstrual cramps)

• pericarditis

• bursitis

• tendinitis

  • nephrogenic diabetes insipidus (prostaglandin inhibits vasopressin's action in the kidney)

  • fever and pain associated with malignant diseases (tumors, bony metastases, lymphogranulomatosis)

  • paroxysmal hemicrania, hemicrania continua and migraine

  • renal colic (pain due to kidney stones)

• cryoglobulinemia

Administration/Absorption

Dosage

Distribution

Mechanism

• non-steroidal anti-inflammatory

  • nonselective inhibitor of cyclooxygenase (COX) 1 and 2

  • Inhibits the production of prostaglandins

Excretion

Side effects

• • reduces plasma renin activity and aldosterone levels, and increases sodium and potassium retention. It also enhances the effects of vasopressin. Together these may lead to:

    • edema

    • hyperkalemia ^[3]

  • hypernatremia

    • hypertension

Interactions

Contraindications

• • concurrent peptic ulcer, or history of ulcer disease

  • allergy to indomethacin, aspirin, or other NSAIDs

  • patients with nasal polyps reacting with an angioedema to other NSAIDs

  • children under 2 years of age (with the exception of neonates with patent ductus arteriosus)

  • severe pre-existing renal and liver damage

  • caution: pre-existing bone marrow damage (frequent blood cell counts are indicated)

  • caution: bleeding tendencies of unknown origin (indomethacin inhibits platelet aggregation)

  • caution: Parkinson's disease^{[citation needed]}, epilepsy, psychotic disorders (indomethacin may worsen these conditions)

  • concurrent with potassium sparing diuretics

  • patients who have a patent ductus arteriosus dependent heart defect (such as Transposition of the great vessels)