Inacid (Indometacin)

Indometacin is indicated for several inflammatory and musculoskeletal conditions where prostaglandin‑mediated pain and swelling are present.

• Rheumatoid arthritis: reduces joint inflammation and pain, improving mobility.
• Osteoarthritis: alleviates cartilage‑related pain and stiffness.
• Ankylosing spondylitis: diminishes spinal inflammation and discomfort.
• Gout: controls acute gouty arthritis attacks by decreasing urate‑induced inflammation.
• Acute pain: provides rapid analgesia for short‑term severe pain episodes.
• Bursitis: lessens inflammation of bursae, reducing pain and swelling.

• Indometacin exerts its anti‑inflammatory and analgesic actions by non‑selectively inhibiting cyclooxygenase‑1 and cyclooxygenase‑2 enzymes, which reduces the synthesis of prostaglandins involved in pain, fever and inflammation. The decreased prostaglandin levels lead to diminished vascular permeability, leukocyte infiltration, and nociceptor sensitization at sites of tissue injury. This inhibition also contributes to antipyretic effects.

Indometacin may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Skin rash: mild erythema or itching.

Serious or Rare Side Effects

• Peptic ulcer disease or gastrointestinal bleeding.
• Renal impairment: elevated creatinine or reduced urine output.
• Severe hypersensitivity reactions: Stevens‑Johnson syndrome or anaphylaxis.

When prescribing Indometacin, clinicians should consider several safety precautions to minimize risk.

• Assess gastrointestinal risk: avoid in patients with active ulcers or history of GI bleeding.
• Monitor renal function: use caution in patients with pre‑existing kidney disease.
• Evaluate cardiovascular status: NSAIDs may increase blood pressure and thrombotic risk.
• Review concomitant medications: avoid use with other NSAIDs, anticoagulants or corticosteroids without supervision.
• Pregnancy and lactation: contraindicated in the third trimester and use only if benefits outweigh risks.
• Store at ambient temperature: keep below 25 °C in the original container, protect from moisture and light.

Indometacin can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Lithium: reduced renal clearance leading to toxicity.
• Methotrexate: heightened toxicity due to reduced renal elimination.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may diminish antihypertensive effect and impair renal function.
• Diuretics: risk of reduced renal perfusion and electrolyte imbalance.
• Other NSAIDs or corticosteroids: additive gastrointestinal toxicity.