Inacid Retard (Indometacin)

Indometacin acts on inflammatory pathways that underlie various musculoskeletal and crystal‑induced disorders.

• Rheumatoid arthritis: reduces joint inflammation and pain, improving function.
• Osteoarthritis: alleviates chronic joint pain and stiffness.
• Ankylosing spondylitis: diminishes spinal inflammation and discomfort.
• Gout: relieves acute gouty arthritis attacks.
• Mild to moderate pain: provides analgesia for diverse painful conditions.
• Post‑operative pain: helps control pain after surgical procedures.

• Indometacin non‑selectively inhibits cyclooxygenase‑1 and cyclooxygenase‑2 enzymes, decreasing the conversion of arachidonic acid to prostaglandins. The resulting reduction in prostaglandin synthesis dampens inflammatory signaling, lowers vascular permeability, and diminishes nociceptor sensitization, thereby providing analgesic, anti‑inflammatory, and antirheumatic effects.

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

Common Side Effects

• Gastro‑intestinal upset (nausea, dyspepsia, abdominal pain).
• Headache.
• Dizziness.
• Skin rash or pruritus.
• Elevated liver enzymes.
• Mild renal function changes.

Serious or Rare Side Effects

• Gastro‑intestinal ulceration or bleeding.
• Severe renal impairment or failure.
• Hepatotoxicity with jaundice.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Anaphylactic or severe hypersensitivity reactions.
• Blood dyscrasias such as agranulocytosis or thrombocytopenia.

Before initiating therapy, clinicians should evaluate patient‑specific risk factors and monitor relevant organ functions.

• Gastro‑intestinal risk: assess history of ulcer disease and consider gastro‑protective agents.
• Renal function: monitor serum creatinine and urine output, especially in the elderly.
• Cardiovascular risk: use the lowest effective dose and limit duration in patients with heart disease.
• Hepatic monitoring: check liver enzymes periodically.
• Hypersensitivity: discontinue if signs of severe allergic reaction appear.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Indometacin can alter the pharmacokinetics or pharmacodynamics of several co‑administered medicines.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Lithium: elevated lithium levels and toxicity.
• Methotrexate: enhanced methotrexate toxicity, especially renal.

Moderate Interactions (Monitor Closely)

• Diuretics: possible reduction in renal perfusion, monitor electrolytes.
• ACE inhibitors or ARBs: may worsen renal function.
• SSRIs or other serotonergic agents: additive risk of gastrointestinal bleeding.
• Corticosteroids: heightened risk of ulceration.
• Oral hypoglycemics: may affect glucose control.