Indocollyre (Indometacin)

Indometacin ophthalmic solution is used to manage inflammatory conditions of the eye by inhibiting prostaglandin synthesis.

• Post‑operative ocular inflammation: reduces swelling, pain and redness after cataract or refractive surgery, promoting faster recovery.
• Anterior uveitis: controls intra‑ocular inflammation, decreasing cellular infiltrate and preventing synechiae formation.
• Corneal epithelial defects: alleviates pain and inflammation associated with superficial corneal injuries, supporting epithelial healing.

• Indometacin exerts its anti‑inflammatory effect by non‑selectively inhibiting cyclooxygenase‑1 and cyclooxygenase‑2 enzymes in ocular tissues. This blockade reduces the conversion of arachidonic acid to prostaglandins and thromboxanes, mediators that drive vasodilation, increased vascular permeability and pain signaling. By limiting these mediators, indometacin helps restore normal ocular homeostasis and reduces discomfort.

Ocular administration of indometacin may be associated with a range of local and systemic adverse reactions.

Common Side Effects

• Burning or stinging sensation on instillation
• Transient ocular redness
• Increased tearing
• Blurred vision
• Foreign body sensation
• Mild conjunctival irritation

Serious or Rare Side Effects

• Corneal ulceration or perforation
• Elevated intra‑ocular pressure
• Severe allergic reaction (e.g., angioedema, anaphylaxis)
• Stevens‑Johnson syndrome or toxic epidermal necrolysis
• Persistent visual loss

Before using Indocollyre, clinicians should consider several precautionary measures to ensure safe ocular therapy.

• Assess for hypersensitivity: avoid if patient has known allergy to indometacin or other NSAIDs.
• Monitor intra‑ocular pressure: use cautiously in glaucoma or ocular hypertension.
• Avoid concurrent ocular NSAIDs: combined use may increase risk of corneal toxicity.
• Use with caution in corneal epithelial defects: may delay healing.
• Store at room temperature: keep in original container, protect from light and moisture.

Indometacin eye drops can interact with systemic and ocular medications, influencing efficacy or safety.

Major Interactions (Avoid)

• Systemic NSAIDs: additive risk of systemic toxicity and impaired renal function.
• Anticoagulants (e.g., warfarin): increased bleeding tendency, especially after ocular surgery.
• Corticosteroid eye drops: potential for reduced anti‑inflammatory benefit and delayed wound healing.

Moderate Interactions (Monitor Closely)

• Antihypertensive agents: NSAIDs may diminish antihypertensive response.
• Lithium therapy: indometacin may raise lithium serum levels, requiring monitoring.
• Diuretics: possible alteration of renal handling of NSAIDs, warranting observation.