Indolar Sr (Indometacin)

Indometacin is employed in the management of inflammatory musculoskeletal disorders and gout.

• Rheumatoid arthritis: reduces joint inflammation and pain, improving function.
• Osteoarthritis: alleviates joint stiffness and discomfort, enhancing mobility.
• Ankylosing spondylitis: diminishes spinal inflammation and pain, supporting posture.
• Gout flares: rapidly decreases acute joint swelling and tenderness.
• Acute pain and inflammation: provides prompt relief of short‑term inflammatory pain.

• Indometacin exerts its therapeutic effect by non‑selectively inhibiting cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes. This inhibition blocks the conversion of arachidonic acid to prostaglandins, leading to reduced synthesis of inflammatory mediators that cause pain, swelling, and fever.

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

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia, or abdominal discomfort.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Skin rash or pruritus.
• Elevated liver enzymes.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding.
• Acute renal impairment or failure.
• Severe cutaneous reactions such as Stevens‑Johnson syndrome.
• Anaphylactic or anaphylactoid reactions.
• Hepatotoxicity with jaundice.

Before prescribing Indolar Sr, clinicians should consider several safety measures.

• Assess renal function: monitor serum creatinine and eGFR before initiation and periodically during therapy.
• Evaluate hepatic status: check liver enzymes, especially in patients with pre‑existing liver disease.
• Review gastrointestinal risk: avoid use in patients with active peptic ulcer disease or a history of serious GI bleeding.
• Monitor cardiovascular health: use cautiously in patients with hypertension or heart failure.
• Check for hypersensitivity: discontinue immediately if signs of allergic reaction appear.
• Store at ambient temperature: keep below 25°C in the original packaging, protected from moisture and direct light.

Indometacin can interact with several medicines, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Selective serotonin reuptake inhibitors (SSRIs): heightened gastrointestinal bleeding risk.
• Lithium: potential for lithium toxicity due to reduced renal clearance.

Moderate Interactions (Monitor Closely)

• Antihypertensives (e.g., ACE inhibitors, diuretics): may diminish blood pressure control.
• Methotrexate: NSAIDs can raise methotrexate plasma levels, increasing toxicity.
• Oral hypoglycemics: possible alteration of blood glucose control.