Indometacin Al (Indometacin)

Indometacin is an NSAID that reduces inflammation and pain in several musculoskeletal disorders.

• Rheumatoid arthritis: decreases joint swelling and pain, improving function.
• Osteoarthritis: alleviates chronic joint discomfort and stiffness.
• Ankylosing spondylitis: reduces spinal inflammation and associated pain.
• Acute gout: relieves sudden joint inflammation and severe pain.
• Pain and inflammation: provides symptomatic relief for various acute inflammatory conditions.

• Indometacin inhibits cyclooxygenase (COX‑1 and COX‑2) enzymes, which blocks the conversion of arachidonic acid to prostaglandins. By lowering prostaglandin synthesis, it diminishes inflammatory mediator levels, leading to reduced inflammation, pain, and fever at the site of tissue injury.

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

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia, or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Skin rash or pruritus.
• Elevated liver enzymes.
• Mild renal function changes.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding.
• Severe skin reactions such as Stevens‑Johnson syndrome.
• Acute kidney injury or chronic renal impairment.
• Hepatotoxicity or liver failure.
• Blood dyscrasias (e.g., agranulocytosis, thrombocytopenia).
• Anaphylactic or severe allergic reactions.

Before prescribing Indometacin, clinicians should consider several safety aspects.

• Renal function: evaluate baseline kidney status and monitor during therapy.
• Gastrointestinal risk: use the lowest effective dose and consider gastro‑protective agents in high‑risk patients.
• Cardiovascular disease: exercise caution in patients with known heart disease.
• Concomitant anticoagulants: monitor for increased bleeding tendency.
• Pregnancy and lactation: avoid unless the benefit outweighs potential fetal or infant risk.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Indometacin can interact with other medicines, requiring careful management.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): heightened risk of bleeding.
• Other NSAIDs or aspirin: additive gastrointestinal toxicity.
• Lithium: increased serum lithium concentrations.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: possible reduction in renal function.
• Diuretics: may impair renal perfusion, especially in volume‑depleted patients.