Indorem (Indometacin)

Indometacin belongs to the NSAID class and is used to manage inflammatory and painful conditions affecting the musculoskeletal system.

• Rheumatoid arthritis: reduces joint inflammation and pain, improving functional ability.
• Osteoarthritis: alleviates chronic joint discomfort and swelling.
• Ankylosing spondylitis: diminishes spinal inflammation and stiffness.
• Gout: provides rapid relief of acute gouty arthritis attacks.
• Acute pain: controls short‑term severe pain from various causes.

• Indometacin inhibits cyclooxygenase (COX‑1 and COX‑2) enzymes, leading to decreased conversion of arachidonic acid to prostaglandins. The reduction in prostaglandin synthesis diminishes inflammation, pain, and fever responses at the site of tissue injury, providing its therapeutic anti‑inflammatory and analgesic effects.

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

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia, or abdominal pain.
• Headache or dizziness.
• Skin rash or mild itching.
• Elevated liver enzymes without symptoms.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding.
• Acute renal impairment or failure.
• Severe hepatic injury.
• Life‑threatening skin reactions such as Stevens‑Johnson syndrome.
• Anaphylactic or severe hypersensitivity reactions.
• Blood dyscrasias including agranulocytosis.

Before initiating Indometacin therapy, consider the following safety measures.

• Assess gastrointestinal risk: evaluate history of ulcers or bleeding.
• Monitor renal function: check serum creatinine and urine output regularly.
• Evaluate hepatic status: perform liver function tests at baseline and during treatment.
• Avoid use in patients with known hypersensitivity to indometacin or other NSAIDs.
• Use the lowest effective dose for the shortest duration needed.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Warfarin: increased risk of serious bleeding.
• ACE inhibitors (e.g., enalapril): may reduce antihypertensive effect and impair renal function.
• Lithium: heightened lithium levels leading to toxicity.

Moderate Interactions (Monitor Closely)

• SSRIs (e.g., sertraline): additive risk of gastrointestinal bleeding.
• Corticosteroids (e.g., prednisone): enhanced ulcerogenic potential.
• Diuretics (e.g., furosemide): possible reduction in renal clearance of indometacin.