Metindol (Indometacin)

Indometacin acts on inflammatory pathways to relieve symptoms in several musculoskeletal and crystal‑induced disorders.

• Rheumatoid arthritis: decreases joint pain, swelling and stiffness, improving functional ability.
• Osteoarthritis: alleviates chronic knee, hip or hand pain and reduces inflammation.
• Gout flares: rapidly controls acute gouty arthritis pain and swelling.
• General musculoskeletal pain: provides analgesia for sprains, strains and postoperative discomfort.
• Inflammatory conditions: reduces systemic inflammation in various acute inflammatory states.

• Indometacin inhibits cyclooxygenase (COX‑1 and COX‑2) enzymes, blocking the conversion of arachidonic acid to prostaglandins. This reduction in prostaglandin synthesis diminishes inflammation, pain signaling, and fever responses at the site of tissue injury or disease.

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

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia or abdominal discomfort.
• Headache or dizziness: transient central nervous system symptoms.
• Skin rash: mild erythema or pruritus.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding: may present as melena or hematemesis.
• Renal impairment: reduced urine output or increased serum creatinine.
• Hepatic dysfunction: elevated transaminases or jaundice.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Anaphylaxis: sudden onset of respiratory distress, hypotension or urticaria.

Before initiating therapy, clinicians should evaluate patient‑specific risk factors and monitor for adverse events.

• Assess renal function: check baseline creatinine and monitor during treatment.
• Evaluate gastrointestinal risk: consider ulcer prophylaxis in patients with prior GI bleeding.
• Review cardiovascular history: avoid in uncontrolled hypertension or active cardiovascular disease.
• Pregnancy and lactation: use only if potential benefit justifies potential risk, as safety data are limited.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Indometacin can alter the pharmacokinetics or pharmacodynamics of several medicines; careful review is required.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Lithium: reduced renal clearance leading to toxicity.
• Methotrexate: enhanced toxicity, especially renal.
• ACE inhibitors or ARBs: may worsen renal function.

Moderate Interactions (Monitor Closely)

• Corticosteroids: additive gastrointestinal ulcer risk.
• SSRIs or SNRIs: heightened bleeding potential.
• Diuretics: possible reduction in renal perfusion.
• Other NSAIDs: increased adverse effect profile.