Metindol Retard (Indometacin)

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

• Rheumatoid arthritis: decreases joint swelling, pain and stiffness.
• Osteoarthritis: alleviates chronic joint pain and improves mobility.
• Gout: reduces acute inflammatory attacks and associated discomfort.
• Ankylosing spondylitis: lessens spinal inflammation and pain.
• Acute pain: provides short‑term relief for severe pain episodes.

• Indometacin exerts its anti‑inflammatory and analgesic effects by non‑selectively inhibiting cyclooxygenase enzymes COX‑1 and COX‑2. This inhibition blocks the conversion of arachidonic acid to prostaglandins, thereby reducing prostaglandin-mediated inflammation, pain signaling, and fever generation throughout the body.

Indometacin may cause a range of adverse reactions, from mild to severe, depending on individual susceptibility and duration of therapy.

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia, abdominal pain.
• Headache or dizziness.
• Skin rash or pruritus.
• Elevated liver enzymes.
• Mild renal function changes.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding.
• Severe renal impairment or failure.
• Hepatotoxicity with jaundice.
• Anaphylactic or severe hypersensitivity reactions.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Cardiovascular events such as myocardial infarction or stroke.

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

• Assess gastrointestinal risk: avoid in patients with active ulcers or history of GI bleeding.
• Monitor renal function: check serum creatinine and electrolytes regularly.
• Use lowest effective dose: limit duration to the shortest period needed for symptom control.
• Avoid in known hypersensitivity to indometacin or other NSAIDs.
• Caution in cardiovascular disease: consider alternative therapy if high risk.
• Store at room temperature: keep in the original pack, protect from moisture and direct sunlight.

Indometacin can alter the pharmacokinetics or pharmacodynamics of several medicines, requiring careful management.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Lithium: reduced renal clearance leading to toxicity.
• Methotrexate: enhanced toxicity, especially at high doses.
• Other NSAIDs or aspirin: additive gastrointestinal and renal adverse effects.

Moderate Interactions (Monitor Closely)

• Diuretics: possible reduction in renal perfusion, monitor kidney function.
• Corticosteroids: heightened risk of GI ulceration.
• ACE inhibitors or ARBs: may diminish antihypertensive effect and affect renal function.
• SSRIs or SNRIs: increased bleeding tendency, monitor for signs of hemorrhage.