II. Mechanism
- NSAID in the acetic acid class (indole)
III. Pharmacokinetics
- Half life: 2 hours
IV. Advantages
V. Indications
- Acute Gouty Arthritis
- Ankylosing Spondylitis
- Pericarditis
- Bartter's Syndrome
- Preterm Labor (Tocolysis)
- Patent Ductus Arteriosus in the newborn
VI. Contraindications
- Peptic Ulcer Disease
- Aspirin Sensitivity
- Renal Disease
- Coagulopathy
- Pregnancy beyond 30 weeks
- Childhood (except Patent Ductus Arteriosus)
- Dementia (consider avoiding in elderly)
VII. Dosing: General Analgesic use
- Regular: 25-50 mg PO tid with food or milk
- Sustained Release: 75 mg PO qd to bid
- Maximum: 200 mg/day
VIII. Dosing Protocol: Preterm Labor
- Protocol 1
- Loading dose: 100 mg suppository rectally
- Maintenance: 25 mg PO every 6 hours for 24 hours
- Repeat for an additional 24 hours maximum
- Protocol 2
- Loading dose: 50 mg PO
- Maintenance: 25 mg PO every 4 hours for 24 hours
- Repeat for an additional 24 hours maximum
- Monitoring
- Amniotic Fluid Index biweekly for use >48 hours
IX. Adverse Effects (more than other NSAIDs)
- Headache
- Peptic ulcer
- Gastrointestinal upset
- Fluid retention
- Prolonged Bleeding Time
- Nausea or Vomiting
- Pruritus
- Bowel changes
- Fetal effects
- Early ductus arteriosus closure
- Oligohydramnios
- Not linked to Intraventricular Hemorrhage
- Nephrotoxic
X. Drug Interactions
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| INDOMETHACIN 25 MG CAPSULE | Generic | $0.10 each |
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