Indomethacin tablets instructions for use. The drug indomethacin
Against the background of degenerative and dystrophic lesions of the vertebrae, joints, with severe bruises, injuries, sprains, inflammation develops, swelling of the tissues appears, and pain of varying intensity disturbs. Indomethacin is a non-selective NSAID with high efficiency.
Tablets of a non-selective cyclooxygenase blocker are prescribed for the relief of acute discomfort, if you need to quickly eliminate negative symptoms. Indomethacin acts actively, but often causes negative reactions. The drug is prescribed in a short course with a powerful pain syndrome against the background of damage to cartilage, bone and muscle tissue.
Composition and form of release
The drug Indomethacin contains an active ingredient with the same name. One tablet of the drug contains 25 mg of the active substance. Biconvex tablets with a diameter of 7 mm are enteric-coated, color - light brown.
There are 1 or 3 blisters in a cardboard pack, the total number of units in a package is 30. Indomethacin can be purchased by prescription.
Action on the body
The indoleacetic acid derivative blocks not only the synthesis of prostaglandins that cause pain, fever, inflammation, but also the protective enzyme cyclooxygenase - 1. Against the background of the action of the active substance, tissue permeability decreases, the inflammatory process decreases, soreness of non-rheumatic and rheumatic origin in the lesion disappears, the temperature decreases.
Suppression of pathological changes has a positive effect on the mobility of the spine and joints. Patients note: the stiffness of the problem area disappears, swelling due to injury or inflammation, the joints react less actively to changes in weather and loads of various kinds.
Indications for use
The drug for systemic use is prescribed for lesions of various parts of the musculoskeletal system. It is important to remember the indiscriminate action of the active substance: uncontrolled intake increases the likelihood of adverse reactions.
Indomethacin tablets help in the treatment of the following pathologies:
- arthritis: juvenile, rheumatic, psoriatic, gouty;
- inflammation of the elements of the musculoskeletal system in Reiter's and Paget's disease;
- rheumatism;
- neuralgic amyotrophy;
- pain syndrome in muscles and joints;
- postoperative period in the surgical treatment of the spine, muscles, joints;
- tendonitis, bursitis;
On a note! Indomethacin is also prescribed for fever, pain, swelling against the background of infectious and inflammatory processes in the pelvis, during childbirth, algomenorrhea, fever, pericarditis. The drug quickly eliminates inflammation and negative sensations if paracetamol and acetylsalicylic acid do not show a noticeable effect. Indomethacin actively relieves toothache.
Contraindications
Non-steroidal anti-inflammatory drug of indiscriminate action is not prescribed:
- patients with peptic ulcer;
- with the aspirin triad;
- with bleeding in various parts of the body;
- against the background of congenital heart defects with impaired patency of the arterial duct;
- with damage to the optic nerve;
- when detecting bronchial asthma;
- under the age of 14;
- patients with glucose-6-phosphate dehydrogenase deficiency;
- with swelling and severe arterial hypertension;
- hearing impaired patients
- with problems with the vestibular apparatus;
- patients with chronic renal failure;
- during pregnancy and breastfeeding;
- with hypersensitivity to indomethacin or other types of NSAIDs;
- revealed hepatitis, severe liver failure.
Instructions for use and daily dosage
Important points:
- tablets are taken after meals, without chewing;
- initial dosage - 25 mg 2 or 3 times a day;
- gradually increase the rate to 100 or 150 mg (be sure to receive a daily dosage for 3 or 4 doses);
- against the background of an attack of gout, the norm is increased to 50 mg per dose, in total - three times a day. After the negative symptoms subside, to prevent exacerbations, the patient takes 1 tablet of Indomethacin in the morning and evening;
- course duration - up to 30 days at a standard dosage or longer (as prescribed by a doctor) with a reduced rate (no more than 75 mg per day);
- the maximum rate for 1 day for the relief of acute pain is 200 mg of indomethacin. It is necessary to remember the consequences for the gastrointestinal tract, liver, heart, central nervous system, to receive the drug in the minimum effective therapeutic dose.
Side effects
Non-selective blocking of the cyclooxygenase enzyme explains a wide range of adverse reactions from various organs and systems. The severity of negative manifestations depends on compliance with the dosage, the individual characteristics of the patient, the state of the gastrointestinal tract, heart, blood vessels.
During therapy, systemic side effects are possible:
- nausea, heartburn, abdominal discomfort, gastropathy while taking NSAIDs, diarrhea, increased ALT and AST;
- high doses of indomethacin with long-term use of tablets provoke the risk of bleeding and ulcerative lesions of the gastrointestinal tract;
- allergic reactions of varying severity;
- violation of the composition of the blood;
- impaired sense of smell, hearing and vision;
- depression, nervousness or apathy;
- excessive fatigue or overexcitation;
- conjunctivitis, corneal damage;
- anemia, thrombocytopenic purpura;
- increased swelling, development of arrhythmia, tachycardia, increased pressure;
- nephrotic syndrome, development of interstitial nephritis, hematuria and proteinuria;
- blood loss against the background of severe damage to the mucous membrane of the uterus, gums, rectum.
Overdose
An excess of indomethacin adversely affects the body: there are signs of drug intoxication, the patient complains of disorientation, dizziness, memory problems. Prolonged intake of high doses of the active substance can provoke paresthesia, numbness of the hands and feet, convulsive syndrome.
To eliminate the signs of an overdose, it is necessary to rinse the stomach as soon as possible, give the patient a sorbent, consult a doctor about symptomatic therapy. It is important to exclude the risk of bleeding in the digestive tract: the patient is under the supervision of a specialist for several days.
Learn about the causes of the development of a deforming disease and about the treatment options for the disease.
A page is written about the symptoms of instability of the cervical spine and the treatment of the disease.
drug interaction
The indiscriminate action of a powerful nonsteroidal agent requires careful use with certain groups of drugs. If the patient is undergoing treatment for arterial hypertension, heart and vascular diseases, chronic kidney pathologies, then you need to indicate to the doctor all the names from the list of prescribed drugs.
Interaction of Indomethacin with some names and types of drugs:
- increases the risk of negative reactions from others;
- reduces the diuretic effect of loop, thiazide and potassium-sparing diuretics;
- increases the activity of indirect anticoagulants, fibrinolytics, antiplatelet agents: the risk of bleeding increases many times;
- gold preparations and antibiotics of the cephalosporin group increase the nephrotoxic effect of indomethacin;
- the risk of bleeding in the digestive tract increases when combined with corticotropin, colchicine, ethanol, corticosteroids;
- a decrease in the prothrombin index, the likelihood of bleeding - a consequence of the combination of indomethacin with cefoperazone, valproic acid, cefotetan, cefamandol;
- the effect of the use of antihypertensive drugs and uricosuric formulations is lower than before the use of non-selective NSAIDs;
- absorption of indomethacin is reduced while taking cholestyramine and antacids;
- combination with myelotoxic drugs adversely affects the composition of the blood.
Price
The price of Indomethacin tablets (packaging No. 30) is low - 70 rubles. The drug should be stored in its original packaging in a ventilated area, the optimum temperature is up to + 25 C. Patients of any age should not use the non-steroid drug uncontrollably: it is important to ensure that children do not accidentally find tablets.
Indomethacin: analogues
Manufacturers offer several items based on indomethacin:
- Metindol.
- Indocollier.
- Metindol Retard.
With poor tolerance of the components of traditional NSAIDs, doctors recommend safer names of the new generation. Effective non-steroidal formulations of selective action:, Celebrex, Rofecoxib.
Content
There are chronic ailments, the exacerbation of which brings severe suffering to patients due to sharp constant pain. To alleviate pain in such diseases, doctors recommend Indomethacin tablets, which bring a tangible effect, relieving pain, allowing a person to lead a relatively normal life without suffering. Indomethacin in tablets is considered a proven universal remedy that helps at different stages of diseases.
What is indomethacin tablets
As an anti-inflammatory, temperature-reducing and anti-clotting drug, Indomethacin tablets are used to suppress inflammatory foci in the body, increase serous exudates and reduce tissue proliferation characteristic of inflammation of various etiologies. Being used to relieve rheumatic pain in the joints, the drug Indomethacin not only extinguishes sharp pain, but also helps to reduce the volume of edema and tumors. This action returns patients to the former quality of life.
However, it is not worth trying to treat a variety of ailments on your own using only these pills. Doctors prescribe the drug Indomethacin to patients as an adjuvant in the main treatment, which consists of drugs that have a selective effect on the cause of the disease. If you "suppress" the pain with Indomethacin tablets for a long period of time, without contacting a specialist, then there is a possibility of additional diseases, since the drug has an extensive list of side effects.
Compound
The medicine is available in the form of round light or dark yellow tablets, which include inclusions. If you cut the tablet in half, you can see that it has two layers. The main active ingredient is indomethacin itself. In addition to it, each tablet contains:
- cellactose;
- potato starch;
- calcium or magnesium stearate;
- titanium dioxide;
- oidragite or eudrogit;
- talc;
- dibutyl phthalate;
- diethyl phthalate;
- colloidal silicon dioxide;
- polyvinylpyrrolidone;
- dye orange or brown.
Pharmacological action of Indomethacin tablets
The mechanism of action of Indomethacin is that the drug inhibits the activity of the apparatus of the enzymatic group that produces prostaglandin hormones, which are most actively involved in the initiation and development of an inflammatory focus in the joints or the body. Bone marrow production of platelets, which contribute to painful swelling and tumors, also decreases. At the same time, the temperature of the body area on which the state of inflammation has arisen decreases, the pain syndrome decreases, morning stiffness and swelling go away.
After taking, according to the description, the tablets are absorbed very quickly, starting to act after 20-30 minutes, the maximum concentration of Indomethacin in the bloodstream is reached after 2 hours. A pronounced anti-inflammatory effect occurs after 5-7 days of constant use. Excreted by the kidneys or intestines after 6-8 hours, after intensive processing by the liver.
antibiotic or not
Many people mistakenly take Indomethacin for an antibacterial drug, trying to treat bacterial infections with pills. However, the drug belongs to the group of NSAIDs, it does not act on pathogens, but on inflammation itself, which is the body's response to exogenous factors. Do not take medicine as an antibiotic! By acting in this way, you can start the disease, and the treatment will continue in the hospital. It must be remembered that indomethacin tablets relieve the symptoms of the disease without affecting its cause.
Application
Indomethacin tablets are prescribed by doctors in the presence of the following pathologies in order to reduce acute pain:
- rheumatoid arthritis;
- polyarthritis of different genesis and etiology;
- periarthritis (inflammation of the tissues around the joint);
- ankylosing spondylitis (damage to the vertebral joints);
- gout (joint damage associated with an excess of uric acid in the body);
- thrombophlebitis;
- various periarticular ailments - bursitis, tendinitis;
- osteoarthritis;
- relief of possible inflammation after surgery;
- inflammation of the dental nerve;
- in the complex therapy of ENT diseases.
Instructions for use of tablets Indomethacin
For adults, the initial dose corresponds to 2-3 tablets per day, divided into 2-3 doses, which must be swallowed without chewing and washed down with milk after meals. If this dose of Indomethacin is not enough to relieve pain, then the number of tablets taken is doubled, bringing it up to 6 pieces per day (2 tablets per dose). However, the maximum dose of Indomethacin should not exceed 200 mg per day. To achieve the desired effect, Indomethacin should be drunk regularly for at least 10 days.
Sometimes doctors recommend drinking Indomethacin for a long time, for a whole month, depending on the severity of inflammation and the intensity of pain. If, without good reason, without good reason, stop treatment with the medication without permission, then all the signs of the disease, according to the patients, appear again, so you must strictly follow the recommendations of the doctors and the instructions for use, which is attached to each package of tablets.
Indomethacin for children
Children under 14 years of age are an absolute contraindication not only for Indomethacin tablets, but also for gels, ointments, eye drops and rectal suppositories. If a small child found a package of pills and ate them, then you should immediately wash his stomach, provide first aid in case of poisoning and call an ambulance for emergency admission to the hospital.
Use in the elderly
The use of Indomethacin tablets for elderly patients should be due to extreme necessity, since the use of the drug can exacerbate chronic ailments, affect the body in an unpredictable way. If the doctor has prescribed a medicine to take, then elderly people need to drink pills very carefully, starting with the minimum dose, closely monitoring the body's reaction to the drug. When side effects, you must stop taking the medicine immediately, informing the doctor about it.
Pregnancy and lactation
Indomethacin can contribute to fetal developmental disorders, blockage of arterial ducts, myocardial insufficiency, bleeding due to a decrease in the number of platelets in the bloodstream, kidney dysfunction, difficulty labor activity or premature birth. Based on the above facts, indomethacin tablets during pregnancy in the last stages and during breastfeeding are prohibited for use. During the first two trimesters, the remedy is prescribed only when absolutely necessary.
Side effects
Since the decrease in the production of prostaglandins and platelets when using the drug has a systemic effect on the entire body, the side effects of the drug can be many. These include:
- From the side of the central, peripheral nervous systems and the brain: dizziness, weakness, fainting, drowsiness, anxiety or depression may develop.
- On the part of the digestive tract: ulceration can be observed on the walls of the stomach and duodenum, bleeding, pain, nausea, vomiting, pain in the stomach.
- From the hematopoietic system: thrombocytopenia, agranulocytosis, leukopenia, lack of erythrocytes in the blood.
- From the genitourinary organs: urinary retention in the body, failure of the liver and kidneys, reduced fertility.
Still often there may be failures in the work of the myocardium, tachycardia, arrhythmia, weak pulse, signs of heart failure (acute), lowering of the upper pressure. If you are allergic to Indomethacin or additional components in the composition of the drug, a rash like urticaria, itching, signs of exfoliative dermatitis appear (infrequently). .
Contraindications
Indomethacin tablets should not be used for the following diseases:
- bronchial asthma, or asthma caused by taking aspirin;
- exacerbation of stomach ulcers or colitis;
- allergies to drug components;
- congenital heart diseases (atresia of the pulmonary artery, coarctation of the aorta);
- severe damage to the liver and kidneys;
- if the patient has a history of hemophilic congenital diseases;
- proctological ailments, hemorrhoids, bleeding;
- damage to the auditory or optic nerves;
- hyperplastic sinusitis.
drug interaction
The combined use of indomethacin tablets with other non-steroidal PVAs enhances their activity and may increase the risk of side effects. When interacting with diuretic and diuretic drugs, their effectiveness decreases. Simultaneous administration of Indomethacin with Paracetamol, gold preparations, cyclosporine, acetylsalicylic acid increases the risk of kidney damage. The combined action of indomethacin tablets and glucocorticosteroids, drugs containing ethanol, colchicine increases the likelihood of developing peptic ulcer.
Analogues
Anti-inflammatory drugs similar to Indomethacin, but with a different main component, are synonymous with it, but not similar. Analogues of a medicinal product containing the same active substance include:
- Indotard;
- Metindol;
- Indobene;
- Indovis;
- Indocollier;
- Indocide;
- Indovis EU;
- Indomethacin-Biosynthesis;
- Movimed.
Price
Indomethacin is not an expensive medicine, the price of tablets is low, if desired, the drug can be bought in the online store from the catalog and ordered for home delivery. Prices for medicines in pharmacies in Moscow can be seen in the table below:
Video: Candles with indomethacin
Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.
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Instructions for use of Indomethacin tablets - composition, indications, side effects, analogues and price
The composition of all dosage forms of the therapeutic agent includes as an active ingredient indomethacin (Indometacin ) in different mass parts: 25 mg for tablets and 50 mg or 100 mg for suppositories (candles), gel and ointment.
Additional ingredients of drugs may vary slightly depending on the manufacturer, which should also be taken into account by the doctor prescribing this or that drug to the patient.
Release form
The medicine Indomethacin is produced in the form of:
- oral tablets No. 10-No. 300;
- candles No. 6-No. 50;
- gel 40 grams;
- ointments of 10-40 grams.
pharmachologic effect
Antiaggregatory, analgesic, anti-inflammatory, antipyretic.
Pharmacodynamics and pharmacokinetics
The drug Indomethacin Sopharma; Berlin Hemi, Balkanpharma etc.) is a derivative indoacetic acid and refers to drugs of the NSAID group, which are characterized by their antipyretic , anti-inflammatory , antiaggregatory and painkillers action.
The effectiveness of this therapeutic agent is associated with its inhibitory (depressant) effect on COX (cyclooxygenase ), which leads to the suppression of metabolic transformations arachidonic acid and decreased synthesis. Also, one of the effects of the drug is inhibition aggregations .
Parenteral and oral use of Indomethacin reduces the severity pain syndrome , especially with regard to joint pain , both in a state of movement and at rest, reduces the manifestations of morning swelling of the joints and their stiffness, and also increases the range of motion. Anti-inflammatory action develops after 5-7 days of treatment.
External use of this drug helps to eliminate pain, reduce swelling and reduce erythema, as well as reduce morning articular stiffness and increase motor activity .
Indomethacin tablets, when taken orally, are rapidly absorbed from the digestive tract. Serum Cmax is noted after 120 minutes. After enterohepatic recirculation, further metabolic transformations take place in the liver. In plasma, the unchanged active ingredient and unbound metabolic products are determined - debenzoyl , demethyl , desmethyl-desbenzoyl metabolites. The average T1 / 2 lasts approximately 4.5 hours. Excretion of 60% of the drug, in the form of unchanged substance and metabolic products, is carried out by the kidneys and 33%, in the form of metabolites, by the intestine.
Rectal suppositories are characterized by rapid absorption in the rectum. Bioavailability with this route of administration of the drug is 80-90%. Approximately 90% of the active ingredient binds to whey proteins. T1 / 2 varies within 4-9 hours. Metabolic transformations take place in the liver. Approximately 70% of the drug is excreted by the kidneys, about 30% by the intestines.
Indications for use
Indications for the use of Indomethacin in the form of tablets and suppositories include:
- articular syndrome (including painful manifestations, ankylosing spondylitis , );
- various ;
- pain syndrome in the spine;
- myalgia ;
- diffuse painful conditions of the connective tissue;
- traumatic inflammatory processes in joints and soft tissues;
- infectious and inflammatory processes noted with, and diseases of the upper respiratory tract (auxiliary therapy).
Gel and ointment Indomethacin is indicated for use in:
- myalgia ;
- traumatic inflammatory processes occurring in the joints and soft tissues;
- articular syndrome (including pain symptoms) gout , rheumatoid arthritis , ankylosing spondylitis , osteoarthritis );
- pain in the spine;
- neuralgia .
Contraindications
Indomethacin tablets (Sopharma, Balkanpharma, etc.), as well as Indomethacin suppositories (Berlin Chemie, Sopharma, etc.), are contraindicated for use with:
- Crohn's disease ;
- liver failure or active;
- hypersensitivity;
- pregnancy;
- breastfeeding;
- acute or, in the past caused by taking NSAIDs;
- confirmed hyperkalemia;
- CRF (with CC less than 30 ml / min) or progressive;
- recent coronary artery bypass grafting ;
- blood clotting disorders;
- congenital heart defects ;
- hematopoietic disorders (including anemia and leukopenia );
- under the age of 14 years.
Additionally, suppositories Indomethacin 50/100 (Berlin Chemie, Sopharma, etc.) are not allowed to be used for:
- manifestations;
- rectal bleeding ;
- symptoms proctitis .
With caution, both dosage forms of the drug should be prescribed for:
- ischemic heart disease ;
- somatic diseases of a severe nature;
- cerebrovascular disorders;
- dyslipidemia;
- hyperlipidemia;
- mental disorders;
- thrombocytopenia;
- pathologies of peripheral arteries;
- ulcerative lesions of the gastrointestinal tract in history;
- long-term use of other NSAIDs;
- CRF (with CC 30-60 ml / min);
- hyperbilirubinemia ;
- availability Helicobacter pylori ;
- with accompanying portal hypertension ;
- parallel use of anticoagulants (), oral glucocorticoids (), antiplatelet agents (,), SSRIs (,);
- in old age.
Gel and ointment for topical use are contraindicated in:
- skin damage in the area of application;
- III trimester of pregnancy (in case of application of the drug to large areas of the body);
- hypersensitivity ;
- under the age of 1 year.
External dosage forms are prescribed with caution when:
- any combination with nasal/paranasal sinuses and intolerance to NSAIDs ;
- I and II trimester of pregnancy;
- exacerbation peptic ulcer of the gastrointestinal tract ;
- breastfeeding;
- blood clotting disorders ;
- up to 6 years old.
Side effects
Side effects when using tablets or suppositories
Digestive system:
- nausea, vomiting;
- gastrointestinal bleeding;
- jaundice ;
- discomfort or pain in the abdomen;
- perforation of the gastrointestinal tract;
- erosive and ulcerative lesions of the gastrointestinal tract ;
- stomatitis ;
- intestinal strictures;
- bleeding from a diverticulum or sigmoid colon;
Candles Indomethacin, instructions for use
Candles Indomethacin ( Altfarm, Sopharma etc.) are intended for rectal (into the rectum) application. The procedure for the introduction of suppositories should be performed at bedtime after preliminary cleaning of the intestines. Candles Indomethacin ( Berlin Hemi, Biosynthesis etc.), it is necessary to try to enter into the rectum as deeply as possible, in order to better absorb the drug. Usually, in 24 hours, a 3-time administration of 50 mg suppositories or a single administration of 100 mg suppositories is prescribed. In case of severe pain syndrome (for example, an attack of gout), rectal daily use of 200 mg of the drug in suppositories is allowed (in addition to oral administration).
Gel and ointment Indomethacin, instructions for use
Gel and ointment Indomethacin ( Sopharma, Balkanpharma etc.) are intended for application and rubbing into the skin, located directly above the site of the painful area of the body, for which Indomethacin gel or ointment ( Sopharma, Akrikhin etc.) apply a thin layer on intact and previously cleansed skin.
5% external agents are indicated to be applied at intervals of 3-4 times in 24 hours. Applications of 10% drugs should be carried out 2-3 times a day. Single and maximum dosages of the external forms of the drug are calculated based on the amount (in centimeters) of the squeezed out gel or ointment from the tube. Adult patients can use 4-5 cm of the extruded drug at a time, and a maximum of 15-20 cm per day. Children are shown to use half the dosage.
Overdose
Negative symptoms of an overdose of Indomethacin, most often observed with the use of oral or rectal dosage forms, are manifested by: nausea / vomiting, severe, memory impairment , . In particularly serious cases, limb numbness , convulsions .
The prescribed treatment should be consistent with the monitored adverse events.
Interaction
Combined use, drugs lithium and increases their serum concentrations, which can cause an increase in their toxicity .
Concurrently received ethanol-containing drugs, glucocorticoids , and corticotropin increase the possibility of gastrointestinal bleeding .
Co-administration with therapeutic agents, including, increases the risk nephrotoxicity .
Combinatorial treatment with and others hypoglycemic drugs enhances their effect.
Simultaneous use with indirect antiplatelet agents , anticoagulants and thrombolytics enhances their effects, which increases the possibility of developing bleeding .
Co-administered drugs gold and raise nephrotoxicity (most likely due to inhibition of synthesis in the kidneys
Indomethacin refers to non-steroidal anti-inflammatory drugs that can not only stop the inflammatory process, but also relieve the symptoms of pain, as well as lower body temperature. The mechanism of pharmacological action is based on the suspension of enzymatic processes, which ultimately leads to a decrease in the production of inflammatory mediators. It is used in the treatment of pathologies of the musculoskeletal system. Able to stop pain in the joints, reduce swelling and intensity of inflammation, restore the patient's motor activity.1. Pharmacological action
Indomethacin is a non-steroidal anti-inflammatory drug with a pronounced analgesic effect. The mechanism for achieving a therapeutic effect is associated with blocking the synthesis of prostaglandins - biologically active substances involved in the development of pain and edema at the site of inflammation. In addition, Indomethacin inhibits the ability of platelets to stick together and form blood clots. The drug is rapidly absorbed and reaches its maximum plasma concentration after 2 hours. Neutralization of Indomethacin occurs in the liver with the formation of the active substance and free decay products. Most of it is excreted in the urine (in unchanged form), the rest is excreted through the intestines.
2. indications for use
The use of Indomethacin in the form of tablets:
- Pain syndrome of various localization and severity associated with various inflammatory diseases of the musculoskeletal system;
- Inflammatory processes of tissues associated with trauma.
- Inflammatory processes of ENT organs caused by various infectious diseases;
- Inflammatory diseases of the bladder;
- Inflammation of the prostate;
- Inflammation of the ovaries and fallopian tubes.
- Prevention of inflammation during ophthalmic operations;
- Prevention of the occurrence of pupillary constriction during surgical interventions.
- Pain syndrome of various localization and severity associated with various inflammatory diseases of the musculoskeletal system.
3. How to use
The dosage of the drug is set individually by the attending physician and depends on the severity of the patient's condition. Recommended dosage of Indomethacin in the form of tablets: The initial dose of the drug is 25 mg, which is gradually increased to 50 mg. The number of applications of Indomethacin - up to 3 times a day. The duration of treatment is long, determined by the attending physician, depending on the condition of the patients and the tolerability of the drug. Recommended dosage of Indomethacin in the treatment of gout:
- In the treatment of attacks in acute form - 0.05 g of the drug three times a day;
- To prevent the occurrence of exacerbations - 0.025 g of the drug twice a day.
4. Side effects
- Nervous system disorders (headaches, sleep disturbances, various mental disorders, persistent long-term mood swings, unreasonable anxiety, dizziness, general fatigue, fainting, convulsive syndrome, peripheral nervous system lesions, involuntary contractions of skeletal muscles, muscle weakness, drowsiness);
- Digestive system disorders (decreased or complete lack of appetite, pain in the abdomen, nausea, stool disorders, vomiting, bleeding of the digestive system, ulcerative lesions of the digestive system, inflammation of the liver, inflammation of the oral cavity, perforation of the digestive system, inflammation of the stomach , spasms of the intestines);
- Disorders of the cardiovascular system (increased blood pressure, cardiac arrhythmias, edema of various localization, pain in the chest, lowering blood pressure, functional heart failure with stagnation);
- Various allergic reactions (skin itching, skin rashes, skin necrosis, Stevens-Johnson syndrome, acute respiratory disorders,);
- Violations of the hematopoietic system (point hemorrhages, a decrease in the content of leukocytes, anemia of various origins, a decrease in the content of platelets);
- Violation of the urinary system (the appearance of blood in the urine, inflammation in the kidneys, the appearance of protein in the urine, functional disorders of the kidneys with the development of renal failure);
- Sensory disturbances (visual disturbances, hearing impairments, eye pain, ringing in the ears, double vision);
- Metabolic disorders (increased blood glucose, increased potassium in the blood serum, the appearance of glucose in the urine, hair loss);
- Local side effects (irritation of the intestinal mucosa, formation of infiltrates at the injection site, skin redness, skin rashes at the application site).
5. Contraindications
- Functional disorders of the kidneys;
- Violations of hematopoietic processes;
- Ulcerative lesions of the digestive system;
- Individual intolerance to the drug and its components;
- Pregnancy from 1st to 3rd trimester and lactation;
- Prolonged increase in blood pressure in severe form;
- Functional disorders of the liver;
- Functional heart failure in severe form;
- Hypersensitivity to the drug and its components;
- aspirin asthma;
- Bleeding from the rectum;
- Patients under 14 years of age;
- Inflammation of the pancreas in severe form.
6. During pregnancy and lactation
Indomethacin is contraindicated for use from the 1st to the 3rd trimester of pregnancy and during lactation. In other cases, the use of the drug should take into account the possible negative impact on the body of the mother and child.
7. Interaction with other drugs
- The simultaneous use of Indomethacin with Probenecid leads to an increase in the plasma concentration of Indomethacin;
- The simultaneous use of Indomethacin with drugs that have a blocking effect on adrenaline receptors and diuretics, there is a decrease in the therapeutic effect of the latter;
- The simultaneous use of Indomethacin with drugs that reduce the ability of blood to coagulate (indirect action) leads to an increase in the therapeutic effect of the latter;
- The simultaneous use of Indomethacin with Methotrexate leads to an increase in the toxicity of the latter;
- The simultaneous use of Indomethacin with Diflunisal leads to the risk of severe bleeding from the digestive system;
- The simultaneous use of Indomethacin with Digoxin leads to an increase in the plasma concentration of the latter.
8. Overdose
The phenomena of an overdose of the drug are not currently described.
9. Release form
Enteric-coated tablets, 25 mg - 10, 20, 30, 40 or 50 pcs. Ointment, 10% - 15 g or 30 g tubes; 10 mg / 1 g - tube 30 g or 40 g; 10% - 40 g tubes, 10, 15, 20, 25, 30 or 40 g cans. Gel, 5 or 10% - tube 40 g. Rectal suppositories, 50 or 100 mg - 6 or 10 pcs.
10. Storage conditions
Indomethacin must be stored in a place well protected from light. The recommended temperature regime is no more than 25 degrees.
11. Composition
1 tablet:
- indomethacin - 25 mg;
- Excipients: lactose monohydrate, potato starch, microcrystalline cellulose, povidone, magnesium stearate.
1 ointment:
- indomethacin - 100 mg.
1 gel:
- indomethacin - 100 mg;
- Excipients: macrogol, carbomer, propylene glycol, sodium benzoate, ethanol.
1 suppository:
- indomethacin - 50 mg.
12. Terms of dispensing from pharmacies
The drug is released according to the prescription of the attending physician.Indomethacin in gynecology
A non-steroidal anti-inflammatory drug called Indomethacin has many forms of release, but suppositories are mainly used in gynecology. Instructions for use of the drug Indomethacin involves the introduction of suppositories into the rectum, but in some cases suppositories are also used for vaginal administration.
The drug has anti-inflammatory, analgesic and antipyretic effects.
In gynecology, Indomethacin is used to treat:
- Algomenorrhea, which is characterized by a painful menstrual cycle;
- Inflammatory diseases of the female genital organs;
- Inflammation of the bladder - cystitis;
- ovarian cysts;
- Severe pain from endometriosis;
- Adnexitis.
The drug is also used in preventive purposes after surgery to prevent adhesion formation.
During pregnancy, the drug is practically not used due to the negative impact on the fetus. But in rare cases, for example, with the threat of miscarriage, Indomethacin can be prescribed for a period from 16 to 32 weeks. The drug in this case does not allow the body to produce hormones that cause uterine tone.
Its use at a later date is prohibited, because this can lead to the closure of the botallian duct.. It is forbidden to use the drug during breastfeeding because of its penetration into breast milk.
Indomethacin has a number of side effects and contraindications, so it should be prescribed only by a doctor who, depending on the disease, will determine the exact dosage, route of administration and duration of treatment.
On average, at a dosage of 100 mg, a single use of the drug per day is prescribed, and at a concentration of 50 mg up to 3 times / day. Usually candles are used at night. If a double dose is prescribed, then after application it is recommended to lie down a bit.
Alcohol and indomethacin
The intake of alcoholic beverages is strictly prohibited with Indomethacin, because this combination leads to a number of negative consequences:
- There is a double load on the liver and severe poisoning of the body;
- The negative effect on the stomach increases, which can lead to ulcers and gastric bleeding;
- The risk of side effects increases while taking Indomethacin with alcohol;
- The effectiveness of drug treatment decreases.
Therefore, from alcoholic beverages for the entire period of treatment should be abandoned.
Indomethacin for prostatitis
The release of the drug is carried out in various forms, but for the treatment of prostatitis, preference is given to rectal suppositories. Thanks to this introduction, Indomethacin reaches the source of inflammation faster. After all, it is the rectum that is in close proximity to the prostate gland.
And also this method of administration is convenient if a man has diseases of the stomach, because with rectal administration, the drug does not affect this organ.
For the treatment of prostatitis, the drug is used as a symptomatic treatment.. In the instructions for Indomethacin, you can see that the drug has anti-inflammatory, antipyretic, analgesic effects. Therefore, Indomethacin is able to relieve inflammation of the prostate gland, while eliminating pain. In addition, the remedy has a beneficial effect on blood circulation, protecting the small vessels of the gland from blood clots and preventing the stagnation of its secretory secretions.
Candles are inserted into the intestine after preliminary emptying and hygiene procedures. The doctor determines the exact dosage and duration of treatment, but on average it is prescribed to insert 1 suppository in the morning and evening. The duration of such treatment is usually 7-10 days, but may be longer.
Throughout the course of treatment, a man should be observed by a urologist and undergo all necessary examinations.
indomethacin for hemorrhoids
With hemorrhoids, a drug such as Indomethacin in the form of an ointment and suppositories can be prescribed. The drug helps to relieve swelling, inflammation and pain.
Candles are used in the presence of internal hemorrhoids. With external manifestations of hemorrhoids, I use an ointment.
Candles are used up to 2 times a day for 3 days. With a decrease in symptoms, then they switch to a single use of the drug. In the case of severe symptoms, the drug continues to be used 2 suppositories with a duration of treatment of 10 days.
After hygiene procedures, the ointment is applied and rubbed in a thin layer into the hemorrhoidal bumps. The doctor determines the exact dosage and duration of treatment.
Indomethacin for the treatment of hemorrhoids is prescribed very rarely, but it can quickly eliminate such unpleasant symptoms as burning and pain.
indomethacin and ibuprofen
Indomethacin and Ibuprofen belong to the same pharmacological group, namely non-steroidal anti-inflammatory drugs. Which of these drugs is better?
Indomethacin is a derivative of indoleacetic acid, and Ibuprofen is propionic. It is rather difficult to determine which of these drugs is better, because both drugs belong to the same pharmacological group and have almost identical medicinal properties.
At the same time, Ibuprofen is considered to be a safer drug, and Indomethacin has a more powerful anti-inflammatory activity. Therefore, only a doctor can choose which remedy is better, who, depending on the degree and form of the disease, will select the most suitable option.
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* Instructions for medical use for the drug Indomethacin is published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USE, IT IS NECESSARY TO CONSULT WITH A SPECIALIST
It has anti-inflammatory, analgesic and antipyretic effects.
Drug: INDOMETACIN
The active substance of the drug:
indomethacin
ATX encoding: M01AB01
CFG: NSAIDs
Reg. number: P No. 014317/01-2002
Date of registration: 16.09.02
The owner of the reg. Award: MAGISTRA C&C (Romania)
Release form Indomethacin, drug packaging and composition.
Rectal suppositories white or almost white, or almost white with a yellowish tinge, elongated in the form of a torpedo with a smooth oily surface, having a uniform appearance on a longitudinal section.
1 supp.
indomethacin
50 mg
Excipients: aerosil, paraffin oil, glycerides.
3 pcs. - blisters (2) - cardboard boxes.
Tablets, enteric-coated, light brown, round, biconvex.
1 tab.
indomethacin
25 mg
Excipients: lactose, wheat starch, gelatin, talc, magnesium stearate, microcrystalline cellulose, eudragit (L-12.5% and S-12.5%), titanium dioxide, macrogol 6000, macrogol 400, lak sikovit (10E172, 30E172) diethyl phthalate, acetone , isopropanol, purified water.
30 pcs. - blisters (1) - packs of cardboard.
DESCRIPTION OF THE ACTIVE SUBSTANCE.
All the information provided is provided only for familiarization with the drug, you should consult a doctor about the possibility of using it.
Pharmacological action Indomethacin
NSAIDs, a derivative of indoleacetic acid. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with inhibition of the COX enzyme, which leads to inhibition of the synthesis of prostaglandins from arachidonic acid.
Suppresses platelet aggregation.
When administered orally and parenterally, it helps to relieve pain, especially joint pain at rest and during movement, reduce morning stiffness and swelling of the joints, and increase range of motion. The anti-inflammatory effect develops by the end of the first week of treatment.
When applied topically, it eliminates pain, reduces swelling and erythema.
When applied externally, it also helps to reduce morning stiffness and increase range of motion.
Pharmacokinetics of the drug.
After oral administration, indomethacin is rapidly absorbed from the gastrointestinal tract. Cmax in plasma is achieved after 2 hours. It is metabolized in the liver. It undergoes enterohepatic recirculation. Indomethacin is determined in the blood plasma as an unchanged substance and unbound metabolites - desmethyl, desbenzoyl, desmethyl-desbenzoyl.
T1 / 2 is about 4.5 hours. Excreted in the urine - 60% in the form of unchanged substance and metabolites, and with feces - 33% mainly in the form of metabolites.
Indications for use:
For systemic use: articular syndrome (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout), pain in the spine, neuralgia, myalgia, traumatic inflammation of soft tissues and joints, rheumatism, diffuse connective tissue diseases, dysmenorrhea. As an aid in infectious and inflammatory diseases of the ENT organs, adnexitis, prostatitis, cystitis.
For local use: prevention of the inflammatory process during surgical interventions for cataracts and in the anterior segment of the eye, inhibition of miosis during surgery.
For external use: articular syndrome (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout), pain in the spine, neuralgia, myalgia, traumatic inflammation of soft tissues and joints.
Dosage and method of application of the drug.
Set individually, taking into account the severity of the course of the disease. For adults, when taken orally, the initial dose is 25 mg 2-3 times / day. With insufficient severity of the clinical effect, the dose is increased to 50 mg 3 times / day. Dosage forms of prolonged action are used 1-2 times / day. Maximum daily dose: 200 mg.
When the effect is achieved, treatment is continued for 4 weeks at the same or reduced dose. With prolonged use, the daily dose should not exceed 75 mg. Taken after meals.
For the treatment of acute conditions or relief of an exacerbation of a chronic process, 60 mg is administered intramuscularly 1-2 times / day. The duration of the / m administration is 7-14 days. Then indomethacin is used orally or rectally, 50-100 mg 2 times / day, while the maximum daily dose should not exceed 200 mg. For maintenance treatment, apply rectally at 50-100 mg 1 time / day at night.
For local use in ophthalmology, the dose, frequency and duration of use are determined individually.
Externally applied 2 times / day.
Side effects of Indomethacin:
From the digestive system: nausea, anorexia, vomiting, pain and discomfort in the abdomen, constipation or diarrhea, erosive and ulcerative lesions, bleeding and perforation of the gastrointestinal tract; rarely - intestinal strictures, stomatitis, gastritis, flatulence, bleeding from the sigmoid colon or from a diverticulum, jaundice, hepatitis.
From the side of the central nervous system and peripheral nervous system: dizziness, headache, depression, fatigue; rarely - anxiety, fainting, drowsiness, convulsions, peripheral neuropathy, muscle weakness, involuntary muscle movements, sleep disturbances, mental disorders (depersonalization, psychotic episodes), paresthesia, dysarthria, parkinsonism.
From the side of the cardiovascular system: edema, increased blood pressure, tachycardia, chest pain, arrhythmia, palpitation, arterial hypotension, congestive heart failure, hematuria.
Allergic reactions: rarely - itching, urticaria, angiitis, erythema nodosum, skin rash, exfoliative dermatitis, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, hair loss, acute respiratory distress, a sharp drop in blood pressure, anaphylactic reactions, angioedema, dyspnea , bronchial asthma, pulmonary edema.
On the part of the hematopoietic system: rarely - leukopenia, petechiae or ecchymosis, purpura, aplastic and hemolytic anemia, thrombocytopenia, DIC syndrome.
From the sensory organs: rarely - a violation of the clarity of visual perception, diplopia, orbital and periorbital pain, tinnitus, hearing impairment, deafness.
From the urinary system: rarely - proteinuria, nephrotic syndrome, interstitial nephritis, impaired renal function, renal failure.
From the side of metabolism: rarely - hyperglycemia, glucosuria, hyperkalemia.
Others: rarely - vaginal bleeding, hot flashes, increased sweating, epistaxis, enlargement and tension of the mammary glands, gynecomastia.
Local reactions: in the place of intramuscular injection in some cases - the formation of an infiltrate, abscess; with rectal use, irritation of the rectal mucosa, tenesmus, exacerbation of chronic colitis are possible.
For external use: itching, redness, rash at the site of application.
Contraindications to the drug:
Hypersensitivity to indomethacin, erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, "aspirin triad", hematopoietic disorders, severe liver and / or kidney dysfunction, severe forms of chronic heart failure, arterial hypertension, pancreatitis, III trimester of pregnancy, children under 14 years of age years; for rectal use: proctitis, recent bleeding from the rectum.
Use during pregnancy and lactation.
Indomethacin is contraindicated in the third trimester of pregnancy. In the I and II trimesters of pregnancy, as well as during lactation (breastfeeding), the use is not recommended.
Indomethacin is excreted in breast milk in small amounts.
Special instructions for the use of Indomethacin.
Use with caution in elderly patients, as well as in diseases of the liver, kidneys, gastrointestinal tract in history, with dyspeptic symptoms at the time of use, arterial hypertension, heart failure, immediately after major surgical interventions, with parkinsonism, epilepsy.
With indications in the anamnesis of allergic reactions to NSAIDs, they are used only in urgent cases.
During the period of treatment, systematic monitoring of the function of the liver and kidneys, the picture of peripheral blood is necessary.
Do not use indomethacin concomitantly with diflunisal.
With the simultaneous use of indomethacin with lithium preparations, the possibility of symptoms of the toxic effects of lithium should be borne in mind.
When applied topically, do not apply to the wound surface of the skin, and avoid contact with the eyes or mucous membranes.
Influence on the ability to drive vehicles and control mechanisms
During the period of treatment, one should refrain from potentially hazardous activities associated with the need to concentrate and increase the speed of psychomotor reactions.
Interaction of Indomethacin with other drugs.
With the simultaneous use of indomethacin can reduce the effects of saluretics, beta-blockers; enhance the effects of indirect anticoagulants.
With the simultaneous use of indomethacin and diflunisal, there is a risk of severe bleeding from the gastrointestinal tract.
With simultaneous use with probenecid, an increase in the concentration of indomethacin in the blood plasma is possible.
Indomethacin can reduce the tubular secretion of methotrexate, which leads to an increase in its toxicity.
With simultaneous use with NSAIDs, the toxicity of cyclosporine increases.
Indomethacin at a dose of 50 mg 3 times / day increases the concentration of lithium in the blood plasma and reduces the clearance of lithium from the body in patients with mental illness.
With the simultaneous use of indomethacin with digoxin, it is possible to increase the concentration of digoxin in the blood plasma and increase the half-life of digoxin.
