$Unique_ID{BRK01991}
$Pretitle{}
$Title{INDOMETHACIN}
$Subject{Indameth (Major)
Indocin (Merck Sharp & Dohme)
Indocin SR (Merck Sharp & Dohme)
Indo-Lemmon (Lemmon)
indomethacin (various manufacturers)}
$Volume{}
$Log{
Indocin 25*0199101.scf
Indocin 50*0199102.scf
Indocin SR*0199103.scf}

Copyright (C) 1991 Publications International, Ltd.


INDOMETHACIN
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BRAND NAMES (Manufacturers):
     Indameth (Major)
     Indocin (Merck Sharp & Dohme)
     Indocin SR (Merck Sharp & Dohme)
     Indo-Lemmon (Lemmon)
     indomethacin (various manufacturers)
TYPE OF DRUG:
     Nonsteroidal anti-inflammatory analgesic
INGREDIENT:
     indomethacin
DOSAGE FORMS:
     Capsules (25 mg and 50 mg)
     Extended-release capsules (75 mg)
     Oral suspension (25 mg per 5-ml spoonful, with 1% alcohol)
     Rectal suppositories (50 mg)
STORAGE:
     Indomethacin capsules, oral suspension, and rectal suppositories should
       be stored in closed containers at room temperature away from heat and
       direct sunlight.  The rectal suppositories can also be stored in the
       refrigerator.

USES

     Indomethacin is used to treat the inflammation (pain, swelling, and
stiffness) of certain types of arthritis, gout, bursitis, and tendinitis.
Indomethacin has been shown to block the production of certain body chemicals,
called prostaglandins, that may trigger pain.  However, it is not yet fully
understood how indomethacin works.

TREATMENT

     You should take this drug immediately after meals or with food, in order
to reduce stomach irritation.  Ask your doctor if you can take indomethacin
with an antacid.
     Do not chew or crush the extended-release capsules; they should be
swallowed whole.  Breaking the capsule would release the medication all at
once--defeating the purpose of the extended-release dosage form.
     The suspension form of this medication should be shaken well just before
measuring each dose.  The contents tend to settle on the bottom of the bottle,
so it is necessary to shake the container to distribute the ingredients evenly
and equalize the doses.  Each dose should be measured carefully with a
specially designed 5-ml measuring spoon.  An ordinary kitchen teaspoon is not
accurate enough.
     To use the rectal suppository form of this medication, remove the foil
wrapper, and moisten the suppository with water.  If the suppository is too
soft to insert, refrigerate it for 30 minutes or run cold water over it before
removing the foil wrapper.  Lie on your left side with your right knee bent.
Push the suppository into the rectum, pointed end first.  Lie still for a few
minutes.  Try to avoid having a bowel movement for at least one hour.
     It is important to take indomethacin on schedule and not to miss any
doses.  If you do miss a dose, take the missed dose as soon as possible,
unless more than an hour has passed.  In that case, do not take the missed
dose at all; just return to your regular dosing schedule.  Do not double the
next dose.
     This drug does not cure arthritis, but will help to control the condition
as long as you continue to take it.  It may take up to four weeks before you
feel the full benefits of this medication.

SIDE EFFECTS

     Minor.

     Bloating, constipation, diarrhea, difficulty in sleeping, dizziness,
drowsiness, headache, heartburn, indigestion, light-headedness, loss of
appetite, nausea, nervousness, soreness of the mouth, unusual sweating, or
vomiting.  As your body adjusts to the drug, these side effects should
disappear.
     To relieve constipation, increase the amount of fiber in your diet (fresh
fruits and vegetables, salads, bran, and whole-grain breads), exercise, and
drink more water (unless your doctor directs you to do otherwise).
     If you become dizzy, sit or lie down for a while; get up slowly from a
sitting or reclining position, and be careful on stairs.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
bloody or black, tarry stools; blurred vision; confusion; depression;
difficult or painful urination; palpitations; a problem with hearing; ringing
or buzzing in the ears; skin rash, hives, or itching; stomach pain; swelling
of the feet; rectal irritation; tightness in the chest; unexplained sore
throat and fever; unusual bleeding or bruising; unusual fatigue or weakness;
unusual weight gain; wheezing or difficulty in breathing; or yellowing of the
eyes or skin.

INTERACTIONS

     Indomethacin interacts with several other types of drugs:
     1. Use of anticoagulants (blood thinners, such as warfarin) can lead to
an increase in bleeding complications.
     2. Anti-inflammatory medications such as aspirin, salicylates, and
diflunisal can cause increased stomach irritation when used while taking this
drug.
     3. Indomethacin can decrease the elimination of lithium from the body,
possibly resulting in lithium toxicity.
     4. Indomethacin may interfere with the blood-pressure-lowering effects of
captopril, enalapril, or beta-blocking medications (acebutolol, atenolol,
betaxolol, carteolol, esmolol, labetalol, metoprolol, nadolol, penbutolol,
pindolol, propranolol, timolol).
     5. Indomethacin can interfere with the diuretic effects of furosemide and
thiazide-type diuretics (water pills).
     6. Probenecid can increase the amount of indomethacin in the bloodstream
when both drugs are being taken.
     7. The concurrent use of triamterene and indomethacin can result in
kidney problems.
     8. Indomethacin can alter the effects of the potassium-sparing diuretics
(such as amiloride, spironolactone, or triamterene).
     BE SURE TO TELL YOUR DOCTOR about any medications you are currently
taking, especially any of those listed above.

WARNINGS

     * Tell your doctor if you have ever had unusual or allergic reactions to
any medications, especially to indomethacin or any of the other chemically
related drugs (including aspirin, other salicylates, diclofenac, diflunisal,
fenoprofen, flurbiprofen, ibuprofen, ketoprofen, meclofenamate, mefenamic
acid, naproxen, oxyphenbutazone, phenylbutazone, piroxicam, suprofen, or
tolmetin).
     * Before taking indomethacin, tell your doctor if you now have or if you
have ever had bleeding problems, colitis, stomach ulcers or other stomach
problems, epilepsy, heart disease, high blood pressure, asthma, kidney
disease, liver disease, mental illness, or Parkinson's disease.
     * If indomethacin makes you dizzy or drowsy, do not take part in any
activity that requires alertness, such as driving a car or operating
potentially dangerous machinery.
     * If you will be taking this medication for a long period of time, your
doctor may want to have your eyes examined periodically by an ophthalmologist.
Some visual problems have been known to occur with long-term indomethacin use.
Your doctor might want to keep a careful watch for these.
     * Stomach problems are more likely to occur if you take aspirin regularly
or drink alcohol while being treated with this medication.  These should,
therefore, be avoided (unless your doctor directs you to do otherwise).
     * The elderly may be at increased risk for experiencing side effects of
this drug.
     * Be sure to tell your doctor if you are pregnant.  Studies in animals
have shown that indomethacin can cause unwanted effects in offspring,
including lower birth weights, slower development of bones, nerve damage, and
heart damage.  If taken late in pregnancy, the drug can also prolong labor.
Studies in humans have not been conducted.  Also, tell your doctor if you are
breast-feeding.  Small amounts of indomethacin can pass into breast milk, so
caution is warranted.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
