INDOCIN belongs to the class of non-steroidal anti-inflammatory drugs (NSAIDs). Inflammation of the joints is caused by chemical named prostaglandins. These are responsible for pain, tenderness and swelling caused by inflammation of joints in osteoarthritis and rheumatoid arthritis. Prostaglandins are synthesised by enzymes cyclooxygenase 1 and 2 (COX 1 and 2). INDOCIN blocks both of these enzymes but has highly selective for COX 1. Cox I produces prostaglandins which are required for maintaince of gastric mucosal layer. Due to this reason INDOCIN is more ulcerogenic than other NSAIDs.

WHAT ARE THE INDICATIONS?

INDOCIN relieves pain and inflammation (redness, swelling), joint stiffness in:

• Osteoarthritis
•  Rheumatoid arthritis
• Ankylosing spondylitis
•  Gout
• Acute painful shoulder (bursitis/tendonitis).

It only helps in relieving the symptoms and has no role in treating the cause. It act as anti-pyretic (one that reduces the body temperature) so used in fever also. It is also used in painful periods.

WHAT IS THE DOSAGE?

INDOCIN should not be taken without doctor’s prescription. Always start with lowest effective dose. INDOCIN is available in both solid (capsules) and liquid (syrups) dosage form. Suppositories are also available for rectal use.

INDOCIN capsules are available in two strengths:

• INDOCIN capsules 25 mg
• INDOCIN capsules 50 mg

Dosage of INDOCIN varies depending upon the severity of disease.

For Moderate to severe rheumatoid arthritis, ankylosing, spondilysis and osteoarthritis: Dose is INDOCIN capsules 25 mg two times or three times a day. Dosage must be increased gradually by 25 or by 50 mg daily to reach the daily dose of 150-200 mg. Total daily dose should not be increased 200mg.

For Acute painful shoulder (bursitis and/or tendinitis): Dose is 75-150 mg daily in 3 or 4 divided doses for 7-14 days.

For gout: Dose is 50 mg three times a day.

For children the dose is 4 mg per kg weight a day or 150 to 200 mg a day.

HOW TO TAKE INDOCIN?

• Always check the expiry date on the pack before using any medicine.
• Take INDOCIN as prescribed by your doctor. Dose depends upon severity of disease.

• Take each of your doses with a meal or just after eating a meal.
• INDOCIN capsules are taken by mouth with water.
• If you do forget to take a dose, take it as soon as you get aware about this. If you forget, skip the missed dose. Avoid taking two doses together.

WHAT ARE THE SIDE EFFECTS?                                                                                      

Common side effects like Headache, pain in stomach, Nausea / Vomiting, gas, Diarrhoea, Indigestion, Heartburn, dizziness are experienced by not all but some patients using INDOCIN.

Immediate medical attention is required if any of these SEVERE side effects occur:

• Severe allergic reactions (rash; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue)
• blood in the urine; bloody or black, tarry stools; change in the amount of urine produced;
• chest pain; confusion
• depression; fainting
•  irregular heartbeat
• fever, chills
• mental or mood changes
• numbness of an arm or leg
• severe joint pain
• difficulty in speaking
• vomiting like coffee ground
•  rectal bleeding
• red, swollen, blistered skin
• seizure
• severe headache or dizziness
• sudden or unexplained weight gain
• swelling of hands, legs, or feet;
•  liver problems (dark urine,  yellowing of the skin or eyes)
• Ringing in ear

 

WHAT ARE THE DRUG INTERACTIONS?

If you are using any of the following medicines then inform your doctor before taking INDOCIN:

• ACE inhibitors like Captopril, Angiotensin II receptor blockers like valsartan, losartan, beta blockers like propranolol- INDOCIN reduces their antihypertensive effect
• Aspirin- incidence of abdominal side effects increase.
• Difunisal
• Digoxin
• Diuretices (spironolactone, triamterene)- risk of kidney problems
• Lithium
• Methotrexate
• Oral anticoagulants like Warfarin- increase chances of bleeding.
• Other NSAIDs (pain relievers, fever reducers) like Celecoxib, Ibuprofen, Ketorolac- increases gastric bleeding.
• Probenecid

These are not all drug interactions. A lot of other drug interactions occur. Prepare a list of all the products you are using (including prescription/nonprescription drugs and herbal products) and discuss it with your doctor.

 

WHAT ARE THE CONTRAINDICATIONS AND PRECAUTIONS?

 

• If you are allergic to INDOCIN or any other NSAID like aspirin, ibuprofen, naproxen, celecoxib; or if you have any other allergies then tell your doctor.
•  If you have any of the diseases; asthma, liver disease, stomach/intestine/oesophagus problems (such as bleeding, ulcers), heart disease (such as history of heart attack), high blood pressure, stroke, blood disorders (such as anaemia, bleeding/clotting problems),  Kidney problems tell your doctor without any hesitation.
• INOCIN produces make you dizziness so do not involve in any activity that requires alertness because it can be life threatening for you.
• Avoid taking alcohol when you are on therapy with INDOCIN because they together diminish alertness to a great extent.
• During pregnancy, this medication should always be used under medical supervision. Do not use if you are more than 29 weeks pregnant.
• Consult your doctor before feeding your infant if you are breast feeding.
• INDOCIN interferes with results of some lab tests. Always make sure that you inform your doctor and lab person that you are using INDOCIN.

WHAT ARE THE STORAGE CONDITIONS?

Indocin should be stored at room temperature, between 59 and 86 degrees F (15 and 30 degrees C) away from heat, moisture, and light. Keep all medications out of the reach of children and pets.