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IndomethacinAka: Indocin

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  1. Mechanism
    1. NSAID in the acetic acid class (indole)
  2. Pharmacokinetics
    1. Half life: 2 hours
  3. Advantages
    1. Only NSAID in suppository form
    2. Most potent NSAID (however this carries renal and GI risks)
  4. Indications
    1. Acute Gouty Arthritis
    2. Ankylosing Spondylitis
    3. Pericarditis
    4. Bartter's Syndrome
    5. Preterm Labor (Tocolysis)
    6. Patent Ductus Arteriosus in the newborn
  5. Contraindications
    1. Peptic Ulcer Disease
    2. Aspirin Sensitivity
    3. Renal Disease
    4. Coagulopathy
    5. Pregnancy beyond 30 weeks
    6. Childhood (except Patent Ductus Arteriosus)
    7. Dementia (consider avoiding in elderly)
  6. Dosing: General Analgesic use
    1. Regular: 25-50 mg PO tid with food or milk
    2. Sustained Release: 75 mg PO qd to bid
    3. Maximum: 200 mg/day
  7. Dosing Protocol: Preterm Labor
    1. Protocol 1
      1. Loading dose: 100 mg suppository rectally
      2. Maintenance: 25 mg PO every 6 hours for 24 hours
      3. Repeat for an additional 24 hours maximum
    2. Protocol 2
      1. Loading dose: 50 mg PO
      2. Maintenance: 25 mg PO every 4 hours for 24 hours
      3. Repeat for an additional 24 hours maximum
    3. Monitoring
      1. Amniotic Fluid Index biweekly for use >48 hours
  8. Adverse Effects (more than other NSAIDs)
    1. Headache
    2. Peptic ulcer
    3. Gastrointestinal upset
    4. Fluid retention
    5. Prolonged Bleeding Time
    6. Nausea or Vomiting
    7. Pruritus
    8. Bowel changes
    9. Fetal effects
      1. Early ductus arteriosus closure
      2. Oligohydramnios
      3. Not linked to Intraventricular Hemorrhage
        1. Suarez (2001) Obstet Gynecol 97:921
    10. Nephrotoxic
      1. See Nephrotoxicity due to NSAIDs
  9. Drug Interactions
    1. Lithium

Indomethacin (C0021246)

Definition (MSH)A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes.
Definition (CSP)non-steroidal anti-inflammatory agent that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids; also inhibits the motility of polymorphonuclear leukocytes.
Definition (NCI)A drug that belongs to the family of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Indomethacin reduces pain, fever, swelling, and redness. It is also being used to reduce tumor-induced suppression of the immune system and to increase the effectiveness of anticancer drugs.
Definition (PDQ)A synthetic nonsteroidal indole derivative with anti-inflammatory activity and chemopreventive properties. As a nonsteroidal anti-inflammatory drug (NSAID), indomethacin inhibits the enzyme cyclooxygenase, thereby preventing cyclooxygenase-mediated DNA adduct formation by heterocyclic aromatic amines. This agent also may inhibit the expression of multidrug-resistant protein type 1, resulting in increased efficacies of some antineoplastic agents in treating multi-drug resistant tumors. In addition, indomethacin activates phosphatases that inhibit the migration and proliferation of cancer cells and downregulates survivin, which may result in tumor cell apoptosis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39489&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39489&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C576" NCI Thesaurus)
Definition (NCI)A synthetic nonsteroidal indole derivative with anti-inflammatory activity and chemopreventive properties. As a nonsteroidal anti-inflammatory drug (NSAID), indomethacin inhibits the enzyme cyclooxygenase, thereby preventing cyclooxygenase-mediated DNA adduct formation by heterocyclic aromatic amines. This agent also may inhibit the expression of multidrug-resistant protein type 1, resulting in increased efficacies of some antineoplastic agents in treating multi-drug resistant tumors. In addition, indomethacin activates phosphatases that inhibit the migration and proliferation of cancer cells and downregulates survivin, which may result in tumor cell apoptosis. (NCI04)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishINDO, Indometacin, Indometacin product, Indomethacin, INDOMETHACIN PREPARATION, Indomethacin product
Spanishindometacina
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Indocin (C0700798)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishIndocin
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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