The treatment of rheumatoid arthritis, ankylosing spondylitis,
osteoarthritis, acute musculoskeletal disorders and acute gout.
Active peptic ulcer or a history of recurrent gastro-intestinal
lesions. Sensitivity to aspirin, indometacin or other non-steroidal
Pregnancy or lactation.
Patients operating machinery.
Patients with epilepsy, parkinsonism, psychiatric disturbances or
Children, since conditions for safe use have not been established.
Severe heart failure.
Most adverse effects are dose related
Gastro-intestinal adverse effects are common and include anorexia,
nausea (with or without vomiting) dyspepsia, abdominal pain and
diarrhoea. Infrequently, ulceration of the upper GI tract,
sometimes with perforation and haemorrhage, has occurred. Acute
pancreatitis has been reported. Hepatic involvement is rare, though
fatal cases of hepatitis and jaundice have been reported.
CNS effects are also common. Severe frontal headache may occur in
25 - 50% of patients who take the drug chronically. Dizziness,
light-headedness, vertigo and mental confusion are also frequent.
Depression and psychosis have also been reported but the incidence
is less than 1%.
Haemopoietic reactions, including neutropenia, thrombocytopenia
and, rarely, aplastic anaemia have been reported.
Hypersensitivity reactions, manifested as rashes, itching,
urticaria or rarely acute asthma, may occur.
Oedema, hypertension, and cardiac failure, have been reported in
association with NSAID treatment.
1. Probenecid. The plasma concentration of Indometacin is
2. Frusemide. The natriuretic and anti-hypersensitivity effects are
antagonised by Indometacin.
3. Thiazide diuretics and beta-blocking agents. Indometacin reduces
the anti-hypertensive effects of these compounds.
4. Antacids. The bioavailability of Indometacin may be reduced by
concomitant antacid therapy.
5. Triamterene. Acute renal failure has been reported with
concomitant Indometacin therapy.
Precautions & Warning:
Indometacin should be used with great care in elderly patients.
Indometacin should be used with caution in patients with impaired
renal function. Indometacin inhibits platelet aggregation and
prolongs bleeding time. It should be used with caution therefore in
patients with bleeding disorders, and concurrent administration of
anti-coagulant agent may be hazardous because of increased risk of
Peptic ulcer has been reported in a small proportion of patients.
If G.I. bleeding occurs, indometacin should be discontinued
immediately. Indometacin may mask the signs and symptoms of
infection. If clinical signs of hepatic disease develop, or if
liver function tests become abnormal, indometacin should be
withdrawn. Indometacin should be given with or immediately after
food in order to lessen the incidence and severity of
Undesirable effects may be minimised by using the lowest effective
dose for the shortest duration necessary to control symptoms (see
section 4.2, and GI and cardiovascular risks below).
Use in Pregnancy and Nursing Mothers:
Indometacin is contraindicated during pregnancy and lactation.
Treatment/antidote in The Event of Overdose:
Gastric lavage should be performed if ingestion is recent.
Otherwise, supportive measures and observation.
Store below 25℃. Protect from moisture. Keep out of reach of