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Concept
Indometacin
Summary
Indometacin, also known as indomethacin, is a nonsteroidal anti-inflammatory drug (NSAID) commonly used as a prescription medication to reduce fever, pain, stiffness, and swelling from inflammation. It works by inhibiting the production of prostaglandins, endogenous signaling molecules known to cause these symptoms. It does this by inhibiting cyclooxygenase, an enzyme that catalyzes the production of prostaglandins.
It was patented in 1961 and approved for medical use in 1963. It is on the World Health Organization's List of Essential Medicines. In 2020, it was the 320th most commonly prescribed medication in the United States, with more than 800 thousand prescriptions.
As an NSAID, indometacin is an analgesic, anti-inflammatory, and antipyretic. Clinical indications for indometacin include:
Joint diseases
rheumatoid arthritis
ankylosing spondylitis
osteoarthritis
gouty arthritis
acute painful shoulder bursitis or tendinitis
Headaches
Trigeminal autonomic cephalgias
Paroxysmal hemicranias
Chronic paroxysmal hemicrania
Episodic paroxysmal hemicrania
Hemicrania continua
Valsalva-induced headaches
Primary cough headache
Primary exertional headache
Primary headache associated with sexual activity (preorgasmic and orgasmic)
Primary stabbing headache (jabs and jolts syndrome)
Hypnic headache
Others
Patent ductus arteriosus
Concurrent peptic ulcer, or history of ulcer disease
Allergy to indometacin, aspirin, or other NSAIDs
Roux-en-Y gastric bypass and gastric sleeve patients
Patients with nasal polyps reacting with an angioedema to other NSAIDs
Children under 2 years of age (with the exception of neonates with patent ductus arteriosus)
Severe pre-existing renal and liver damage
Caution: pre-existing bone marrow damage (frequent blood cell counts are indicated)
Caution: bleeding tendencies of unknown origin (indometacin inhibits platelet aggregation)
Caution: Parkinson's disease, epilepsy, psychotic disorders (indometacin may worsen these conditions)
Concurrent with potassium sparing diuretics
Patients who have a patent ductus arteriosus dependent heart defect (such as transposition of the great vessels)
Significant hypertension (high blood pressure)
Concomitant administration of lithium salts (such as lithium carbonate)
Nonsteroidal anti-inflammatory drug
In general, the adverse effects of indometacin are similar to those of all other NSAIDs.
Official source
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