Diferencia entre revisiones de «Indomethacin»

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==General==
==General==
*Type: NSAID
*Type: [[NSAID]]
*Dosage Forms: PO (Generic in 25 and 50mg tabs)
*Dosage Forms: PO (Generic in 25 and 50mg tabs)
*Common Trade Names: Indocin
*Common Trade Names: Indocin
Línea 9: Línea 9:


[[Osteoarthritis]]:  
[[Osteoarthritis]]:  
*25 mg PO BID-TID, max 200 mg/day, give with food
*25mg PO BID-TID, max 200mg/day, give with food


[[Gout and Pseudogout]]:
[[Gout and Pseudogout]]:
*50 mg PO TID, taper dose rapidly
*50mg PO TID, taper dose rapidly


[[Ankylosing Spondylitis]]:
[[Ankylosing Spondylitis]]:
*25 mg PO bid-tid, max 200 mg/day
*25mg PO bid-tid, max 200mg/day


[[Rheumatoid Arthritis]]:
[[Rheumatoid Arthritis]]:
*25 mg PO bid-tid, max 200 mg/day
*25mg PO bid-tid, max 200mg/day


==Pediatric Dosing==
==Pediatric Dosing==


Patent Ductus Arteriosus:
[[Patent ductus arteriosus]]:
*<48 hour old: start 0.2 mg/kg IV x 1, then 0.1 mg/kg q12-24h x 2
*<48 hour old: start 0.2mg/kg IV x 1, then 0.1mg/kg q12-24h x 2
*2-7 days old: Start 0.2 mg/kg IV x 1, then 0.2 mg/kg q12-24h x 2
*2-7 days old: Start 0.2mg/kg IV x 1, then 0.2mg/kg q12-24h x 2
*> 7 days old: Start 0.2 mg/kg IV x 1, then 0.25 mg/kg q12-24h x 2
*> 7 days old: Start 0.2mg/kg IV x 1, then 0.25mg/kg q12-24h x 2


[[Rheumatoid_arthritis|Rheumatoid Arthritis]]
[[Rheumatoid_arthritis|Rheumatoid Arthritis]]
*1-2 mg/kg/day PO divided BID-QID, max 4 mg/kg/day up to 150-200 mg/day
*1-2mg/kg/day PO divided BID-QID, max 4mg/kg/day up to 150-200mg/day


==Special Populations==
==Special Populations==
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*CABG surgery period use
*CABG surgery period use
*caution if cardiovascular disease
*caution if cardiovascular disease
*caution if HTN
*caution if hypertension
*caution if CHF
*caution if CHF
*caution if fluid retention
*caution if fluid retention
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===Serious===
===Serious===
*pulmonary hemorrhage (neonates)
*pulmonary hemorrhage (neonates)
*GI bleeding
*[[GI bleeding]]
*GI perforation/ulcer
*GI perforation/ulcer
*MI
*[[MI]]
*Stroke
*Stroke
*Thromboembolism
*Thromboembolism
*HTN
*hypertension
*CHF
*[[CHF]]
*Renal Papillary Necrosis
*Renal Papillary Necrosis
*Acute Renal Failure
*[[Acute Renal Failure]]
*Hepatotoxicity
*Hepatotoxicity
*[[Steven_Johnson_syndrome|Steven-Johnson syndrome]]
*[[Steven_Johnson_syndrome|Steven-Johnson syndrome]]
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*Excretion: urine 60%, feces 33%
*Excretion: urine 60%, feces 33%
*Mechanism of Action: exact mechanism unknown, inhibits cyclooxygenase, reducing prostaglandin and thromboxane synthesis
*Mechanism of Action: exact mechanism unknown, inhibits cyclooxygenase, reducing prostaglandin and thromboxane synthesis
==Indications by Condition==
''The following table is automatically generated from disease/condition pages across WikEM.''
{{#ask:[[Has DrugName::Indomethacin]]
|?Has Indication=Indication
|?Has Dose=Dose
|?Has Context=Context
|?Has Route=Route
|?Has Population=Population
|format=table
|headers=plain
|mainlabel=-
|sort=Has Indication
|limit=50
}}


==See Also==
==See Also==
*[[NSAID toxicity]]


==References==
==References==

Revisión actual - 21:56 20 mar 2026

General

  • Type: NSAID
  • Dosage Forms: PO (Generic in 25 and 50mg tabs)
  • Common Trade Names: Indocin

Adult Dosing

Preterm labor/Tocolysis

  • 50-100mg loading dose, 25mg q4-6 hrs for 48 hrs

Osteoarthritis:

  • 25mg PO BID-TID, max 200mg/day, give with food

Gout and Pseudogout:

  • 50mg PO TID, taper dose rapidly

Ankylosing Spondylitis:

  • 25mg PO bid-tid, max 200mg/day

Rheumatoid Arthritis:

  • 25mg PO bid-tid, max 200mg/day

Pediatric Dosing

Patent ductus arteriosus:

  • <48 hour old: start 0.2mg/kg IV x 1, then 0.1mg/kg q12-24h x 2
  • 2-7 days old: Start 0.2mg/kg IV x 1, then 0.2mg/kg q12-24h x 2
  • > 7 days old: Start 0.2mg/kg IV x 1, then 0.25mg/kg q12-24h x 2

Rheumatoid Arthritis

  • 1-2mg/kg/day PO divided BID-QID, max 4mg/kg/day up to 150-200mg/day

Special Populations

  • Pregnancy Rating: B
  • Lactation: probably safe
  • Renal Dosing
    • Adult: no adjustment
    • Pediatric: no adjustment
  • Hepatic Dosing
    • Adult: not defined, caution advised if hepatic impairment
    • Pediatric: not defined, caution advised if hepatic impairment

Contraindications

  • Allergy to class/drug
  • ASA or NSAID-induced ashtma or urticaria
  • Pregnancy 3rd trimester
  • Infection, untreated (neonates)
  • Active bleeding (neonates)
  • Thrombocytopenia (neonates)
  • Coagulation Disorder (neonates)
  • Necrotizing enterocolitis (neonates)
  • renal impairment, significant (neonates)
  • Pulmonary atresia (neonates)
  • Tetralogy of Fallot, severe (neonates)
  • Aortic coarctation, severe (neonates)
  • CABG surgery period use
  • caution if cardiovascular disease
  • caution if hypertension
  • caution if CHF
  • caution if fluid retention
  • caution if GI bleeding or ulcer history
  • caution in elderly patients
  • caution if dehydration
  • caution if sepsis
  • caution if asthma
  • caution if prolonged use

Adverse Reactions

Serious

Common

  • dyspepsia
  • nausea
  • abdominal pain
  • constipation
  • headache
  • dizziness
  • rash
  • ALT,AST elevation
  • fluid retention
  • tinnitus
  • corneal deposits
  • photosensitivity

Pharmacology

  • Half-life: 4.5 hours, 12-21 hours in neonates
  • Metabolism: Liver; CYP450, 2C9 substrate
  • Excretion: urine 60%, feces 33%
  • Mechanism of Action: exact mechanism unknown, inhibits cyclooxygenase, reducing prostaglandin and thromboxane synthesis


Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

IndicationDoseContextRoutePopulation
Acute pain management25-50 mg PO q12h or 100 mg PR q24hNon-opioid analgesic (NSAID)PO/PRAdult
Gout and pseudogout50mg TID x 3-5 daysFirst-line NSAID option for acute goutPOAdult
Patent ductus arteriosus0.2mg/kg IV x1, then 0.1-0.25mg/kg q12-24h x2 (dose varies by age)Medical closure, first 10-14 days of lifeIVPediatric
Preterm labor50-100mg load, then 25mg q4-6hr x 48hrTocolytic; avoid >32 weeks gestation (risk of ductus arteriosus closure)PO/PRAdult

See Also

References

Obtenido de «https://www.wikem.org/w/index.php?title=Indomethacin&oldid=387415»