indomethacin

What is the most important information I should know about indomethacin?

Indomethacin can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Indomethacin may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using indomethacin, especially in older adults.

What is indomethacin?

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID).

Indomethacin is used to treat moderate to severe osteoarthritis, rheumatoid arthritis, gouty arthritis, or ankylosing spondylitis. Indomethacin is also used to treat shoulder pain caused by bursitis or tendinitis.

Extended-release indomethacin (Indocin SR) should not be used to treat gouty arthritis.

Indomethacin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking indomethacin?

Indomethacin can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Indomethacin may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using indomethacin, especially in older adults.

Tell your doctor if you have ever had:

• heart disease, high blood pressure;
• a heart attack, stroke, or blood clot;
• fluid retention;
• bleeding problems;
• stomach ulcers or bleeding;
• asthma;
• liver or kidney disease; or
• if you smoke.

If you are pregnant, you should not take indomethacin unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.

This medicine may temporarily affect fertility (ability to have children) in women.

How should I take indomethacin?

Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.

Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the form and strength your doctor prescribes.

If you use this medicine long-term, you may need frequent medical tests.

If you need surgery, tell your surgeon you currently use this medicine. You may need to stop for a short time.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include severe drowsiness, stomach pain, or vomiting.

What should I avoid while taking indomethacin?

Avoid taking aspirin unless your doctor tells you to.

What are the possible side effects of indomethacin?

• a skin rash, no matter how mild;
• changes in your vision;
• heart problems --swelling, rapid weight gain, feeling short of breath;
• signs of liver or pancreas problems --loss of appetite, upper stomach pain (that may spread to your back), nausea, vomiting, diarrhea, unusual tiredness, itching, flu-like symptoms, dark urine, jaundice (yellowing of the skin or eyes);
• signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
• low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Common side effects may include:

• indigestion, nausea;
• headache; or
• dizziness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect indomethacin?

Ask a doctor or pharmacist before using indomethacin with any other medications, especially:

• cyclosporine;
• lithium;
• methotrexate;
• probenecid;
• heart or blood pressure medication, including a diuretic or "water pill";
• a blood thinner --warfarin, Coumadin, Jantoven; or
• other NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, meloxicam, and others.

This list is not complete. Other drugs may affect indomethacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about indomethacin.