Indomethacin is a type of medication called a non-steroidal anti-inflammatory (NSAID). These medications treat symptoms such as swelling, stiffness, pain and fever by inhibiting the production of molecules called prostaglandins. Indomethacin also is called indometacin and is sold under brand names such as Indocin®:, Indocid® and Indocrhron®.
This medication is used to reduce symptoms of inflammatory conditions such as osteoarthritis, rheumatoid arthritis, menstrual pain, gout, tendinitis and bursitis. The primary symptoms of these conditions generally are pain, stiffness and swelling, all of which are reactions associated with the inflammatory response. As well as this, the drug is a tocolytic, which means it can reduce uterine contractions in women who are undergoing premature labor.
Some of the most important molecules involved in promoting the inflammatory response are prostaglandins. These molecules are produced by most of the cell types in the body in response to cell damage. After they are produced and secreted by cells, prostaglandins act on mast cells, a type of immune cell that is central to the development of inflammation. Prostaglandins also act on endothelial cells, which line blood vessels and cells in the uterus.
Indomethacin works to suppress inflammation in several ways. The primary mechanism of action is the inhibition of prostaglandin synthesis. This is achieved through the inhibition of cyclooxygenase, an enzyme that is central to prostaglandin production. In addition, the drug reduces motility of certain types of white blood cells, which prevents them from migrating to sites of inflammation and escalating the response.
This medication has several possible side effects. Headaches, vertigo, dizziness, tinnitus and visual disturbances are the most common side effects. Other possible effects include high blood pressure, fluid retention and increased potassium and sodium levels. In very rare cases, life-threatening side effects such as tachycardia and severe low blood pressure can occur.
Indomethacin has certain contraindications; that is, people with certain conditions cannot take this medication. For example, people who have a peptic ulcer or history of peptic ulcers must avoid most NSAIDs. This is because prostaglandins are important in maintaining the health of the gastrointestinal tract, and prolonged NSAID use can lead to stomach irritation. In addition, people with kidney or liver damage, bone marrow damage or blood clotting problems generally cannot take indomethacin. This medication also can worsen symptoms of epilepsy, Parkinson’s disease and certain psychosis disorders.
The long list of potential adverse effects mean that the use of this medication is limited, and newer NSAIDS with fewer side effects often are used instead. In most cases, this drug is prescribed only for short-term use. For example, women might be prescribed this drug for menstrual pain, because it is safe to take when usage is limited to a few days at a time.
