In this episode, I discuss a medication known as indomethacin (Indocin).
Everybody welcome back to another episode of drug talk is always at my host gary campbell they are gonna be discussing the medication known as indomethacin its brand name is endo sin now before i talk about the medication itself just keep in mind that this channel is for information purposes only and not to be used as a source for recommendations for your personal
Healthcare so indomethacin is an nsaid or non-steroidal anti-inflammatory drug that has anti-inflammatory antipyretic as well as anti pain or analgesia effects inhibition of cyclooxygenase that is cox-1 and cox-2 which lead to a decrease in prostaglandin synthesis is thought to be its mechanism of action in terms of indications for use this medication can be used
For rheumatoid arthritis it can be used to treat acute mild or moderate pain there’s a place in therapy to use this medication to treat osteoarthritis as well as goudy arthritis in acute situations and finally it can also be used in the treatment of ankylosing spondylitis now before somebody was to use indomethacin there are some contraindications that they must
Clear as well as some precautions and warnings that they should be made aware of this medication will be contraindicated in patients who has asthma like reactions utak area or other allergic type reactions after the administration of aspirin or other non-steroidal anti-inflammatory drugs it also be contraindicated in patients with a history of proctitis or in
Those who have recent rectal bleeding it will be contraindicated in patients who have had hypersensitivity reactions or serious skin reactions to indomethacin in the past or to other non-steroidal anti-inflammatory medications will be contraindicated in patients who have a hypersensitivity to indomethacin or any other component of the product and it’s used in
The setting of a cabbage or coronary artery bypass graft surgery setting would also be contraindicated now in terms of precautions it’s important to note that cardiovascular thrombotic events myocardial infarctions or heart attacks as well as strokes have been reported in patients using indomethacin with or without vascular disease as well as in patients with
Or without risk factors for the development of cardiovascular disease this medication is also on the biers criteria which is a list of medications that the elderly population should either avoid or use very cautiously we would want to try avoiding to use this medication in the elderly population because there’s an increased risk of gastrointestinal bleeds peptic
Ulcer disease as well as acute kidney injury it should also be noted that indomethacin has more of a likelihood to cause adverse cns effects when compared to other nsaids anaphylactic reactions may occur in patients with or without known hypersensitivities to in no medicine patients with asthma should be made aware that changes in their asthma signs and symptoms
May occur with the use of this medication bleeding events may occur with this medication this would be more common in patients who have coagulation disorders or in patients who are using this medication and also using warfarin it’s not recommended to use indomethacin with other medications from the non-steroidal anti-inflammatory drug class or nsaid class patients
Should be made aware that this medication can mask signs and symptoms of fever as well as inflammation fluid retention as well as edema may occur with the use of indomethacin hyperkalemia or high potassium levels may happen in patients using in amethyst in’ who don’t have renal impairment new onset or exacerbation of hypertension or high blood pressure may occur
With the use of indomethacin and this could put patients who have cardiovascular disease at an increased risk of experiencing a cardiovascular event we would want to avoid using this medication in advanced renal disease unless the benefits of using the medication outweigh the risks if it is to be used in these patients monitoring will be recommended some serious
Skin reactions may develop with the use of indomethacin such as exfoliated dermatitis steven johnson syndrome as well as toxic epidermal necrolysis signs or symptoms of any of these manifestations occur the medication should be discontinued now after somebody is cleared of the contraindications and made aware of the precautions and warnings and they start to
Use indomethacin the a couple different ways they can receive their dose however today we’re just going to talk about the oral formulation that is the capsule formulation if somebody is using in amethyst in to treat their acute mild to moderate pain they may use twenty milligrams three times daily or some other patients may use 40 milligrams two or three times
Daily if somebody is using this medication to treat their acute gouty arthritis they would typically start with an initial dose of 50 milligrams three times daily it would use this dosing regiment until pain is tolerable and then tapered the medication based on pain response towards discontinuation in ankylosing spondylitis the medication will be started off
With an initial dose of 25 milligrams taken two or three times daily the dose can then be increased in weekly intervals by twenty-five or fifty milligrams till sometimes reaching doses as high as 150 milligrams or 250 milligrams daily in terms of maximum doses the maximum individual dose would be 100 milligrams per dose and the maximum daily dose would be 200
Milligrams well as with all medications there are some side effects or adverse reactions that patients may experience while using indomethacin so i’ll go over some of those here now one to three percent of patients may experience abdominal pain constipation falls in that same percentage of one to three percent and so does diarrhea so this may also happen in one
To three percent of patients in digestion may happen between one and nine percent in three to nine percent of patients may experience some nausea some patients may experience increased liver enzymes three to nine percent may experience dizziness headache falls between 11 and 16 percent and somnolence as well as tinnitus fall back within that 1 to 3 percent range
Now some more serious side effects would be hearing loss this happens in less than 1% of individuals afro toxicity or renal failure this is also very rare finally persistent pulmonary hypertension of a newborn falls below 3% of the time that’s all we’re going to talk about today with indomethacin as always i’m very thankful you took the time to come by and watch
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Transcribed from video
INDOMETHACIN (INDOCIN) – PHARMACIST REVIEW – #139 By Drug Talk