Indomethacin is a potent nonsteroidal anti-inflammatory drug (NSAID). This medication reduces pain, lowers fever, and decreases inflammation. Available only by prescription, indomethacin is known for its strong effects. It is often prescribed when other NSAIDs may not provide sufficient relief.
Medical Conditions Treated
Indomethacin 50 mg is frequently prescribed to manage various inflammatory conditions. For individuals with types of arthritis such as moderate to severe rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis, it helps alleviate joint pain and swelling. It works by reducing the inflammation that underlies these chronic conditions.
The medication is also effective in treating acute gouty arthritis, a condition characterized by sudden, intense pain and inflammation in a joint, often the big toe. During a flare-up, a 50 mg dose provides rapid relief, reducing the severe pain and swelling associated with gout. Indomethacin also addresses acute painful shoulder, particularly when caused by bursitis or tendinitis. These conditions involve inflammation of the bursae (fluid-filled sacs) or tendons, and indomethacin diminishes the associated pain and inflammation.
Beyond common inflammatory conditions, indomethacin has a specific use in neonatology, though not typically at a 50 mg dose or in adult capsule form. It is used to facilitate the closure of a patent ductus arteriosus (PDA) in premature infants, a condition where a blood vessel connecting the aorta and pulmonary artery fails to close after birth. This use highlights the drug’s diverse actions, though the dosage and formulation differ from typical adult uses.
How Indomethacin Works
Indomethacin works by targeting processes that contribute to pain and inflammation. When the body experiences injury or illness, it produces substances known as prostaglandins. These lipid compounds act as signaling molecules, triggering inflammation, pain, and fever. By influencing nerve endings and blood vessel dilation, prostaglandins amplify the body’s response to damage.
Indomethacin works by blocking the activity of enzymes called cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). These enzymes synthesize prostaglandins from their precursors. By inhibiting both COX-1 and COX-2, indomethacin reduces prostaglandin production. This reduction in prostaglandin levels directly leads to a decrease in inflammation, pain, and fever.
Proper Administration of the 50 mg Dose
The 50 mg dose of indomethacin is available as a capsule for oral administration. To minimize stomach upset, take the medication with water and food or milk. This helps protect the stomach lining from irritation.
Patients should adhere to their doctor’s prescribed schedule, typically two to three times a day, depending on the condition and individual response. After taking the dose, remain upright for at least 10 minutes to prevent esophageal irritation. Using the lowest effective dose for the shortest possible duration minimizes risks.
Side Effects and Important Warnings
Like all medications, indomethacin 50 mg can cause side effects, ranging from common and mild to serious and potentially life-threatening. Common side effects often include gastrointestinal upset such as heartburn, nausea, vomiting, or abdominal pain. Headaches, dizziness, and drowsiness are also frequently reported.
More serious warnings are associated with indomethacin, particularly regarding cardiovascular and gastrointestinal health. NSAIDs like indomethacin can increase the risk of serious cardiovascular thrombotic events, including heart attack and stroke, especially with prolonged use or in individuals with pre-existing heart conditions. This risk can occur early in treatment and may increase with higher doses.
Furthermore, indomethacin carries a significant risk of serious gastrointestinal adverse events, such as bleeding, ulceration, and perforation of the stomach or intestines. These events can occur without warning symptoms and may be fatal. Indomethacin should not be used right before or after coronary artery bypass graft (CABG) surgery due to increased cardiovascular risk. It is also contraindicated in individuals with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs, and generally avoided in late pregnancy. Patients should always inform their doctor about all other medications they are taking, as indomethacin can interact with drugs such as blood thinners, certain blood pressure medications, and other NSAIDs, potentially increasing risks or reducing effectiveness.