Indomet 25 mg

Indication :

Indomet 25 mg is indicated for the treatment of-

• Musculoskeletal Disorders: Pain and moderate to severe inflammation in rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis.
• Acute Gout: Management of acute gouty arthritis.
• Dysmenorrhoea: Relief of pain and associated symptoms in primary dysmenorrhoea.
• Patent Ductus Arteriosus (PDA): Used in neonates to close a hemodynamically significant patent ductus arteriosus.

Dosage and Administration :

• Adults (Oral – Immediate Release): Initially 50–200 mg daily in divided doses, taken with food.
• Adults (Oral – Modified Release): 75 mg once or twice daily.
• Adults (Rectal): 100 mg at night, repeated in the morning if necessary. (Maximum total daily dose 200 mg).
• Children (Pain and Inflammation):
  • 1 month to 18 years: 0.5–1 mg/kg every 12 hours (Max 4 mg/kg daily in divided doses).
• Neonates (PDA): Administered via intravenous injection or orally under strict neonatal specialist supervision, with doses adjusted according to postnatal age and renal function.

Administration Note: To minimize gastrointestinal irritation, oral doses should be taken with food, milk, or antacids.

Pharmacology:

• Mechanism of Action: Indometacin is a potent Non-Steroidal Anti-Inflammatory Drug (NSAID) with pronounced analgesic and antipyretic properties. It works as a non-selective inhibitor of the enzymes Cyclooxygenase-1 (COX-1) and Cyclooxygenase-2 (COX-2). By inhibiting these enzymes, it prevents the synthesis of Prostaglandins from arachidonic acid. Prostaglandins are the primary mediators of pain, fever, and inflammation.
• Pharmacodynamics: It reduces the recruitment of polymorphonuclear leukocytes and helps in stabilizing lysosomal membranes. In neonates, it inhibits prostaglandin synthesis to facilitate the closure of a patent ductus arteriosus (PDA).
• Pharmacokinetics: It is rapidly absorbed from the gastrointestinal tract, metabolized in the liver, and excreted primarily through urine and feces.

Side Effects :

• Common: Gastro-intestinal disturbances (nausea, vomiting, epigastric pain), headache (common in high doses), dizziness, and vertigo.
• Serious: GI ulceration and bleeding, salt and water retention, hypersensitivity reactions (bronchospasm, rashes), and blood disorders.

Interactions :

• Anticoagulants: Increased risk of gastrointestinal bleeding.
• Antihypertensives: Reduces the effect of ACE inhibitors, Beta-blockers, and Diuretics.
• Other NSAIDs: Increased risk of side effects.

Lithium/Methotrexate: Increases plasma concentration of these drugs, leading to toxicity.

Pregnancy and Lactation :

• Pregnancy: Avoid unless essential. Contraindicated in the 3rd trimester (risk of premature closure of ductus arteriosus and delayed labor).
• Lactation: Small amounts are excreted in breast milk; use with caution.

Overdose :

• Symptoms include severe headache, nausea, vomiting, mental confusion, and seizures. Management is supportive and symptomatic (e.g., gastric lavage, maintaining hydration).

Therapeutic Class :

• Non-Steroidal Anti-Inflammatory Drug (NSAID).

Storage Condition :

Store below at 30°C  temperature in a dry place. Away from light and out of reach of children. Do not use the medication after its expiration date.