Indomethacin

General

• Type:
• Dosage Forms:
• Common Trade Names:

Adult Dosing

Preterm labor/Tocolysis

• 50-100mg loading dose, 25mg q4-6 hrs for 48 hrs

Osteoarthritis:

• 25 mg PO BID-TID, max 200 mg/day, give with food

Acute Gout:

• 50 mg PO TID, taper dose rapidly

Ankylosing Spondylitis:

• 25 mg PO bid-tid, max 200 mg/day

Rheumatoid Arthritis:

• 25 mg PO bid-tid, max 200 mg/day

Pediatric Dosing

Patent Ductus Arteriosus:

• <48 hour old: start 0.2 mg/kg IV x 1, then 0.1 mg/kg q12-24h x 2
• 2-7 days old: Start 0.2 mg/kg IV x 1, then 0.2 mg/kg q12-24h x 2
• > 7 days old: Start 0.2 mg/kg IV x 1, then 0.25 mg/kg q12-24h x 2

Rheumatoid Arthritis

• 1-2 mg/kg/day PO divided BID-QID, max 4 mg/kg/day up to 150-200 mg/day

Special Populations

• Pregnancy Rating: B
• Lactation: probably safe
• Renal Dosing
  • Adult: no adjustment
  • Pediatric: no adjustment
• Hepatic Dosing
  • Adult: not defined, caution advised if hepatic impairment
  • Pediatric: not defined, caution advised if hepatic impairment

Contraindications

• Allergy to class/drug
• ASA or NSAID-induced ashtma or urticaria
• Pregnancy 3rd trimester
• Infection, untreated (neonates)
• Active bleeding (neonates)
• Thrombocytopenia (neonates)
• Coagulation Disorder (neonates)
• Necrotizing enterocolitis (neonates)
• renal impairment, significant (neonates)
• Pulmonary atresia (neonates)
• Tetralogy of Fallot, severe (neonates)
• Aortic coarctation, severe (neonates)
• CABG surgery period use
• caution if cardiovascular disease
• caution if HTN
• caution if CHF
• caution if fluid retention
• caution if GI bleeding or ulcer history
• caution in elderly patients
• caution if dehydration
• caution if sepsis
• caution if asthma
• caution if prolonged use

Pharmacology

• Half-life:
• Metabolism:
• Excretion:
• Mechanism of Action: