Always be in the mood. Analogs of Indomethacin ointment: Russian and foreign substitutes. The drug Indomethacin

Indomethacin – medicine, which belongs to a fairly large group of NSAIDs. I'll look at the instructions for its use.

What are the composition and release form of Indomethacin?

The medicine is produced by the pharmaceutical industry in various dosage forms ah, in particular, in tablets, in suppositories, as well as in ointments and gels, where the active substance is indomethacin.

The ointment is intended for external use, it is homogeneous 10%, the color of the medicine varies from yellow to brownish-yellowish. In addition, excipients have been added to the medication: petroleum jelly, cholesterol, white wax, stearyl alcohol, as well as dimethyl sulfoxide and anhydrous lanolin. The product is supplied to the pharmaceutical market in aluminum tubes with a capacity of 40 grams.

Indomethacin gel is also used externally, it is in aluminum tubes of 40 grams, its concentration is 5 and 10%, the dosage form is homogeneous, its color is yellow, the medicine has a faint alcoholic odor. The active substance is presented in quantities of 50 and 100 milligrams. Excipients: carbomer, macrogol 400, propylene glycol, in addition, sodium benzoate, as well as ethanol 96%.

Rectal suppositories are torpedo-shaped and are sealed in special packaging. It is better to store them in cool conditions, for example in a refrigerator. Suppositories should not be used if the expiration date or manufacturing date is not visible on the medicine box. Indomethacin is available without a prescription.

What is the effect of Indomethacin?

Indomethacin is one of the drugs from NSAID groups, a derivative of the so-called indoleacetic acid. The medication has an anti-inflammatory and antipyretic effect on the body, in addition, it has an analgesic effect. The mechanism of action of the drug is associated with the process of inhibition of the enzyme cyclooxygenase, which leads to inhibition of prostaglandins.

The drug helps suppress platelet aggregation, leads to a weakening of pain, especially of an articular nature, both at rest and during movement, in addition, it increases the range of movements. When used topically, swelling and redness are reduced.

After taking indomethacin, the active substance is rapidly absorbed in the digestive tract. Maximum plasma concentration occurs after two hours. The drug is metabolized in the liver. The half-life is approximately 4.5 hours. Approximately 60% is excreted through the kidneys, in addition through the intestines.

What are Indomethacin's indications for use?

For systemic use, Indomethacin is indicated in the following situations: articular syndrome, which is characteristic of rheumatoid arthritis, osteoarthritis, gout, as well as ankylosing spondylitis, in addition, medicine is prescribed for pain in the spine, in the presence of neuralgia and myalgia, as well as for traumatic inflammation of the joints and soft tissues, for rheumatism, for dysmenorrhea, for pathology connective tissue.

In addition, the drug Indomethacin is prescribed as an adjuvant drug for infectious diseases ENT organs, as well as for cystitis, adnexitis and in the presence of prostatitis. Locally in ophthalmology it is used to prevent inflammation after cataract surgery.

What are the contraindications for use of Indomethacin?

I will list when Indomethacin is contraindicated for use:

In case of hypersensitivity to the components of the drug;
With damage to the gastrointestinal tract of an ulcerative-erosive nature;
With the so-called “aspirin triad”;
For hypertension;
With proctitis;
With recent bleeding from the rectum;
During pregnancy, in particular in the third trimester;
In case of hematopoietic disorders;
In severe heart failure.

The drug is not prescribed until the age of fourteen. And we are on this page of the website www.!

What are the uses and dosage of Indomethacin?

The use of the dosage form of the drug Indomethacin is determined depending on the disease. The tablet form of the drug is usually prescribed after meals in the amount of 25 mg three times a day, the dose is increased to 50 mg as necessary. The maximum dosage per day should not exceed 200 mg.

For local use in ophthalmology, the dosage of the drug is determined taking into account the disease. The ointment and gel are applied externally up to two times a day after prior consultation with a specialist.

What are Indomethacin side effects?

I will list a number of side effects that may occur when using the drug Indomethacin: nausea, anorexia, jaundice, vomiting, abdominal pain, flatulence, constipation or diarrhea, erosive-ulcerative lesions, dizziness, possible intestinal strictures, muscle weakness, sleep disturbances, tachycardia, mental disorders, increased blood pressure, pain in chest, hematuria, in addition, arrhythmia, as well as allergic manifestations.

Other manifestations: vaginal bleeding, proteinuria, hyperglycemia, hepatitis, headache, stomatitis, gastritis, paresthesia, noted depressive state, fatigue, nephrotic syndrome, characteristic increased sweating and other manifestations.

special instructions

During treatment with Indomethacin drugs, the patient must be systematically monitored, in particular, monitor liver and kidney function, as well as picture indicators peripheral blood.

How to replace Indomethacin, what analogues?

The drug Indovis EU, Metindol, Indomethacin-Biosynthesis, Indomethacin-Acri, Indocollir, Indobene, in addition, Indomethacin Sopharma, Metindol retard, Indotard, Indocid, as well as Indomethacin-Altfarm are analogues.

Conclusion

We reviewed the drug Indomethacin, instructions for use of this drug. Before using the drug, it is recommended to enlist the help of a doctor; the medication should be used only as prescribed by the doctor.

To date a large number of medications are available in the form of rectal or vaginal suppositories. Medicines in this form can significantly speed up the healing process, because they completely repeat the effect of the tablets with the only difference that they are not taken orally, but are injected directly into the rectum or vagina, which guarantees their rapid entry into the blood and the provision of a therapeutic effect on the entire body . In this regard, it is worth paying attention to the powerful anti-inflammatory drug Indomethacin suppositories. The instructions for use given in this article will answer all the questions of interested parties.

Release form

Indomethacin suppositories can be used either rectally or vaginally. Each of the suppositories, depending on the form, can contain either 50 or 100 mg of the active substance - the component indomethacin. The only auxiliary substances of such suppositories are solid fat and corn starch.

pharmachologic effect

The drug Indomethacin is one of the most famous non-steroidal drugs. Once in the body, it has a strong anti-inflammatory, as well as a pronounced analgesic effect, suspends the production of biologically active substances that provoke swelling and painful sensations in places of inflammation. For pain relief due to serious illnesses This drug has been used for a long time in gynecological practice. It should also be noted antipyretic effect which this medicine provides.

Analogs of Indomethacin suppositories

Other medications in the form of suppositories, for example, Diclofenac, Ketoprofen or Naproxen, have similar anti-inflammatory and analgesic effects.

Indications for use

The range of uses of the drug Indomethacin is quite wide. This remedy is effective for diseases such as: osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, periarthritis, as well as inflammation of connective tissues and the skeletal system.

In addition, Indomethacin suppositories are recommended for use in cases of rheumatism, myalgia, neuralgia, edema with impaired protein metabolism, traumatic inflammation of tissues or musculoskeletal system. Often this drug is prescribed for the treatment of prostatitis or diseases of the ENT organs. If we consider gynecological diseases, then Indomethacin is used for painful menstruation, to eliminate the consequences of dysmenorrhea, also for the treatment of adnexitis or cystitis.

Methods of application

Considering treatment with Indomethacin suppositories, we can say that both rectal and vaginal suppositories, often used once a day, putting one 100 mg suppository at night. Suppositories of 50 mg of active substance can be used up to 3 times a day. An acute attack of gout involves the simultaneous administration of two 100 mg suppositories. Before using suppositories, doctors recommend cleansing the intestines. For some diseases, experts recommend using combination treatment, that is, administer a suppository at night, and take two Indomethacin tablets during the day.

Contraindications of the drug

It should be noted that this remedy has many contraindications. These include:

• arterial hypertension;
• liver failure;
• heart failure;
• cirrhosis of the liver;
• peptic ulcer and ulcerative colitis;
• congenital heart defects;
• chronic renal failure;
• internal bleeding;
• optic nerve diseases;
• pregnancy or breastfeeding;
• increased sensitivity to the component indomethacin;
• the age of a teenager is up to 18 years.

Side effects

Taking Indomethacin can cause nausea and vomiting, insomnia and dizziness, increased blood pressure, leukopenia, conjunctivitis, blurred vision, as well as allergic reactions, for example, bronchospasm, Quincke's edema, skin itching, urticaria and even anaphylactic shock. Good health to you!

And hematopoiesis), so it should not be taken without a doctor’s recommendation.

What is the active substance of indomethacin?

Pharmacological group and action of indomethacin

Indomethacin is a universal anti-inflammatory drug, which is one of the standards for assessing the therapeutic effect of NSAIDs. However, when using it, unwanted side effects occur more often than when using other drugs from the NSAID group. This fact significantly limits the use of this medicine in medical practice currently.

Indomethacin has the following effects:

• strong anti-inflammatory ( is one of the most powerful anti-inflammatory drugs of all NSAIDs);
• strong pain reliever ( completely relieves or reduces pain of various origins);
• antipyretic ( reduces elevated temperature and does not affect normal);
• weak antiaggregation ( thins the blood - reduces the likelihood of blood clots);
• weak immunosuppressive ( can, with long-term use, reduce the activity of the immune system).

However, these enzymes are also present in the body healthy people. Thus, COX-1 is found in almost all organs and tissues, in particular in the digestive tract and kidneys. Prostaglandins synthesized by COX-1 are involved in maintaining the integrity of the mucous membrane of the stomach and intestines, maintaining the necessary blood flow, reducing secretion of hydrochloric acid, increasing pH, secretion of phospholipids and mucus. Therefore, when the production of COX-1 is suppressed, the level of prostaglandins decreases not only at the site of inflammation, but throughout the body, which can lead to serious complications. COX-2 is absent or present in small quantities in healthy tissues. Its level increases during inflammation and at its source.

Therefore, by acting on the enzymes COX-1, COX-2, indomethacin has not only a pronounced therapeutic, but sometimes also a negative effect on the stomach, kidneys and other organs.

How and how long does it take to remove indomethacin from the body?

Is indomethacin an antibiotic?

Is indomethacin a hormonal drug?

Trade names of drugs containing indomethacin

In Russian pharmaceutical market The following drugs are presented:

• indomethacin Sopharma;
• indomethacin Berlin Chemie;
• indomethacin Biosynthesis;
• indomethacin Altfarm and many others.

Composition and types of indomethacin

This drug is available in the following dosage forms:

• in tablets, dragees, capsules of 0.025 g and 0.05 g;
• retard tablets 0.075 g;
• in the form of suppositories ( candles) rectal 0.05 g and 0.1 g;
• in the form of ointment 5% or 10% in tubes or jars;
• in the form of a gel 5% or 10% in tubes;
• in the form of eye drops 0.1% in bottles.

What is the composition of indomethacin tablets?

The excipients of this drug in tablet form are:

• lactose monohydrate;
• wheat starch;
• microcrystalline cellulose ( type 101);
• povidone K25;
• anhydrous colloidal silicon dioxide;
• talc;
• magnesium stearate;
• shell ( Eudragit L-12.5 and S-12.5 ( dry), dibutyl phthalate, diethyl phthalate, macrogol 400, macrogol 6000, castor bean seed oil, talc, titanium dioxide, brown dye ( E110) and chocolate HT ( E155) ).

What is the composition of indomethacin suppositories?

The excipients of this drug in the form of suppositories are:

• hard fat;
• corn starch.

What is the composition of indomethacin ointment?

The excipients of this drug in the form of an ointment are:

• white petroleum jelly;
• beeswax;
• dimethyl sulfoxide;
• colloidal silicon dioxide;
• lavender oil;
• lanolin anhydrous.

What is the composition of indomethacin gel?

The excipients of this drug in the form of a gel are:

• macrogol 400;
• carbomer;
• propylene glycol;
• sodium benzoate;
• ethanol 96%.

What is the composition of indomethacin eye drops?

The excipients of this drug in the form of eye drops are:

• thiomersal;
• arginine;
• hydroxypropyl;
• hydrochloric acid;
• purified water.

What is indomethacin retard?

Indomethacin analogues

Indomethacin analogues belonging to the NSAID group are the following drugs:

• amidopyrine;
• aspirin and other drugs.

Ibuprofen and indomethacin

Ibuprofen is approved for use in children ( in the form of candles for children from 3 months). Available in various dosage forms - tablets, suspension, rectal suppositories, and gel for external use. Ibuprofen can be used as an alternative to indomethacin for mild cases of arthritis, arthrosis and to relieve pain of various origins.

Diclofenac ( Voltaren) and indomethacin

Diclofenac is an effective and popular drug, available under different names and in various dosage forms ( in injections, tablets, suppositories, in the form of ointment, gel, eye drops). Approved for use from 6 years of age. Despite its pronounced therapeutic effect, just like indomethacin, it causes serious side effects. Therefore, treatment with this drug should be carried out under the supervision of a physician.

Meloxicam ( movalis) and indomethacin

Paracetamol and indomethacin

Unlike indomethacin, paracetamol is considered one of the safest NSAIDs. It causes virtually no side effects and is included in the list of vital and essential drugs. World Organization Health ( WHO). However, it is hepatotoxic and long-term use nephrotoxic. It is produced in many countries around the world in various dosage forms ( in tablets, powders, injections, in the form of a suspension, syrup, in rectal suppositories). Some of its forms are used in children from 3 months ( in the form of syrup, suspension or rectal suppositories). It is recommended for use, first of all, in the presence of contraindications to other NSAIDs ( in patients with bronchial asthma, stomach ulcers). In many cases, paracetamol is an excellent replacement indomethacin.

Ketoprofen and indomethacin

Piroxicam and indomethacin

It has numerous side effects inherent in NSAIDs. According to the adverse effect on gastrointestinal tract even superior to indomethacin. Indications for its use are the same as for indomethacin. It is also available in various dosage forms - tablets, injections, rectal suppositories, and gel. Approved for use from 15 years of age.

Nimesil ( nimesulide) and indomethacin

Indomethacin and troxevasin ( troxerutin)

Indomethacin and dimexide

Which drug from the NSAID group is better than indomethacin and does not cause side effects?

Therefore, for each patient the most appropriate effective drug with the best tolerability. Therapy is usually started with small doses of the least toxic NSAIDs, which include propionic acid derivatives ( ibuprofen and others). The dose of NSAIDs is increased gradually, the effect is assessed, and only if it is absent after 5-10 days, a more toxic drug is used ( including indomethacin). If the patient has contraindications to the use of NSAIDs, simple analgesics are used ( paracetamol), and for rheumatoid arthritis - low doses glucocorticoids.

Significantly reduce toxicity and improve treatment tolerability various diseases allows the use of selective and highly selective COX-2 inhibitors, which include meloxicam, nimesulide and other drugs. Decreases negative influence NSAIDs in the gastrointestinal tract can be achieved with simultaneous use antiulcer therapy ( use of omeprazole and other similar drugs ). Reduce use of NSAIDs systemic action allows use local treatment (ointments, gels), physiotherapy, the use of antioxidants, chondroprotectors with anti-inflammatory properties.

Indications for use of indomethacin

Indomethacin preparations can have a systemic effect - when used in the form of injections, tablets, suppositories, or act locally - when using ointment, gel or eye drops.
Depending on the type of pathology, the doctor individually selects the dosage form of the drug, dose and duration of treatment. Begin therapy at severe cases usually with intramuscular administration of this drug, followed by a transition to tablet forms, the use of which can be combined with the use rectal suppositories or ointments ( gel).

In what cases is systemic indomethacin prescribed ( in injections, tablets, suppositories)?

Indications for the use of indomethacin in injections, tablets or suppositories are:

• rheumatic diseases ( rheumatism, juvenile, rheumatoid, gouty, psoriatic arthritis, ankylosing spondylitis ( ankylosing spondylitis), Reiter's syndrome and others);
• non-rheumatic diseases of the musculoskeletal system ( osteoarthritis, myositis, tenosynovitis, bursitis and others);
• injuries ( sprains, bruises of bones and soft tissues, dislocations, fractures);
• neurological diseases ( neuralgia, radiculitis, sciatica, lumbago);
• pain of various origins ( head, dental, muscle pain, pain in the spine, postoperative pain, renal colic , hepatic colic, pain in women before menstruation);
• connective tissue diseases;
• fever ( at a body temperature above 38.5 degrees when acetylsalicylic acid and paracetamol are ineffective);
• How aid in gynecology ( at inflammatory processes in the pelvis (with inflammation of the ovaries, cystitis and other pathologies)); to maintain pregnancy or during premature birth as an analgesic and tocolytic agent ( Tocolytics relax smooth muscle, which prevents uterine contractions);
• as part of complex therapy in ENT practice ( with pronounced pain syndrome for pharyngitis, tonsillitis, otitis media);
• as an aid in dentistry ( for arthritis or arthrosis of the temporomandibular joint, inflammatory diseases oral tissues, myalgia, neuralgia, in the postoperative period).

In what cases is topical indomethacin prescribed ( in the form of an ointment or gel)?

This drug is in the form of an ointment ( gel) is prescribed in the following cases:

• for arthrosis ( excluding degenerative diseases of the hip joints);
• for arthritis;
• for injuries of the musculoskeletal system ( sprains, dislocations, bruises and other cases);
• with inflammation of soft tissues ( tendovaginitis, tendinitis, bursitis, myalgia, radiculitis, sciatica, lumbago and in other cases).

In what cases is indomethacin eye drops prescribed?

Eye drops are prescribed in the following cases:

• for the prevention of miosis ( constriction of the pupil) during cataract surgery;
• for inflammation caused by surgery;
• in the prevention and treatment of cystoid edema macular spot retina after surgical removal cataracts;
• in the treatment and prevention of inflammatory processes of the eyeball;
• for non-infectious conjunctivitis.

Instructions for use of indomethacin

The use of non-hormonal anti-inflammatory drugs is especially in demand in medical practice, since the list of side effects of such drugs is significantly limited. Taking a detailed interest in this pharmacological group, it becomes clear what Indomethacin is when this medication is prescribed.

Indomethacin - instructions

If necessary, influence musculoskeletal system, there is an urgent need to prescribe this medication. For diseases of dystrophic, traumatic, rheumatic and inflammatory origin, this is an indispensable drug that relieves increased swelling, suppresses an attack of pain, stabilizes temperature regime and restores the mobility of joints and cartilage. The instructions for Indomethacin indicate that the drug has several forms of release, which helps to completely eliminate cases of intoxication of the body.

Indomethacin suppositories

In this form of release, the specified medication is intended for rectal administration. Indomethacin suppositories have a convex, oblong shape, yellow tint, specific smell. Self-titled active ingredient productively absorbed into the systemic circulation, distributing healing effect throughout the body. Its effect is noticeable after a quarter of an hour, and indomethacin reaches its maximum concentration in biological fluid after a couple of hours from the moment rectal administration suppository. The duration of use and daily dosage are determined individually.

Indomethacin ointment

This form of medication is intended for external use according to the attached instructions. Indomethacin ointment provides analgesic, antipyretic and anti-inflammatory effects, relieves swelling and limited movement of the affected joints. It is a reliable remedy for sprained ligaments, tendons, and muscles. Its use as part of complex therapy for arthritis, radiculitis, bursitis, myalgia, and osteoarthritis is possible. Apply a thin layer to the affected surface, do not cover with a bandage, and do not rinse with water.

Indomethacin tablets

At acute pain in the spine, it is recommended to take a painkiller with a temporary effect. Just like that pharmacological action has Indomethacin tablets, available without a prescription. This effective method suppress articular syndrome, quickly relieve inflammation of soft tissues and suppress pain attacks different intensity.

There are other indications, which, together with daily doses, are detailed in the instructions for use of Indomethacin. Together with the tablets, you can combine the ointment of the same name to speed up the overall therapeutic effect in organism. However, it is important to remember that a duet with acetylsalicylic acid or other representatives of NSAIDs are strictly contraindicated.

Indomethacin gel

This yellow composition viscous consistency with a noticeable odor of alcohol. This non-steroidal anti-inflammatory drug becomes a worthy alternative to the ointment of the same name; it is used externally according to the same principle and indications specified in the instructions. If you buy it in an online store, it will be inexpensive, and the price of the medicinal gel is higher than the cost of the ointment, although therapeutic effect identical. Before using Indomethacin gel, you should consult your doctor and read the instructions.

Indomethacin capsules

Before you choose more cheap analogue of the specified medicine, you need to carefully study all its release forms and instructions for use. Extended-release capsules have the same list of indications, but they are much more convenient to use as intended. One pill contains 25 or 50 mg of indomethacin. Take the drug orally, do not chew it, wash it down with water, and each dose should take place 15 minutes after a meal. Indomethacin capsules according to the instructions are recommended for such clinical pictures:

• ankylosing spondylitis;
• arthrosis or osteoarthritis;
• diffuse diseases connective tissue;
• gout;
• radiculitis, spondylitis;
• rheumatism;
• spinal injuries;
• rheumatoid arthritis;
• intervertebral disc herniation.

Indomethacin - side effects

For systemic use of this medication, there are abnormal reactions of the body, reflected in the attached annotation. Side effects arise at the very beginning of the course, as a consequence of the adaptation of an organic resource. They can be short-term or protracted, and in the second case, the specialist must select for the patient a more gentle analogue of the same pharmacological group of NSAIDs. For local application characteristic “special effects” are completely excluded. So, possible side effects Indomethacin is as follows:

• allergic, local reactions on the skin in the form of urticaria, itching, hyperemia of the skin, anaphylactic shock;
• signs of neuralgia such as tinnitus, migraine attacks, decreased visual acuity, temporary loss of sensitivity;
• signs of dyspepsia, bronchospasm.

Indomethacin - contraindications

Not all patients are allowed this medication. If you are interested in conservative treatment with the drug Indomethacin, the instructions for use should be studied first. It specifies medical restrictions that narrow the circle of potential buyers of the medicine. So, absolute and relative contraindications Indomethacin are presented below:

• in gynecology – the period of pregnancy, breastfeeding;
• hypocoagulation;
• injury to the soft tissues of the skin;
• increased sensitivity to active substance medicines;
• childhood up to 14 years old;
• chronic lesions of the gastrointestinal mucosa.

Price for Indomethacin

When choosing indometacin, some patients are not interested in the instructions for use, but in the price of the issue. The drug will act differently, depending on its release form. According to this principle, the final price also differs, both in Internet catalogs and in local pharmacies. The second condition for determining the cost of a medicine is the manufacturer.

So if you need to find out how much Indomethacin costs, it is important to clarify the release form of the specified medication and the pharmaceutical company. For example, the cost of Indomethacin Sopharma ointment is about 100 rubles, and Indomethacin-Acri will cost up to 200 rubles. The gel will be more expensive - depending on the manufacturer, its cost varies up to 450 rubles.

Indomethacin - analogues

This treatment for joints, with instructions for use included, has equally effective substitutes. Their detailed description can be read in the instructions for use, but before ordering and treating the source of pathology, you need to consult a doctor. The following are considered analogues of Indomethacin: medical supplies:

• Indovazin;
• Eftimethacin;
• Tridocin;
• Elmetacin and others.

Video: Indomethacin suppositories - instructions for use

Included in all dosage forms remedy included as active ingredient indomethacin (Indometacin ) in different mass fractions: 25 mg for tablets and 50 mg or 100 mg for suppositories (suppositories), gel and ointment.

Additional ingredients of drugs may vary somewhat depending on the manufacturer, which should also be taken into account by the doctor prescribing this or that drug to the patient.

Release form

The drug Indomethacin is produced in the form:

• oral tablets No. 10-No. 300;
• candles No. 6-No. 50;
• 40 grams of gel;
• ointments 10-40 grams.

pharmachologic effect

Antiaggregation, analgesic, anti-inflammatory, antipyretic.

Pharmacodynamics and pharmacokinetics

The drug Indomethacin ( Sopharma; Berlin Hemi, Balkanfarma etc.) is a derivative indoleacetic acid and belongs to the NSAID group of drugs, which are characterized by their antipyretic , anti-inflammatory , antiaggregation And painkillers action.

The effectiveness of this medicinal product is associated with its inhibitory (depressant) effect on COX (cyclooxygenase ), which leads to suppression of metabolic transformations arachidonic acid and decreased synthesis. Also, one of the effects of the drug is inhibition aggregation .

Parenteral and oral administration Indomethacin reduces the severity pain syndrome , especially regarding joint pain , both in a state of movement and at rest, reduces the manifestations of morning swelling of the joints and their stiffness, and also increases the range of movements. The anti-inflammatory effect develops after 5-7 days of treatment.

External use of this drug helps eliminate pain, reduce swelling and weaken erythema, as well as reduce morning joint stiffness and increase motor activity .

Indomethacin tablets for orally quickly absorbed from the gastrointestinal tract. Serum Cmax is observed after 120 minutes. After enterohepatic recirculation, further metabolic transformations occur in the liver. The unchanged active ingredient and unbound metabolic products are determined in plasma - disbenzoyl , demethylated , desmethyl-desbenzoyl metabolites. The average T1/2 lasts approximately 4.5 hours. Excretion of 60% of the drug, in the form of unchanged substance and metabolic products, is carried out by the kidneys and 33%, in the form of metabolites, by the intestines.

Rectal suppositories are characterized by rapid absorption in the rectum. Bioavailability with this route of administration of the drug is 80-90%. Approximately 90% of the active ingredient is bound to whey proteins. T1/2 varies between 4-9 hours. Metabolic transformations occur in the liver. Approximately 70% of the drug is excreted by the kidneys, and about 30% by the intestines.

Indications for use

Indications for the use of Indomethacin in the form of tablets and suppositories include:

• joint syndrome (including painful manifestations, ankylosing spondylitis , );
• various ;
• pain syndrome in the spine;
• myalgia ;
• diffuse painful conditions connective tissue;
• traumatic inflammatory processes in joints and soft tissues;
• infectious and inflammatory processes observed in and diseases of the ENT organs (auxiliary therapy).

Indomethacin gel and ointment is indicated for use for:

• myalgia ;
• traumatic inflammatory processes occurring in joints and soft tissues;
• articular syndrome (including painful manifestations gout , rheumatoid arthritis , ankylosing spondylitis , osteoarthritis );
• pain in the spine;
• neuralgia .

Contraindications

Indomethacin tablets (Sopharma, Balkanfarma, etc.), as well as Indomethacin suppositories (Berlin Chemie, Sopharma, etc.) are contraindicated for use in:

• Crohn's disease ;
• liver failure or active;
• hypersensitivity;
• pregnancy;
• breastfeeding;
• acute or in the past caused by taking NSAIDs;
• confirmed hyperkalemia;
• chronic renal failure (with CC less than 30 ml/min) or progressive;
• recently held coronary artery bypass grafting ;
• bleeding disorders;
• congenital heart defects ;
• hematopoietic disorders (including anemia And leukopenia );
• under the age of 14 years.

Additionally, Indomethacin 50/100 suppositories (Berlin Hemi, Sopharma, etc.) are prohibited for use when:

• manifestations;
• rectal bleeding ;
• symptoms proctitis .

Both dosage forms of the drug should be prescribed with caution when:

• IHD ;
• somatic diseases of a severe nature;
• cerebrovascular disorders;
• dyslipidemia;
• hyperlipidemia;
• mental disorders;
• thrombocytopenia;
• pathologies of peripheral arteries;
• ulcerative lesions of the gastrointestinal tract in the anamnesis;
• long-term use of other NSAIDs;
• chronic renal failure (with CC 30-60 ml/min);
• hyperbilirubinemia ;
• availability Helicobacter pylori ;
• with accompanying portal hypertension ;
• parallel use of anticoagulants (), oral glucocorticoids (), antiplatelet agents (,), SSRIs (,);
• in old age.

Gel and ointment for topical use are contraindicated for:

• skin damage in the area of ​​application;
• III trimester of pregnancy (if the drug is applied to large areas of the body);
• hypersensitivity ;
• up to 1 year of age.

External dosage forms are prescribed with caution when:

• any combination from the nose/paranasal sinuses and intolerance to NSAIDs ;
• I and II trimester of pregnancy;
• exacerbation peptic ulcer Gastrointestinal tract ;
• breastfeeding;
• bleeding disorders ;
• up to 6 years old.

Side effects

Side effects when using tablets or suppositories

Digestive system:

• nausea, vomiting;
• gastrointestinal bleeding;
• jaundice ;
• unpleasant or painful sensations in the abdomen;
• gastrointestinal perforation;
• erosive and ulcerative lesions of the gastrointestinal tract ;
• stomatitis ;
• intestinal strictures;
• bleeding from a diverticulum or sigmoid colon;

Indomethacin suppositories, instructions for use

Indomethacin suppositories ( Altfarm, Sopharma etc.) are intended for rectal (into the rectum) use. The procedure for administering suppositories should be performed before bedtime after preliminary cleansing of the intestines. Indomethacin suppositories ( Berlin Hemi, Biosynthesis etc.) you must try to insert it into the rectum as deeply as possible in order to better absorb the drug. Typically, 3-time administration of 50 mg suppositories or a single administration of 100 mg suppositories are prescribed within 24 hours. In case of severe pain syndrome (for example, an attack of gout), rectal daily use 200 mg of the drug in suppositories (in addition to oral administration).

Indomethacin gel and ointment, instructions for use

Indomethacin gel and ointment ( Sopharma, Balkanfarma etc.) are intended for application and rubbing into skin located directly above the painful area of ​​the body, for which Indomethacin gel or ointment ( Sopharma, Akrikhin etc.) apply a thin layer to intact and previously cleansed skin.

5% external agents are indicated to be applied at intervals of 3-4 times every 24 hours. Applications of 10% drugs should be carried out 2-3 times a day. Single and maximum dosages of external forms of the drug are calculated based on the amount (in centimeters) of gel or ointment squeezed out of the tube. Adult patients can use 4-5 cm of squeezed out drug one time, and a maximum of 15-20 cm per day. Children are advised to use half the dosage.

Overdose

Negative symptoms of an overdose of Indomethacin, most often observed when using oral or rectal dosage forms, are manifested by: nausea/vomiting, severe memory impairment , . In particular serious cases noted numbness of the limbs , convulsions .

The prescribed treatment should be consistent with the negative manifestations being monitored.

Interaction

Parallel reception with potassium-sparing diuretics reduces their effects and, as a result, increases the risk of formation hyperkalemia .

Combination therapy using cefamandole , plicamycin, cephaperazone , valproic acid , cefotetan increases the risk of bleeding and increases the frequency of formation hypoprothrombinemia .