(Indomethacin)

Indications: pain and moderate to severe inflammation in rheumatic disease and other acute musculoskeletal disorders; acute gout; dysmenorrhoea; closure of ductus arteriosus.

Cautions: may impair the ability to drive or operate machinery; allergic disease, particularly asthma; hepatic and renal impairment, pregnancy, epilepsy, parkinsonism, psychiatric disturbances, elderly patients. During prolonged therapy ophthalmic and blood examinations are advisable. Avoid rectal administration in proctitis and haemorrhoids.

Contra-indications: peptic ulceration, salicylate hypersensitivity.

Side Effects: frequently gastro-intestinal disturbances (including diarrhoea), headache, dizziness, and light- headedness; gastro-intestinal ulceration and bleeding; rarely, drowsiness, confusion, insomnia, convulsions, psychiatric disturbances, depression, syncope, blood disorders (particularly thrombocytopenia), hypertension, hyperglycaemia, blurred vision, corneal deposits, peripheral neuropathy, and intestinal strictures; suppositories may cause rectal irritation and occasional bleeding.

Drug Interactions: Refer to table below.

Dose: by mouth, 50-200mg daily in divided doses with food. By rectum in suppositories, 100mg at night, repeated in the morning if required.

If rectal and oral treatments are to be combined, max. total daily dose 150-200mg.