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indomethacin dose pediatric

Use the lowest effective dose for the shortest amount of time possible. Indoleacetic acid is an NSAID with analgesic and antipyretic effects that is used for RA, OA, and in premature neonates to close a patent ductus arteriosus.

Other names for this medication:
Indocin, Tivorbex

Similar Products:
Imitrex, Celecoxib, Ecosprin, Decadron, Probenecid, Naprelan, Zanaflex, Meloxicam, Phenazopyridine, Celebrex, Ditropan, Ibuprofen


The ductus arteriosus is typically closed at birth due to the significant increase in oxygen tension that occurs after birth. By inhibiting the synthesis of prostaglandins, indometacin promotes the closure of ductus arteriosus. Arachidonic acid is transformed into PGG2 and PGG2 is transformed into PGH2 by COX-2. Inflammatory stimuli have a high ability to induce the expression of COX-2. By catalyzing the transformation of arachidonic acid into prostaglandin (PG) G2 and PGG2 into PGH2, the COX-1 enzyme contributes to the protection of the gastric mucosa, platelet, and kidney function. Reduced inflammatory responses are brought on by dropping PGE2 levels. PGH2 is further transformed into PGE2 and PGI2 (also known as prostacyclin) through the COX-2-mediated pathway. Through the activation of protein kinase R (PKR) and downstream phosphorylation of eIF2, which prevents protein synthesis, indomethacin has been said to have anticancer and antiviral properties. The cyclo-oxygenase (COX) enzyme, also known as prostaglandin G/H synthase, is irreversibly and non-specifically inhibited by indometacin. It is known that indomethacin inhibits both COX isoforms, but does so more selectively for COX-1, which explains why it has more negative side effects on the stomach than other NSAIDs. Unlike other NSAIDs, indomethacin also prevents phospholipase A2, an enzyme that releases arachidonic acid from phospholipids, from working. It binds to the enzyme's active site and prevents the interaction between the enzyme and its substrate, arachidonic acid. It is located in various organs, including the kidneys, uterus, and the central nervous system. Its antipyretic effects might be brought on by how the hypothalamus reacts to it, increasing peripheral blood flow, causing vasodilation, and causing heat to dissipate as a result. PGE1 widens the ductus arteriosus by relaxing the smooth muscles and preventing the ductus arteriosus from closing. PGE2 plays a role in regulating fever, pain, and inflammation. PGE1 mediates an opposite effect to that of oxygen and is linked to congenital heart malformations in premature infants with patent ductus arteriosus. The analgesic, antipyretic and anti-inflammatory effects of indomethacin as well as adverse reactions associated with the drug occur as a result of decreased prostaglandin synthesis. The exact mechanism of action of indometacin in inducing closure of a patent ductus arteriosus is not fully understood; however, it is thought to be through inhibition of prostaglandin synthesis. There are two known isoforms of COX: COX-1, which is universally present in most body tissues and is involved in the synthesis of prostaglandins and thromboxane A2, and COX-2, which is expressed in response to injury or inflammation.


Never take it in larger or smaller amounts or more frequently than your doctor has instructed. One or two times a day is the typical dosage for extended-release capsules. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. If you have any questions, consult your doctor or pharmacist before starting this regimen. If your symptoms are under control, your doctor may start you on an average dose of indomethacin and then lower it. In some circumstances, your doctor might start you on a low dose of indomethacin and gradually increase it, not more frequently than once per week. Two to four times a day, indomethacin liquid and capsules are typically taken. Take indomethacin with food, right after a meal, or with antacids if it is available in capsule, extended-release capsule, or suspension form. There are three oral dosage forms of indomethacin: capsules, extended-release (long-acting) capsules, and suspension. Additionally, indomethacin is occasionally used to treat a specific kind of low blood pressure, to reduce the amount of calcium in the blood, to treat fever, pain, and inflammation brought on by a variety of ailments and injuries, and to relieve these symptoms. Before each use, thoroughly shake the suspension to mix the medication. Do not split, chew, or crush the extended-release capsules; instead, swallow them whole. Take indomethacin every day at roughly the same time. Do not alter the dosage of indomethacin. The risks of using this medication for your condition should be discussed with your doctor. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Unless your doctor tells you otherwise, continue your normal diet. Throughout your treatment, your doctor might adjust the dosage of your medication.

Missed dose

Never combine two doses into one. If it's almost time for your next dose, skip the missed dose and take the medication as soon as you remember.


If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Call 1-800-222-1222 to reach the poison control hotline in the event of an overdose. At, you can also find information online. Symptoms of overdose may include the following: nausea vomiting headache dizziness confusion extreme tiredness feeling of numbness, pricking, burning, or creeping on the skin seizures


However, you should not flush this medication down the toilet. The best way to get rid of your medication is instead through a medication take-back program. As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Store this medication out of children's reach in the tightly closed, original container. See the FDA's Safe Disposal of Medicines website ( for more information if you do not have access to a take-back program. Keep it at room temperature, away from sources of extreme heat, and dry (not in the bathroom). To find out about take-back programs in your neighborhood, speak with your pharmacist or get in touch with your city's garbage/recycling department. Always lock safety caps and immediately store medications up and away and out of young children's sight and reach. Unused medications should be disposed of in special ways to ensure that pets, children, and other people cannot ingest them.

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Side effects

For medical advice about side effects, contact your doctor. Typical negative effects could be: Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath. If you experience symptoms of an allergic reaction, such as hives, trouble breathing, swelling of the face or throat, or a severe skin reaction, such as fever, sore throat, burning eyes, skin pain, or a red or purple skin rash with blistering and peeling, seek emergency medical attention. The negative effects of indomethacin If you experience any of the following: There may be other side effects; this is not a comprehensive list. Call 1-800-FDA-1088 to report side effects to the FDA. a skin rash, regardless of how minor; changes in vision; heart issues—swelling, rapid weight gain, feeling out of breath; indications of liver or pancreas issues—loss of appetite; upper stomach pain (that may radiate to your back); nausea, vomiting, diarrhea; unusual tiredness; itching; flu-like symptoms; dark urine; jaundice (yellowing of the skin or eyes); indications of stomach bleeding—bloody or tarry stools; coughing up blood; indigestion, nausea; headache; or dizziness.


Skip the alcohol. Drug absorption is unaffected by food. Food, however, might lessen how much indomethacin irritates the digestive system. Drinking alcohol can make GI bleeding more likely. Use whether or not you are eating.


You might feel more groggy or faint if you drink alcohol or use marijuana (cannabis). Avoid tanning booths and sunlamps. Inform your doctor or dentist of all the products you use, including prescription, over-the-counter, and herbal medications, before having surgery. If you have any allergies, including those to aspirin, NSAIDs (such as ibuprofen, naproxen, and celecoxib), or indomethacin, let your doctor or pharmacist know before you take it. Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), bleeding or clotting problems, growths in the nose (nasal polyps), heart disease (such as previous heart attack), high blood pressure, liver disease, stomach/intestinal/esophagus problems (such as bleeding, ulcers, recurring heartburn), stroke. Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks. When using this medication, children should use caution. Children may be more vulnerable to this medication's side effects, especially severe liver issues. Consult your doctor before breast-feeding. For more details, speak with your physician or pharmacist. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Discuss the risks and benefits of treatment with your doctor. Till you can do it safely, avoid operating machinery, driving, or doing anything else that requires alertness. To avoid becoming dehydrated, make sure to follow your doctor's instructions to drink plenty of fluids. You should also notify your physician right away if the amount of urine changes. If your doctor determines that you need to take this medication between weeks 20 and 30 of pregnancy, you should take it for the shortest amount of time possible at the lowest effective dose. It is not recommended for use in pregnancy from 20 weeks until delivery. When taking NSAIDs, including indomethacin, kidney issues can occasionally arise. Stop smoking and drink in moderation. Limit your time in the sun. While taking this medication, older adults may be more susceptible to mental/mood changes, kidney issues, heart attacks, strokes, stomach/intestinal bleeding, and kidney problems. Dehydration, heart failure, kidney disease, being an older adult, taking certain medications, and being dehydrated all increase the likelihood of problems developing (see also the section on drug interactions). If you use cannabis (marijuana), speak with your doctor. For more information, speak to your pharmacist. Tell your doctor if you are pregnant or if you plan to become pregnant. Tell your doctor right away if you get sunburned or have skin blisters/redness. You might feel light-headed or sleepy after taking this medication. This medication enters breast milk and could have negative effects on a nursing infant. This medication may harm an unborn baby and cause problems with normal labor/delivery. You may become more sensitive to the sun as a result of this medication. This medicine may cause stomach bleeding. This product might include inactive components that could lead to allergic reactions or other issues. When outdoors, apply sunscreen and don protective gear. You should not use this medication after 30 weeks of pregnancy.

How long do Indocid suppositories take to dissolve?

Try not to go to the toilet and open your bowels for at least an hour after using the suppository. The suppository takes about one hour to be completely absorbed and do its work. If you are not sure how to use a suppository, ask your doctor or pharmacist.

Does indomethacin make you sleepy?

This medicine may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on arising.

Is indomethacin better than ibuprofen?

Indocin and ibuprofen provide similar pain relief when used in arthritis patients. 6 A study that compared the drugs found that they were similarly effective, but patients preferred Indocin, although the study authors did not say why.

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user6800816 Nov 14, 2015, 6:31:43 AM

Gastrointestinal : Nausea, vomiting, indigestion, diarrhea, abdominal distress or pain and constipation. Monitor liver function, kidney function, lung function, blood counts regularly while taking this medication. • Central Nervous System : Headache, dizziness, vertigo, drowsiness, depression and fatigue. Please do write to us ([email protected]) if a drug is missing from our comprehensive drug price list.

user1676146 Oct 20, 2016, 12:40:20 PM

In summary Dr Ravichandran said that the 210 patients comprised 102 in the indomethacin group and 108 in the paracetamol group. This centre was ideal for the study as the doctors were enthusiastic and a dedicated ward was available for the study. He went on to prescribe indomethacin to a small number of patients with covid-19, all of whom recovered without hospitalisation, despite having multiple comorbidities including renal disease, diabetes, obesity and advanced age.

Alfred Coleman Apr 10, 2015, 8:10:23 AM

Figure 2 shows the timeline for pain scores in two study groups. compared the intravenous administration of morphine and paracetamol among 146 renal colic patients who visited emergency department [8]. the efficacy of celecoxib, also an NSAID, in the management of renal colic was evaluated [15].

Ardhi Dec 15, 2015, 3:10:09 PM

Particulate Matter Leads to Indomethacin, Sodium Chloride Recalls One lot of American Regent’s concentrated sodium chloride injections and one lot of Bedford Laboratories’ Indomethacin injections have been recalled due to contamination by particulate matter.

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