Indomethacin, rectal, 100 mg 10 pcs

Indomethacin has anti-inflammatory, analgesic, antipyretic and antiaggregant effect. Inhibits the activity of pro-inflammatory factors, reduces platelet aggregation.

Inhibiting cyclooxygenase 1 and 2 it disrupts arachidonic acid metabolism, decreases quantity of prostaglandins (Pg) both in inflammatory focus and healthy tissues, suppresses exudative and proliferative phases of inflammation.

It causes easing or disappearance of pain syndrome of rheumatic and non-rheumatic character (including pain in the joints). In case of pain in the joints at rest and on movement, decreases morning stiffness and joint swelling, increases the range of motion; in inflammatory processes after operations and injuries it quickly relieves spontaneous pain as well as pain on movement, reduces inflammatory swelling of the wound area.

Indications

Inflammatory and degenerative diseases of the musculoskeletal system: rheumatoid, psoriatic, juvenile chronic arthritis, arthritis in Paget’s disease and Reiter’s disease, neuralgic amyotrophy (Personej-Turner disease), ankylosing spondylitis (Behterev disease), gouty arthritis (in acute gout attack, fast acting pharmaceutical forms are preferable), rheumatism.

Pain syndrome: headache (including menstrual syndrome) and toothache, lumbago, sciatica, neuralgia, myalgia, after injuries and surgery accompanied by inflammation, bursitis and tendinitis (most effective for localization in the shoulder and forearm).

Algodysmenorrhea; Bartter’s syndrome (secondary hyperaldosteronism); pericarditis (symptomatic treatment); childbirth (as analgesic and tocolytic agent); pelvic inflammatory processes, including Adnexitis.

Infection of the Botallic duct.

Infectious inflammatory diseases of the ENT with a pronounced pain syndrome (in the treatment): pharyngitis, tonsillitis, otitis.

Fever syndrome (including lymphogranulematosis, other lymphomas and liver metastases of solid tumors) – in case of ineffectiveness of ASA and paracetamol. The drug is intended for symptomatic therapy, to reduce pain and inflammation at the time of use, it has no effect on the progression of the disease.

Active ingredient

How to take, the dosage

Set individually, taking into account the severity of the disease. For adults when taken orally, the initial dose is 25 mg 2-3 times per day. In case of insufficient clinical effect the dose is increased to 50 mg 3 times per day. Long-acting dosage forms are used 1-2 times per day. Maximum daily dose: 200 mg.

In case of effect, treatment is continued for 4 weeks in the same or a reduced dose. With long-term use, the daily dose should not exceed 75 mg. It is taken after meals.

For treatment of acute conditions or relieving acute exacerbation of a chronic process it is administered in the form of 60 mg 1 to 2 times per day. The duration of intravenous injection is 7-14 days. Then indomethacin is used orally or rectally at 50-100 mg twice a day; the maximum daily dose should not exceed 200 mg. For maintenance treatment, it is used rectally 50-100 mg once a day at night.

Interaction

Concomitant use of indomethacin may reduce the effects of saluretics, beta-adrenoblockers; increase the effects of indirect anticoagulants.

In concomitant use of indomethacin and diflunisal there is a risk of severe bleeding from the gastrointestinal tract.

Concomitant use with probenecid may increase the plasma concentration of indomethacin.

Indomethacin may decrease the tubular secretion of methotrexate, which leads to increased toxicity.

The toxicity of cyclosporine is increased when used concomitantly with NSAIDs.

Indomethacin in dose of 50 mg 3 times daily increases plasma lithium concentration and decreases clearance of lithium from the body in patients with psychiatric disorders.

Concomitant use of indomethacin with digoxin may increase the plasma concentration of digoxin and increase the elimination half-life of digoxin.

Contraindications

Hypersensitivity;

Bronchial asthma, urticaria or acute rhinitis triggered by taking ASA or other NSAIDs.

Gastric and duodenal ulcer, inflammatory bowel disease (ulcerative colitis, Crohn’s disease), bleeding (including intracranial, from gastrointestinal organs), congenital heart defects (severe coarctation of the aorta, atresia of the pulmonary artery, severe tetrada Fallo), period after aortocoronary bypass surgery;

disorders of coagulation (including hemophilia, prolonged bleeding time, tendency to bleeding), hepatic insufficiency, active liver disease;

CPU (CK less than 30 ml/min), advanced renal disease, hematopoiesis disorders (leukopenia and anemia); confirmed hyperkalemia;

pregnancy, lactation;

for rectal use – rectal bleeding, proctitis, hemorrhoids, childhood (under 14 years).

With caution. CHD, cerebrovascular diseases, CHD, dyslipidemia, hyperlipidemia, diabetes mellitus, thrombocytopenia, peripheral arterial disease, arterial hypertension, smoking, CPP (CK 30-60 ml/min), cirrhosis with portal hypertension, hyperbilirubinemia, peptic ulcer disease in past history, presence of H. pylori, long-term use of NSAIDs, frequent alcohol consumption, severe somatic diseases; concomitant therapy with the following drugs: anticoagulants (including warfarin), antiplatelet agents (including acetylsalicylic acid, clopidogrel), oral GCS (including prednisolone), oral antiplatelet agents (including antiplatelet agents), and antiplatelet agents.Prednisolone), selective serotonin reuptake inhibitors (including citalopram, fluoxetine, paroxetine, sertraline);
mental disorders, epilepsy, parkinsonism, depression, old age.

Side effects

Digestive system disorders: nausea, anorexia, vomiting, abdominal pain and discomfort, constipation or diarrhea, erosive ulcerative lesions, bleeding and perforations of the gastrointestinal tract; rarely – intestinal strictures, stomatitis, gastritis, flatulence, bleeding from the sigmoid colon or from diverticulum, jaundice, hepatitis.

CNS and peripheral nervous system disorders: dizziness, headache, depression, fatigue; rarely – anxiety, fainting, somnolence, seizures, peripheral neuropathy, muscle weakness, involuntary muscle movements, sleep disorders, mental disorders (depersonalization, psychotic episodes), paresthesia, dysarthria, parkinsonism.

Cardiovascular system disorders: edema, increased BP, tachycardia, chest pain, arrhythmia, palpitation, arterial hypotension, congestive heart failure, hematuria.

Allergic reactions: rare – itching, urticaria, angiitis, erythema nodosum, skin rash, exfoliative dermatitis, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, hair loss, acute respiratory distress, severe BP drop, anaphylactic reactions, angioneurotic edema, dyspnea, bronchial asthma, pulmonary edema.

Hematopoietic system disorders: rarely – leukopenia, petechiae or ecchymoses, purpura, aplastic and hemolytic anemia, thrombocytopenia, DIC syndrome.

Sense organs: rarely – visual disturbances, diplopia, orbital and periorbital pain, tinnitus, hearing disorders, deafness.

Urinary system disorders: rarely – proteinuria, nephrotic syndrome, interstitial nephritis, renal failure.

Metabolism: rarely – hyperglycemia, glucosuria, hyperkalemia.

Others: rare – vaginal bleeding, hot flashes, increased sweating, nasal bleeding, enlargement and tightness of the mammary glands, gynecomastia.

Local reactions: at the site of injection in/m in some cases – formation of infiltrates, abscesses; with rectal administration irritation of the rectal mucosa, tenesmus, exacerbation of chronic colitis are possible.

In external application: itching, redness, rash in the application area.

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