Indomethacin 50 mg, 10 rectal suppositories (Tula Pharmaceutical Factory)

Who is the drug allowed or prohibited?

Indomethacin suppositories are intended for short-term treatment of acute or chronic pain syndrome that occurs against the background of inflammatory, degenerative processes in the musculoskeletal region:

• for osteoarthritis;
• bursitis;
• tendinitis;
• gouty or rheumatoid arthritis;
• ankylosing spondylitis.

The medicine is contraindicated in patients:

• with individual intolerance to the component composition;
• allergies to acetylsalicylic acid;
• ulcer or perforation of the gastrointestinal tract;
• bleeding in the digestive tract;
• failure of the liver, kidneys, heart;
• nasal polyps;
• proctitis, hemorrhoids.

Indomethacin suppositories are not prescribed to minors under 14 years of age, in the 3rd trimester of gestation and during breastfeeding.

Nosological classification (ICD-10)

• H60 Otitis externa
• H66 Suppurative and unspecified otitis media
• H70 Mastoiditis and related conditions
• J01 Acute sinusitis
• J02.9 Acute pharyngitis, unspecified
• J03.9 Acute tonsillitis, unspecified (angina agranulocytic)
• J04 Acute laryngitis and tracheitis
• K08.8.0* Toothache
• M06.9 Rheumatoid arthritis, unspecified
• M08 Juvenile arthritis
• M10 Gout
• M13.8 Other specified arthritis
• M45 Ankylosing spondylitis
• M77.9 Enthesopathy, unspecified
• M79.0 Rheumatism, unspecified
• M79.2 Neuralgia and neuritis, unspecified
• N30 Cystitis
• N41 Inflammatory diseases of the prostate gland
• N70 Salpingitis and oophoritis
• N94.6 Dysmenorrhea, unspecified
• R51 Headache

Overdose symptoms

The abstract indicates that the rectal use of suppositories causes the appearance of non-standard symptoms in exceptional cases. Intoxication manifests itself:

• severe cephalalgia;
• dyspeptic disorders;
• disturbances of orientation in space and memory;
• loss of sensitivity;
• convulsive syndrome.

Help with overdose consists of supportive and restorative procedures. Hemodialysis is not performed.

Interaction

Reduces the effectiveness of uricosuric drugs, antihypertensive and diuretics (saluretics); enhances the effect of indirect anticoagulants, antiplatelet agents, fibrinolytics, side effects of mineralocorticosteroids, estrogens, and other NSAIDs; enhances the hypoglycemic effect of sulfonylurea derivatives.

Combined use with paracetamol increases the risk of nephrotoxic effects. Ethanol, colchicine, glucocorticosteroids - increase the risk of developing gastrointestinal complications accompanied by bleeding.

Increases the concentration of lithium, methotrexate and digoxin in the blood. Cyclosporine and gold preparations increase the nephrotoxicity of indomethacin. Cefamandole, cefoperazone, valproic acid - increase the risk of developing hypoprothrombinemia and the risk of bleeding. Reduces the elimination of penicillins. Potentiates the toxic effect of zidovudine.

How to use correctly

Dosages for indomethacin suppositories are set individually for each patient. During therapy, the minimum effective doses are used and the consumption of alcoholic beverages is prohibited.

The instructions recommend the following treatment regimen:

• patients over 14 years old - one suppository of 50 mg up to 3 times a day or one suppository of 100 mg up to 2 times a day;
• for night pain and morning stiffness - 100 mg of the drug in the evening;
• the maximum daily dosage is 200 mg;
• the duration of the procedures should not exceed a calendar week;
• in old age, the smallest dosages are prescribed with constant monitoring of the body’s condition.

Before using indomethacin suppositories, the patient must cleanse the intestines (naturally or artificially) and inject the medication 3 cm deep into the rectum. After the process is completed, the patient remains in bed for 20-30 minutes. If immediately after the procedure (less than 10 minutes) a bowel movement occurs, then an additional suppository must be used.

Composition and release form

Indomethacin 50 Berlin-Chemie

in a blister pack 5 pcs.; in a cardboard pack there are 2, 6 or 10 packs.

Indomethacin 100 Berlin-Chemie

in a blister pack 5 pcs.; in a cardboard pack there are 2, 6 or 10 packs.

Adverse reactions

Therapeutic manipulations with indomethacin suppositories sometimes provoke the development of non-standard responses of the body. During treatment the following are observed:

• allergies with obsessive itching, skin rashes, nettle fever;
• erythema multiforme, Lyell's or Stevens-Johnson syndrome;
• swelling of the lung tissue, shortness of breath, anaphylactic shock;
• depression, indifference and constant fatigue with drowsiness;
• disturbances in clarity of consciousness, sleep problems;
• cephalgia with dizziness, convulsive syndrome, coma;
• severe muscle weakness, involuntary movements;
• epilepsy attacks, decreased visual acuity;
• changes in the structure of the retina, pain in the eyes;
• deposits on the corneal tissue, hearing problems, partial deafness;
• tissue swelling, heart failure, increased heart rate;
• chest discomfort, tachycardia.

Uncontrolled use of indomethacin suppositories can become a factor in the development of stroke and heart attack.

The list of additional side effects includes:

• increase and decrease in blood pressure;
• dyspeptic disorders, pain in the epigastric region;
• anorexia, stomatitis, gastrointestinal bleeding;
• gastritis, flatulence, hepatitis, jaundice;
• erythema of the skin of the neck and face of a transient type;
• insufficient kidney function, proteinuria, nephrotic syndrome;
• inflammatory processes in the mammary glands, bleeding from the vagina.

Less commonly, adverse reactions include partial baldness, proctitis, rectal itching or bleeding. When carrying out laboratory diagnostics, an increase in the amount of glucose and potassium in the blood is recorded.

Contraindications

Hypersensitivity, “aspirin asthma”, gastric and duodenal ulcers, ulcerative colitis, bleeding (intracranial, gastrointestinal), congenital heart defects (coarctation of the aorta, pulmonary atresia, tetralogy of Fallot), impaired color vision, cirrhosis of the liver with portal hypertension , diseases of the optic nerve, bronchial asthma, heart failure, edema, arterial hypertension, hemophilia, hypocoagulation, liver failure, chronic renal failure, hearing loss, vestibular apparatus pathology, glucose-6-phosphate dehydrogenase deficiency; blood diseases; proctitis, hemorrhoids; pregnancy, breastfeeding period, childhood and adolescence up to 18 years.

With caution - hyperbilirubinemia, thrombocytopenia, epilepsy, parkinsonism, depression, children and old age.

Analogs

If non-standard symptoms develop during therapeutic procedures, it is recommended to replace the drug. A list of popular analogues of suppositories with indomethacin is presented:

• Adolor;
• Airtalom;
• Bioran;
• Voltaren;
• Diklakom;
• Dicloran;
• Diclofenac;
• Ibuprofen;
• Ketalgin;
• Ketanov;
• Ketorol;
• Nise;
• Naklofen;
• Ortofen;
• Piroxicam;
• Rapten.

These drugs are available in different forms, but all have a similar spectrum of action and belong to the NSAID subgroup. The replacement of the main medication is carried out by the attending physician, based on diagnostic data and the reasons for the forced discontinuation of suppositories with indomethacin.

Indomethacin

Nonsteroidal anti-inflammatory drugs (NSAIDs) today are more than drugs: they are a real phenomenon in medicine, salvation in many situations, an object of cult, a subject of heated debate and debate. The unique fusion of anti-inflammatory, antipyretic and analgesic effects has deprived them of competitors and has led to the fact that at the present time approximately 20% of the world's inhabitants are already on regular courses of NSAIDs. Whether this is good or bad is another question. But this is the reality. Indomethacin is a “pioneer” of the NSAID group: it burst into clinical practice in the early 60s of the last century and proved to be a powerful anti-inflammatory drug that can quickly achieve significant improvement in rheumatic diseases of an inflammatory nature. For example, in rheumatoid arthritis, indomethacin not only numbs the pain, but also helps overcome morning stiffness, making it easier for the joints to function. Clinical studies have proven its high effectiveness in ankylosing spondylitis, incl. compared to other NSAIDs. According to some expert estimates, indomethacin is an ideal treatment for seronegative spondylitis. And the effectiveness of indomethacin for relieving attacks of gouty arthritis is almost a reference (however, in fairness, it should be noted that in this case there is still no objective evidence of the leadership of indomethacin among other NSAIDs in terms of analgesic and anti-inflammatory effect). The mechanism of action of indomethacin is based on its ability to suppress the activity of the enzymes COX-1 and COX-2, as a result of which the synthesis of inflammatory mediators prostaglandins, “responsible” for pain, increased temperature and capillary permeability, is reduced.

The drug also has antithrombic properties.

Every barrel of honey has its own fly in the ointment. Such a benign picture of the effectiveness of indomethacin also has several black smears. Thus, this drug is prone to promote the development of a number of complications from the digestive tract, including persistent dyspepsia and gastrointestinal bleeding. Moreover, the risk of developing the latter exceeds that of other drugs in this group, which is confirmed by clinical trials. Therefore, without in any way detracting from the outstanding advantages of indomethacin in terms of pain relief and suppression of inflammation, we should not forget about its side effects. Thus, it seems inappropriate to talk about the advantages of this drug over other NSAIDs. Considering the above, we can characterize indomethacin as a good strong reserve drug in patients for whom taking other NSAIDs has proven to be ineffective. In this case, indomethacin can only be taken by persons who are not at risk of developing NSAID-potentiated gastropathy.

Indomethacin is available in several dosage forms: tablets, ointment, suppositories, gel. A wide range of release forms allows doctors to vary the route of administration, which can significantly optimize the therapeutic process. Considering the potential danger of indomethacin, its use must be agreed with a specialist.

Note!

The description of the drug Indomethacin on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.

Special instructions when using Indomethacin

The drug should be used with caution in elderly patients and people with renal or hepatic impairment.

For people with exacerbation of erosive and ulcerative diseases of the gastrointestinal tract, treatment with Indomethacin is carried out under the supervision of a doctor.

If you are taking anticoagulants, antiplatelet agents, selective serotonin reuptake inhibitors or glucocorticosteroids, you should inform your doctor before using Indomethacin.

During treatment, it is recommended to refrain from activities that require increased concentration.