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Indomethacin / Indocin

- Adult:
    - NSAIA w/ analgesic and antipyretic action:
    - moderate to Severe OA, RA, AS:
    - 25mg PO bid/tid, incr dose at weekly intervals to max of 150-200 mg/day;
    - if SR capsule is used, initial dose is 75mg qd;
    - extended release caps: 75 mg PO qam or qpm, may increase to 75 mg PO bid, w/ max of 200 mg PO/day;
    - shoulder bursitis/tendinitis: 25-50mg PO tid (usual duration of therapy is 7-14 days);
    - acute Gouty Arthritis: 50mg PO tid initially, then taper off gradually;
    - supplied: caps: 25, 50 mg; caps extended release: 75 mg;
    - often causes GI upset and in some cases PUD
    - administer capsule immediately after meals or with antacids and consider prophylactic use of anti-ulcer agents;

- Peds:
    - not recommended for children less than 14yrs except for neonates with patent ductus arteriosus;

- Precautions:
    - contraindicated w/ Syndrome of nasal polyps, angioedema, or bronchospastic reaction to asprin and other NSAIA;
    - contraindicated with active GI bleeding or h/o recurrent GI lesions;
    - contraindicated w/ use of Lithium (may result in lithium toxicity);
    - use with caution in patients with renal or hepatic insufficiency, bleeding disorders (inhibition of platlet aggregation), parkinsonism, depression, epilepsy, psychiatric disturbances (worsening of symptoms)

Longterm treatment with nonsteroidal antiinflammatory drugs in rheumatoid arthritis: a prospective drug survival study.

The use of indomethacin to prevent the formation of heterotopic bone after total hip replacement. A randomized, double-blind clinical trial.

Time-Dependent Inhibitory Effects of Indomethacin on Spinal Fusion.

Indomethacin reduces cell damage: shedding new light on compartment syndrome.