Indometacin for pain and inflammation

Anti-inflammatory painkillers like indometacin are sometimes called non-steroidal anti-inflammatory drugs (NSAIDs), or just 'anti-inflammatories'. Indometacin is used to treat painful conditions such as arthritis, sprains and strains, back pain, period (menstrual) pain, and gout pain.

Indometacin works by blocking the effect of chemicals in your body, called cyclo-oxygenase (COX) enzymes. These enzymes help to make other chemicals in the body, called prostaglandins. Some prostaglandins are produced at sites of injury or damage, and cause pain and inflammation. By blocking the effect of COX enzymes, fewer prostaglandins are produced, which means pain and inflammation are eased.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking indometacin, it is important that your doctor knows:

• If you have asthma or any other allergic disorder.
• If you have ever had a stomach or duodenal ulcer, or if you have an inflammatory bowel disorder such as Crohn's disease or ulcerative colitis.
• If you are pregnant or breast-feeding.
• If you are over 65 years of age.
• If you have liver or kidney problems.
• If you have a heart condition, or a problem with your blood vessels or circulation.
• If you have high blood pressure.
• If you have a high blood sugar level or cholesterol level.
• If you are a smoker.
• If you have epilepsy, or Parkinson's disease, or a mental health problem.
• If you have any blood clotting problems.
• If you have a connective tissue disorder, such as systemic lupus erythematosus. This condition is also called lupus, or SLE.
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
• If you have ever had an allergic reaction to any other NSAID (such as aspirin, naproxen, diclofenac, and ibuprofen), or to any other medicine.

• Before you start taking indometacin, read the manufacturer's printed information leaflet from inside the pack. There are several strengths of indometacin capsule available. The manufacturer's leaflet will give you more information about the strength of capsule you have been given, and it will also provide you with a full list of the side-effects which you may experience.
• Follow the instructions given by your doctor for taking indometacin. Your dose will depend upon the reason why you are taking it - you may be asked to take just one dose a day, or several doses each day. Your dose will be printed on the label of the pack, but if you are still unsure what to do, ask your pharmacist for advice.
• Take indometacin capsules with a meal or after a snack. Doing this can help to prevent side-effects such as indigestion. Many people find it helps to swallow the capsules with a drink.
• If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose). Do not take two doses together to make up for a forgotten dose.

• Your doctor will try to prescribe you the lowest dose for the shortest time in order to reduce the risk of side-effects. If you need to take indometacin for a long time, your doctor may want to prescribe another medicine along with it to protect your stomach from irritation.
• Try to keep any regular appointments with your doctor. This is so your doctor can check on your progress, and is especially important if you are taking indometacin for a long-term condition.
• If you have asthma, symptoms such as wheeze or breathlessness can be made worse by anti-inflammatories. If this happens to you, you should stop taking indometacin and see your doctor as soon as possible.
• If you buy any medicines, check with a pharmacist that they are safe to take with an anti-inflammatory. This is because you should not take indometacin with any other anti-inflammatory painkiller, some of which are available in cold and flu remedies which can be bought over the counter.
• If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with indometacin. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Important: if you experience any of the following less common but more serious symptoms, stop taking indometacin and contact your doctor for advice straightaway:

• If you have any breathing difficulties such as wheeze or breathlessness.
• If you have any signs of an allergic reaction such as swelling around your mouth or face, or a severe itchy skin rash.
• If you pass blood or black stools, vomit blood, or have severe tummy (abdominal) pains.

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.