home Adviсe Indomethacin suppositories for rectal use in gynecology. Suppositories with indomethacin. Names of drugs, indications for use, dosage

Indomethacin suppositories for rectal use in gynecology. Suppositories with indomethacin. Names of drugs, indications for use, dosage

Anti-inflammatory drugs are used to relieve inflammation itself, have an analgesic effect, lower fever, and relieve fever. Drugs of the NSAID group (non-steroidal) have their advantage over others - the absence of undesirable properties of steroids. Indomethacin is a drug of this group, the prescription of which is inevitable in some situations.

This medicine may be released in various forms(tablets, suppositories, ointments), about him positive impact There are conflicting opinions, as it gives strange consequences.

The first thing worth noting is this remedy It should not be used in any way without the recommendation and prescription of a doctor. The drug belongs to the group of NSAIDs, and is also a manufacturer of indoleacetic acid. Its actions are aimed at coping with the inflammatory process, reducing painful sensations at the site of the lesion. Indomethacin tablets block the work of inflammatory agents and also reduce platelet aggregation. Active substance– indomethacin. In various forms of the drug, other excipients may be used.

Absorption is quite fast, the process of drug breakdown, its metabolism, takes place in the liver.

This medicine is used to improve the condition of a patient who suffers from pain syndromes of a rheumatic nature. But you should understand that without a doctor’s prescription, it is not recommended to buy drugs from this group, as they may side effects that contribute to poor health. There are options for administration, both internally and externally. Depending on the diagnosis and personal tolerance, the doctor prescribes the best option, there are cases when the drug is used in several forms at once. The use of indomethacin can be prescribed for the following ailments:

Neuralgia;
Pain in the spine and other joints;
Various types of traumatic inflammation.

These ailments cause serious pain; in such cases, a specialist may suggest indomethacin ointment for quick external use. If the patient has had surgical interventions, then in order to relieve inflammation, such a drug can be used (local application).

There are also a number of reasons why you will be prescribed an NSAID drug:

Inflammation associated with joint deformation, various kinds arthritis, which we recommend reading about in more detail;
In cases of soft tissue damage, but only if it is rheumatic in nature;
Prescribed in cases and complex therapy, but again, in order to relieve pain and inflammation itself.

Release forms, how to use the drug correctly

This medicine, as mentioned above, can be released in different forms, this is necessary so that the doctor can select the patient quality course treatment, directions to eliminate pain and inflammation in areas of immediate localization. Prices for such a drug may vary, depending on what you buy - ointment or tablets. But you should understand that if you are prescribed pills, you do not need to replace them with something else.

Today, the following forms of drug release can be distinguished:

Eye drops. They are rarely prescribed, but they do occur. Their price is approximately 200-220 rubles;
Indomethacin suppositories. They can be prescribed in cases of severe pain in the spine, with severe inflammation soft tissues (for conditions of a traumatic nature), for pain in the joints;
Tablets/dragés. The most common treatment option. It is in this form that the doctor prescribes this drug. But there is another opinion here that it is better to use suppositories or ointments for quick effect eliminate pain and inflammation. Tablets are best used in complex method treatment, then the effect will be 100%. The issue price is 30-45 rubles;
Capsules. Similar to tablets. They are prescribed, but it is better to do it in combination. They have an advantage over tablets - they dissolve quickly;
Ointment. Used in cases of severe pain in the joints and back. The ointment is applied to the affected area. The effect occurs after a minimum amount of time. Should be used as prescribed by a doctor.

There can’t even be any talk of self-medication with such a drug. Therefore, the specialist himself will prescribe a course of treatment for you and determine the dosage. Instructions for use of Indomethacin are attached to any release form, but it is better to take the drug based on the instructions prescribed by your doctor:

Pills. Their quantity and duration of use depend on the severity of the disease. In general, an adult should take about 25 mg of this substance, and then split it into 2-3 doses. It is possible to increase the dosage up to 50 mg. After 4 weeks of treatment, if the outcome is positive, the dosage begins to be reduced. In no case should you exceed 75 mg of the drug per day. Since the drug is quite serious, it should not be taken on an empty stomach; use it after meals;
The use of Indomethacin suppositories is prescribed for severe back pain. It is worth understanding that the drug enters the body through the rectum, so it is worth emptying the intestines before directly using the drug. Most often, an adult is prescribed only 100 mg of the drug, 1 suppository. The option is two times 50 mg. If it is more acute, they can increase the dosage, up to 200 mg;
Injections. They will be used in the most serious forms of the disease. Prescribed 60 mg, administered intramuscularly. This course of treatment lasts about 2 weeks, while the injection itself is given once every 1-2 days.

Rectal suppositories

Indomethacin rectal suppositories have been used in medicine for a long time; they have a number of properties necessary for the treatment of diseases of the spine and other joints:

Pain relief;
Their action is aimed at reducing inflammatory process;
They have the ability to relieve heat.

The suppositories received positive reviews when they were used in the following diseases:

Various types of arthritis, osteoarthritis.
Joint diseases;
Neuralgia, various pains in the spine;
During the treatment of soft tissues that have suffered due to various types of injuries.

The instructions for the suppositories may tell you how much to use this drug, but without a doctor’s recommendation, this is not recommended. As practice shows, with strong acute manifestations pain and inflammation, the patient may be prescribed 2 suppositories per day. Dosage of the substance is from 50 mg to 100 mg. It is worth understanding that using more than 200 mg per day is not recommended.

The instructions for using suppositories state that this drug has side effects and a number of contraindications. Side effects may include:

Vomiting, nausea (from the gastrointestinal tract);
Constant drowsiness, dizziness, irritability, depression (from nervous system);
Shortness of breath appears, pain in the heart is possible (from the side of cardio-vascular system);
Lower back pain (from the genitourinary system);
Allergies are possible.

Despite the fact that these candles have good action, and easily cope with their functions, there are a number of contraindications that should be taken into account so as not to provoke other diseases:

Direct personal intolerance to the drug, increased sensitivity to the main substance;
All degrees of ulcer;
Problems with the liver and kidneys;
Inflammation of the rectum, no matter what stage;
Hemorrhoids, as well as inflammation of the colon.

Indomethacin is also used in gynecology. This is due to the fact that almost all diseases of the female genital organs are associated with severe pain in the back, so doctors safely prescribe this drug.

Its direct function in this matter is pain relief. Due to the fact that the drug suppository is quickly absorbed, relief occurs almost instantly. In addition, the drug relieves inflammation, which is also necessary for a number of ailments.

The use of indomethacin suppositories in gynecology is logical and possible for the following diseases:

In gynecology it is used for cystitis. In this situation, it is prescribed with a number of other tablets (antibiotics);
Suppositories with indomethacin in gynecology are relevant in postoperative period time to prevent the formation of adhesions;
Uterine fibroids.

Instructions for the use of suppositories in gynecology must be written out by the doctor himself, since in such a situation self-medication is strictly prohibited. Most often, during treatment, the patient is not prescribed more than 1-2 suppositories per day. This amount of the drug allows you to maintain the correct therapeutic concentrate in the blood.

Indomethacin ointment

What indomethacin ointment helps with has long been known. It is prescribed for problems with joints, pain in the spine, and also for muscle pain. The composition of such a drug includes not only the main substance, but also auxiliary ones (dimexide, trolamine).

Biosynthesis ointment is applied directly to sore spot. It not only has an analgesic effect, but also relieves inflammation. But you should understand that it should be used 2-3 times a day, no more. The ointment is absorbed through the pores of the skin and carries out its effect.

The main substance has a rapid analgesic effect. But you should understand that there are certain contraindications that should be taken into account before using the ointment:

Immediate sensitivity to the drug.

It is important to understand that before you start using the ointment, make sure that you are not taking other NSAID medications. The ointment itself should be applied exclusively to the site of injury. In case of contact with eyes, rinse immediately.

The use of indomethacin ointment is carried out according to a certain scheme: the daily dose of ointment should not be more than 15 cm squeezed out of the tube. Apply only to affected areas, in a thin layer, 2-3 times a day.

The instructions for the ointment describe that when using such an ointment, side effects may be noticed:

Inflammation at the sites where the ointment was applied;
Dryness and flaking;

Tablets, how to replace indomethacin

Indomethacin tablets instructions for use state that it should be used at a dose of 25 mg, 2-3 times a day, but only after a doctor’s prescription. The dosage of use may be increased, but this is done only after visiting a doctor. Up to 50 mg per day 3 times. Daily norm This drug should not exceed 200 mg.

Indomethacin tablets are used only as prescribed by a doctor. Pills may also have side effects associated with the disorder. various systems human body. Also, it is worth noting that indomethacin biosynthesis is not always combined with other drugs. For example, it should not be used together with NSAID drugs groups.

If you are not satisfied with the price of this drug, or the pharmacy does not have it, you may be offered analogues to indomethacin: Methindol Retard, Indocollir and others.

It is worth understanding that absolutely all treatment with NSAID drugs should be carried out only with the advice of the attending physician.

From this medical article you can familiarize yourself with the drug Indomethacin. The instructions for use will explain in what cases you can take tablets, ointments or suppositories, what the medicine helps with, what are the indications for use, contraindications and side effects. The annotation presents the forms of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about Indomethacin, from which you can find out whether the medicine helped in the treatment of inflammation in rheumatology and gynecology in adults and children. The instructions list analogues of Indomethacin, prices of the drug in pharmacies, as well as its use during pregnancy.

Indomethacin is a non-steroidal anti-inflammatory drug with analgesic and antipyretic effects. Instructions for use recommend taking Sopharma suppositories 50 mg and 100 mg, tablets and capsules 25 mg and 50 mg, gel 5%, ointment 10% for neuralgia, rheumatism, spinal pain, dysmenorrhea.

Release form and composition

Indomethacin is available in the form:

Enteric-coated tablets: round, biconvex.
Rectal suppositories (suppositories).
Ointment for external use 10% - from dark yellow to light yellow with a greenish tint and a specific odor.
Gel for external use 5% or 10%: has a homogeneous structure yellow color and a faint odor of alcohol. Sold in 40 g quantities in aluminum tubes.

Active substance – indomethacin:

tablets – 25 mg;
suppositories – 50 or 100 mg;
1 g ointment – 100 mg;
1 g of gel – 50 or 100 mg.

Pharmacological properties

Indomethacin, the instructions for use confirm this, is a non-steroidal anti-inflammatory drug, a derivative of indoleacetic acid. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with inhibition of the COX enzyme, which leads to inhibition of the synthesis of prostaglandins from arachidonic acid.

Suppresses platelet aggregation. When administered orally and parenterally, it helps to weaken pain syndrome, especially pain in the joints at rest and during movement, reduction morning stiffness and swelling of the joints, increased range of motion. The anti-inflammatory effect develops by the end of the first week of treatment.

At local application eliminates pain, reduces swelling and erythema. When used externally, it also helps reduce morning stiffness and increase range of motion. After oral administration, it is quickly absorbed from the gastrointestinal tract.

What does Indomethacin help with?

Indications for use of the drug include external use:

lumbago;
neuralgia;
myalgia;
post-traumatic inflammation of soft tissues and joints;
muscle pain of rheumatic and non-rheumatic origin;
bursitis;
sciatica;
inflammatory damage to tendons and ligaments;
articular syndrome with exacerbation of gout and rheumatism;
radiculitis;
psoriatic arthritis;
rheumatoid arthritis;
osteochondrosis with radicular syndrome;
osteoarthritis;
pain in the spine;
ankylosing spondylitis.

Why is Indomethacin used systemically?

dysmenorrhea;
diffuse diseases connective tissue;
as part of complex therapy for prostatitis, adnexitis, cystitis, infectious and inflammatory diseases in otorhinolaryngology;
neuralgia;
pain in the spine;
myalgia;
inflammatory processes in soft tissues and joints as a result of injury;
rheumatism;
articular syndrome (including osteoarthritis, rheumatoid arthritis, gout, ankylosing spondylitis).

Local use is indicated:

prevention of inflammatory processes after surgical operations on the anterior segment of the eye and for cataracts;
inhibition of miosis during surgery.

Instructions for use

Indomethacin ointment and gel

Rub a thin layer into the skin of diseased areas of the body 2-3 times a day. Daily dose: for adults – no more than 15 cm of ointment squeezed out of a tube; for children over 14 years old - no more than 7.5 cm.

Indomethacin gel is rubbed into the diseased areas of the body in a thin layer:

5% - 3-4 times a day;
10% - 2-3 times a day.

A single dosage for adults is 4-5 cm of gel, for children over 14 years old – 2-2.5 cm.

Daily dose of gel:

for adults - no more than 20 cm of 5% or 15 cm of 10% gel;
for children – 10 cm 5% or 7.5 cm 10% gel.

Candles

Indomethacin suppositories are administered rectally (into the rectum). It is recommended to cleanse the intestines before use. Wash your hands thoroughly, remove the suppository from the package, and insert it into the rectum with the pointed end as deeply as possible.

Indomethacin suppositories 50 mg:

adults – 1-3 times a day;
children over 14 years old – 1 time per day.

100 mg suppositories are given once a day. In case of a gout attack - up to 200 mg per day. It is recommended to use candles at night.

Pills

Indomethacin tablets are taken during or after meals with milk. The starting dose for adults is 25 mg 2-3 times a day. If the effect is insufficient, the dose is increased to 50 mg 3 times a day. General maximum dose Indomethacin tablets per day – 200 mg.

After achieving the effect, treatment is continued for 4 weeks at the same or lower dose. With prolonged use of tablets, the maximum daily dose equal to 75 mg.

Contraindications

childhood up to 14 years old;
3rd trimester of pregnancy;
hypersensitivity to indomethacin;
severe forms chronic heart failure, arterial hypertension, pancreatitis;
For rectal use: proctitis, recent bleeding from the rectum;
severe dysfunction of the liver and/or kidneys;
"aspirin triad";
hematopoietic disorders;
erosive and ulcerative lesions Gastrointestinal tract in the acute phase.

Side effects

Children, pregnancy and breastfeeding

Indomethacin tablets and suppositories are contraindicated during pregnancy and breastfeeding. Gel and ointments are contraindicated in the third trimester (when applied to large areas of the body). In the first and second trimesters, the drug is prescribed with caution.

Indomethacin tablets and suppositories are contraindicated in children under 14 years of age. Ointment and gel are contraindicated in children under 1 year of age.

special instructions

The drug should be used with caution if the patient has dyspeptic symptoms. Concomitant use with acetylsalicylic acid and other NSAIDs, with diflunisal. Only in in case of emergency Indomethacin is used if there is a history of allergic reactions to NSAIDs.

The use of the drug must be accompanied by systematic monitoring of the peripheral blood picture, liver and kidney function. Ointment and gel are applied only to areas with intact integrity skin, they should not be allowed to come into contact with mucous membranes, including the eyes.

Drug interactions

Combination with Insulin and other hypoglycemic drugs enhances their effect. Together with Methotrexate, lithium preparations and Digoxin, their serum concentrations increase, which can enhance their toxic properties.

Combination with indirect antiplatelet agents, anticoagulants and thrombolytics enhances their effects and increases the risk of bleeding. Simultaneous use with ethanol-containing drugs, glucocorticoids, colchicine and corticotropin increases the risk of gastrointestinal bleeding.

Combination with paracetamol increases the risk of nephrotoxicity.

Analogues of the drug Indomethacin

Analogues are determined by structure:

Methindol.
Indomethacin Sopharma (Movimed, -Biosynthesis, Berlin-Chemie (50 or 100), -Altfarm, Akri).
Indocide.
Methindol retard.
Indocollier.
Indobene.
Indovis EU.
Indotard.

Vacation conditions and price

The average price of INDOMETHACIN (50 mg suppositories No. 6) in Moscow is 64 rubles. In Kyiv you can buy 50 mg suppositories No. 6 for 27 hryvnia, in Kazakhstan - for 365 tenge. In Minsk, pharmacies offer the drug for 2 bel. ruble Tablets and suppositories are available from pharmacies with a prescription, ointment and gel are available free of charge. Shelf life is 3-5 years depending on the dosage form and manufacturer.

Indomethacin suppositories are prescribed as an anesthetic. They act quickly and effectively, finding application in various fields of medicine.

Indomethacin suppositories - what kind of medicine?

The drug Indomethacin is available in the form of ointments, tablets, solution, and suppositories. The last named form is most in demand among patients due to its relative safety (compared to by mouth), low cost and speed of action.

Indomethacin belongs to the class of nonsteroidal anti-inflammatory drugs (NSAIDs), a group of indoleacetic acid derivatives. Contains indomethacin 50 or 100 mg. Additional components of candles:

The drug is available in different pharmaceutical companies- “Berlin-Chemie”, “Pharmtechnologies”, “Sopharma”, “Altpharm” and others. Its price depends on the manufacturer, dosage and ranges from 100-410 rubles for 10 pieces. Suppositories have a standard torpedo-shaped shape, white, yellowish in color.

The actions of the drug are due to its belonging to the NSAID group. Here are the main ones:

Indomethacin inhibits the specific enzyme COX, which subsequently leads to a decrease in the production of prostaglandins (these are pain mediators produced from arachidonic acid). The blood-thinning effect is weak, it is due to a decrease in platelet adhesion processes.

It should be noted that Indomethacin reduces pain, erythema and inflammation both at the injection site and in other parts of the body, since it has systemic absorption. The maximum concentration is observed 2 hours after administration.

Indications of the drug

The drug has various indications- general and local. In proctology, suppositories are prescribed to people suffering from acute stage hemorrhoids without bleeding. Also, the medicine, when placed in the rectum, quickly relieves pain due to thrombosis hemorrhoidal node, which causes the most painful sensations. As symptomatic remedy Indomethacin suppositories are recommended for proctitis, but only as a one-time measure.

In men, Indomethacin quickly relieves pain due to acute prostatitis.

Among the indications for the use of suppositories with Indomethacin are: women's diseases. Thus, in gynecology, the drug can quickly reduce pain associated with inflammation of the ovary, appendages or ovarian cyst. Suppositories are also administered as an anti-inflammatory agent for the following problems:

Medicine how rectal suppositories can be prescribed by general indications. They relieve any pain syndrome - from headaches and toothaches, from neuritis and neuralgia, and normalize the temperature during fever. IN complex treatment They are used for musculoskeletal problems:

A course of use will not only relieve pain, but also remove stiffness, swelling, and redness of the joints. Among other things, the medicine is indicated for infections of the ENT organs, including viral ones, to normalize the general condition.

How to use Indomethacin?

The dose is set individually. Typically, the initial dose for an adult is 50 mg; at this dosage, suppositories can be given 2 pieces per day. An alternative treatment regimen is the administration of 100 mg (one suppository in the appropriate dosage) once a day. IN severe cases It is allowed to use 3 suppositories/50 mg at regular intervals. For gouty arthritis in the acute phase, for gout of the legs, you can use 200 mg/day - 2 injections of 100 mg each.

The drug is administered rectally only after bowel movements and thorough washing of the anal area.

For vaginal administration, the dosages will be similar, but this method is not prescribed in the instructions and should be discussed with your doctor.

More often even with gynecological diseases Rectal use of suppositories is practiced. The course of therapy should be as short as possible; usually 3-7 days are enough to achieve a clinical result. On the recommendation of a doctor, the course can last up to 14-28 days.

Contraindications and side effects - what to fear?

Most contraindications concern acute diseases digestive organs or the risk of exacerbation of these pathologies in chronic form. These include:

It is strictly forbidden to place candles at anal fissures or hemorrhoids, which are accompanied by bleeding. Suppositories will help increase blood flow as they prevent clotting.

Other contraindications include any internal bleeding(except menstruation), the presence of severe heart defects, hypertension and heart failure. Do not use suppositories for bronchial asthma, cirrhosis, lesions optic nerve, hemophilia. They are prohibited during pregnancy, under the age of 18, and during lactation.

Side effects most often relate to abdominal pain, irritation of the stomach and intestines.

Also among the side effects are increased AST, ALT of the liver, sleep disturbances and depression, visual disturbances, arrhythmia, problems with urine excretion and kidney damage.

If abused, bleeding and changes in blood composition may occur.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are now more than medicines: this is a real phenomenon in medicine, salvation in many situations, an object of cult, a subject of heated debate and discussion. 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 - "pioneer" NSAID groups: he burst into clinical practice in the early 60s of the last century and proved to be a powerful anti-inflammatory drug capable of as soon as possible achieve significant improvement with rheumatic diseases 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. IN clinical studies it was proven high efficiency with 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 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 effects). 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 contribute to the development of a number of complications from 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 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. So talk about the benefits this drug before other NSAIDs seems inappropriate. 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.

Pharmacology

NSAIDs, a derivative of indoleacetic acid. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with inhibition of the COX enzyme, which leads to inhibition of the synthesis of prostaglandins from arachidonic acid.

Suppresses platelet aggregation.

When administered orally and parenterally, it helps to relieve pain, especially pain in the joints at rest and during movement, reduce morning stiffness and swelling of the joints, and increase the range of movements. The anti-inflammatory effect develops by the end of the first week of treatment.

When applied topically, it eliminates pain, reduces swelling and erythema.

When used externally, it also helps reduce morning stiffness and increase range of motion.

Pharmacokinetics

After oral administration, indomethacin is rapidly absorbed from the gastrointestinal tract. Cmax in plasma is reached after 2 hours. Metabolized in the liver. Subject to enterohepatic recirculation. Indomethacin is determined in blood plasma in the form of unchanged substance and unbound metabolites - desmethyl, desbenzoyl, desmethyl-desbenzoyl.

T1/2 is about 4.5 hours. It is excreted in the urine - 60% in the form of unchanged substance and metabolites, and in feces - 33% mainly in the form of metabolites.

Release form

Tablets, enteric-coated, white or almost white, round, biconvex; on the break of the tablet two layers are visible - a white or white core with a yellowish tint and a film shell.

	1 tab.
indomethacin	25 mg

Excipients: lactose monohydrate 41.6 mg, potato starch 10 mg, microcrystalline cellulose 16 mg, povidone 2.5 mg, magnesium stearate 0.9 mg.

Film shell composition: cellacephate 2.2 mg, polysorbate-80 0.72 mg, titanium dioxide 1.08 mg.

10 pieces. - contour cellular packaging (aluminum/PVC) (1) - cardboard packs.
10 pieces. - contour cellular packaging (aluminum/PVC) (2) - cardboard packs.
10 pieces. - contour cellular packaging (aluminum/PVC) (3) - cardboard packs.
10 pieces. - contour cellular packaging (aluminum/PVC) (4) - cardboard packs.
10 pieces. - contour cellular packaging (aluminum/PVC) (5) - cardboard packs.
10 pieces. - contour cellular packaging (aluminum/PVC) (6) - cardboard packs.
10 pieces. - contour cellular packaging (aluminum/PVC) (8) - cardboard packs.
10 pieces. - contour cellular packaging (aluminum/PVC) (10) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (1) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (2) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (3) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (4) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (5) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (6) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (8) - cardboard packs.
30 pcs. - contour cellular packaging (aluminum/PVC) (10) - cardboard packs.
10 pieces. - polymer jars (1) - cardboard packs.
20 pcs. - polymer jars (1) - cardboard packs.
30 pcs. - polymer jars (1) - cardboard packs.
40 pcs. - polymer jars (1) - cardboard packs.
50 pcs. - polymer jars (1) - cardboard packs.
60 pcs. - polymer jars (1) - cardboard packs.
100 pieces. - polymer jars (1) - cardboard packs.

Dosage

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

When the effect is achieved, treatment is continued for 4 weeks at the same or reduced dose. At long-term use the daily dose should not exceed 75 mg. Take after meals.

For treatment acute conditions or relief of exacerbation chronic process administered intramuscularly at 60 mg 1-2 times a day. The duration of intramuscular administration is 7-14 days. Then indomethacin is administered orally or rectally at 50-100 mg 2 times a day, while the maximum daily dose should not exceed 200 mg. For maintenance treatment, use 50-100 mg rectally 1 time/day at night.

For topical use in ophthalmology, the dose, frequency and duration of use are determined individually.

Apply externally 2 times/day.

Interaction

With simultaneous use, indomethacin can reduce the effects of saluretics and beta-blockers; enhance the effects of indirect anticoagulants.

With the simultaneous use of indomethacin and diflunisal, there is a risk of heavy bleeding from the gastrointestinal tract.

When used simultaneously with probenecid, an increase in the concentration of indomethacin in the blood plasma is possible.

Indomethacin may reduce the tubular secretion of methotrexate, resulting in increased toxicity.

When used simultaneously with NSAIDs, the toxicity of cyclosporine increases.

Indomethacin at a dose of 50 mg 3 times a day increases the concentration of lithium in the blood plasma and reduces the clearance of lithium from the body in patients with mental illness.

With simultaneous use of indomethacin with digoxin, it is possible to increase the concentration of digoxin in the blood plasma and increase the half-life of digoxin.

Side effects

From the outside digestive system: nausea, anorexia, vomiting, pain and discomfort in the abdomen, constipation or diarrhea, erosive and ulcerative lesions, bleeding and perforation of the gastrointestinal tract; rarely - intestinal strictures, stomatitis, gastritis, flatulence, bleeding from sigmoid colon or from diverticulum, jaundice, hepatitis.

From the central nervous system and peripheral nervous system: dizziness, headache, depression, feeling tired; rarely - anxiety, fainting, drowsiness, convulsions, peripheral neuropathy, muscle weakness, involuntary muscle movements, sleep disturbances, mental disorders(depersonalization, psychotic episodes), paresthesia, dysarthria, parkinsonism.

From the cardiovascular system: edema, increased blood pressure, tachycardia, pain in chest, arrhythmia, palpitation, arterial hypotension, congestive heart failure, hematuria.

Allergic reactions: rarely - itching, urticaria, angitis, erythema nodosum, skin rash, exfoliative dermatitis, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, hair loss, acute respiratory distress, sharp drop HELL, anaphylactic reactions, angioedema, dyspnea, bronchial asthma, pulmonary edema.

From the hematopoietic system: rarely - leukopenia, petechiae or ecchymosis, purpura, aplastic and hemolytic anemia, thrombocytopenia, DIC syndrome.

From the senses: rarely - impaired clarity of visual perception, diplopia, orbital and periorbital pain, tinnitus, hearing impairment, deafness.

From the urinary system: rarely - proteinuria, nephrotic syndrome, interstitial nephritis, renal dysfunction, renal failure.

Metabolism: rarely - hyperglycemia, glucosuria, hyperkalemia.

Other: rarely - vaginal bleeding, tides, increased sweating, nose bleed, enlargement and tension of the mammary glands, gynecomastia.

Local reactions: at the site of intramuscular injection in some cases - formation of infiltrate, abscess; When administered rectally, irritation of the rectal mucosa, tenesmus, and exacerbation of chronic colitis are possible.

For external use: itching, redness, rash at the site of application.

Indications

For systemic use: articular syndrome (including rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout), pain in the spine, neuralgia, myalgia, traumatic inflammation of soft tissues and joints, rheumatism, diffuse diseases connective tissue, dysmenorrhea. How aid for infectious and inflammatory diseases of the ENT organs, adnexitis, prostatitis, cystitis.

For local use: prevention of the inflammatory process during surgical interventions ah regarding cataracts and on the anterior segment of the eye, inhibition of miosis during surgery.

For external use: articular syndrome (including rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout), spinal pain, neuralgia, myalgia, traumatic inflammation of soft tissues and joints.

Contraindications

Hypersensitivity to indomethacin, erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, "aspirin triad", hematopoietic disorders, severe liver and/or kidney dysfunction, severe forms of chronic heart failure, arterial hypertension, pancreatitis, third trimester of pregnancy, children under 14 years; for rectal use: proctitis, recent bleeding from the rectum.

Features of application

Use during pregnancy and breastfeeding

Indomethacin is contraindicated in the third trimester of pregnancy. In the first and second trimesters of pregnancy, as well as during lactation ( breastfeeding) use is not recommended.

Indomethacin is excreted in small quantities into breast milk.

Use for liver dysfunction

Contraindicated in cases of severe liver dysfunction. Use with caution for liver diseases.

Use for renal impairment

Contraindicated in cases of severe renal impairment. Use with caution for kidney diseases.

Use in children

Contraindicated for children under 14 years of age.

special instructions

Use with caution in elderly patients, as well as with a history of liver, kidney, gastrointestinal diseases, dyspeptic symptoms at the time of use, arterial hypertension, heart failure, immediately after major surgical interventions, parkinsonism, epilepsy.

If the history indicates allergic reactions NSAIDs are used only in emergency cases.

During the treatment period, systematic monitoring of liver and kidney function and peripheral blood patterns is necessary.

Indomethacin should not be used simultaneously with diflunisal.

When using indomethacin concomitantly with lithium preparations, the possibility of symptoms should be kept in mind. toxic effect lithium.

When applied topically, it should not be applied to the wounded surface of the skin, and also avoid contact with the eyes or mucous membranes.

Impact on the ability to drive vehicles and operate machinery

During treatment, you should refrain from potentially dangerous species activities related to the need to concentrate attention and increased speed psychomotor reactions.