Indocin Suppositories (Indomethacin)

A typical dose of INDOCIN for rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis is 75 milligrams (mg) two or three times a day, but your doctor will try to find the lowest dose that works for you.

INDOCIN comes in regular capsules, extended-release capsules, liquid form, and suppositories.

Don't open or crush the extended-release capsules, and mix the liquid thoroughly. Take INDOCIN with food or after a meal.

Treatment for shoulder pain may continue for one or two weeks, but treatment for gout should stop as soon as pain goes away.

In 2014, the FDA approved a low-dose version of INDOCIN: 20-mg and 40-mg capsules sold under the brand name Tivorbex.

This version of the drug is made of smaller particles of INDOCIN that dissolve more quickly.

INDOCIN Overdose

An overdose of INDOCIN can cause nausea, vomiting, severe headache, dizziness, confusion, and tiredness.

Severe symptoms can include numbness, tingling, and seizure.

If you think you have taken an overdose, or if someone else may have overdosed on INDOCIN, call a poison control center..

Missed Dose of INDOCIN

Take INDOCIN exactly as directed by your doctor. Don’t take more or less.

If you miss a dose of INDOCIN, take the missed dose as soon as you remember.

But if it’s almost time for your next dose, skip the missed dose and continue your regular dosing schedule.

Don't double your dose to make up for the missed one.

Possible side effects of INDOCIN include:

• Nausea and vomiting
• Indigestion and stomachache
• Constipation
• Headache
• Dizziness
• Fatigue
• Sleepiness
• Depression
• Ringing in the ears

Serious side effects can occur with INDOCIN.

If you have any of these side effects, stop taking INDOCIN and call your doctor right away. For severe side effects, get emergency help, or call 911:

• Chest pain
• Wheezing or difficulty breathing
• Weakness on one side of the body
• Slurred speech
• Stomach pain
• Vomiting blood or something resembling coffee grounds
• Bloody diarrhea or tarry stools
• Unusual bleeding or bruising
• Skin rash or blistering
• Skin rash with fever
• Fatigue, nausea, yellowing of skin or eyes, dark-colored urine, and flu-like symptoms
• Swelling of the face, throat, tongue, or body
• Difficulty swallowing or talking
• Blurred vision

If you have any side effects from INDOCIN, let your doctor know.

People older than 65 are more prone to side effects of INDOCIN, including GI bleeding. If you are over 65, ask your doctor whether there are safer alternatives.

INDOCIN and other NSAIDs can cause heart attack and stroke.

These can occur without warning and can be fatal. This risk may increase if you take INDOCIN for a prolonged period of time.

You also may be at higher risk if you have a history of heart disease or high blood pressure. Taking INDOCIN may trigger high blood pressure or make it worse, and high blood pressure is a risk factor for stroke and heart attack.

INDOCIN and other NSAIDs may cause ulcers, perforations, and sudden bleeding in your stomach or intestine (known as gastrointestinal, or GI, bleeding).

This can occur at any time during treatment. You may be at higher risk for GI bleeding if you are elderly, drink a lot of alcohol, smoke, are in poor health, or take any blood-thinning medication.

You may also be at higher risk if you have a history of ulcers or GI bleeding.

About 1 percent of people who take INDOCIN every day for three to six months experience GI bleeding.

You should not take INDOCIN if you have asthma, nasal polyps, and an allergy to aspirin.

This triple combination -- known as ASA triad, aspirin triad, or Samter's triad -- can results in anaphylaxis, a potentially fatal allergic reaction.

Talk with your doctor about the warnings related to stroke, heart attack, GI bleeding, and anaphylaxis.

Tell your doctor about any history of heart disease, stroke, ulcers, or GI bleeding, including any family history of heart disease or stroke.

Ask your doctor how you will be checked for these conditions and any warning symptoms to watch for.

Use INDOCIN with caution if you have high blood pressure, heart failure, or edema (fluid retention), or if you have ever had a peptic ulcer.

You should not take INDOCIN for two weeks after having a type of heart bypass surgery called coronary artery bypass graft. Taking INDOCIN could increase your risk for stroke or heart attack after this surgery.

Before starting INDOCIN, also let your doctor know if you have any of these conditions:

• Kidney disease
• Liver disease
• Anemia
• Eye disease
• Depression
• Epilepsy
• Parkinson’s disease
• Abnormal bleeding
• Lung disease or asthma

INDOCIN and Pregnancy

INDOCIN is not safe to take during later stages of pregnancy because it may cause heart defects and other problems to a developing fetus.

Before taking INDOCIN, let your doctor know if you are pregnant or may become pregnant. And if you become pregnant while taking INDOCIN, tell your doctor right away.

INDOCIN is also unsafe to take while breastfeeding because it can pass into breast milk.

Children 14 years old and younger should not take INDOCIN.

Some drugs may affect the way INDOCIN works, and INDOCIN may affect other drugs you are taking.

It’s very important to let your doctor know about all drugs you take, including any other prescription drugs, over-the-counter medications, illegal or recreational drugs, herbal remedies, or supplements.

Types of drugs that are known to interact with INDOCIN include:

• Over-the-counter NSAIDs including Advil, Aleve, and Motrin
• Prescription NSAIDs, such as diflunisal (Dolobid) and naproxen (Naprosyn)
• Aspirin
• Angiotensin-converting enzyme (ACE) inhibitors for high blood pressure such as benazepril (Lotensin), captopril (Capoten), and enalapril (Vasotec)
• Beta blockers for high blood pressure, including atenolol (Tenormin), labetalol (Normodyne), and metoprolol (Lopressor, Toprol XL)
• Angiotensin receptor blockers (ARBs) for high blood pressure, such as candesartan (Atacand), eprosartan (Teveten), and irbesartan (Avapro)
• Oral corticosteroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone)
• Drugs used to treat rheumatoid arthritis, including methotrexate (Rheumatrex)
• Diuretics (water pills) such as triamterene (Dyrenium, in Dyazide)
• Blood thinners such as warfarin (Coumadin)
• The cardiac drug digoxin (Lanoxin)
• The bipolar disorder drug lithium (Eskalith, Lithobid)
• The gout treatment probenecid (Benemid)
• The seizure medication phenytoin (Dilantin)

Other INDOCIN Interactions

INDOCIN may cause drowsiness and headache, so don’t drive or do other activities that require careful attention until you know how INDOCIN affects you.

You shouldn’t drink alcohol while taking this medication because it can worsen the side effects of INDOCIN.