Indomet SR
Generic Name
Indomethacin Sustained Release 75 mg Capsule
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| indomet sr 75 mg capsule | ৳ 4.02 | ৳ 40.20 |
Description
Overview of the medicine
Indomethacin is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, swelling, and fever. The sustained-release formulation allows for once or twice daily dosing, providing prolonged therapeutic effects.
Uses & Indications
Dosage
Adults
The usual dosage of Indomethacin SR is 75 mg once or twice daily. Maximum recommended daily dose is 150 mg.
Elderly
Lower doses should be considered for elderly patients due to increased risk of adverse effects, particularly gastrointestinal bleeding and renal impairment.
Renal_impairment
Use with caution in patients with renal impairment. Dosage reduction may be necessary, and renal function should be monitored closely.
How to Take
Take capsules orally with food, milk, or an antacid immediately after meals to minimize gastrointestinal irritation. Swallow the capsule whole; do not chew, crush, or open it.
Mechanism of Action
Indomethacin works by inhibiting the enzyme cyclooxygenase (COX-1 and COX-2), which is responsible for the synthesis of prostaglandins. Prostaglandins are inflammatory mediators that cause pain, fever, and inflammation. By inhibiting their production, indomethacin reduces these symptoms.
Pharmacokinetics
Onset
Onset of action for pain relief is typically within 1-2 hours for sustained-release capsules, providing prolonged effect.
Excretion
Approximately 60% of the dose is excreted in the urine, and 33% in the feces.
Half life
The elimination half-life is approximately 4.5 hours, but the sustained-release formulation provides extended therapeutic levels.
Absorption
Rapidly and completely absorbed from the gastrointestinal tract. Sustained-release formulation leads to a slower and prolonged absorption profile.
Metabolism
Extensively metabolized in the liver, primarily by demethylation and debenzoylation, followed by glucuronidation.
Side Effects
Contraindications
- Known hypersensitivity to indomethacin, aspirin, or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active gastrointestinal ulceration, bleeding, or perforation
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery (peri-operative pain)
Drug Interactions
Lithium
Indomethacin can increase plasma lithium levels, leading to toxicity.
Methotrexate
Increases methotrexate plasma concentrations, leading to toxicity.
Diuretics and ACE Inhibitors
May reduce the natriuretic and antihypertensive effects; increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Other NSAIDs and Corticosteroids
Increased risk of gastrointestinal adverse effects, including ulceration and bleeding.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, epigastric pain, lethargy, drowsiness, and headache. Gastric emptying, activated charcoal, and supportive treatment are recommended. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C (D in third trimester). Avoid use in the third trimester due to potential premature closure of the fetal ductus arteriosus. Use with caution during lactation as indomethacin is excreted in breast milk.
Side Effects
Contraindications
- Known hypersensitivity to indomethacin, aspirin, or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active gastrointestinal ulceration, bleeding, or perforation
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery (peri-operative pain)
Drug Interactions
Lithium
Indomethacin can increase plasma lithium levels, leading to toxicity.
Methotrexate
Increases methotrexate plasma concentrations, leading to toxicity.
Diuretics and ACE Inhibitors
May reduce the natriuretic and antihypertensive effects; increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Other NSAIDs and Corticosteroids
Increased risk of gastrointestinal adverse effects, including ulceration and bleeding.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, epigastric pain, lethargy, drowsiness, and headache. Gastric emptying, activated charcoal, and supportive treatment are recommended. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C (D in third trimester). Avoid use in the third trimester due to potential premature closure of the fetal ductus arteriosus. Use with caution during lactation as indomethacin is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture.
Availability
Pharmacies
Approval Status
Approved
Patent Status
Off-patent
Clinical Trials
Indomethacin has been extensively studied in numerous clinical trials establishing its efficacy and safety for various inflammatory and painful conditions.
Lab Monitoring
- Complete Blood Count (CBC)
- Liver Function Tests (LFTs)
- Renal Function Tests (serum creatinine, BUN)
- Blood Pressure Monitoring
- Fecal occult blood test (for long-term use)
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor patients for signs of gastrointestinal bleeding, cardiovascular events, and renal dysfunction, especially in elderly or high-risk patients.
- Inform patients about the potential for adverse effects and when to seek medical attention.
Patient Guidelines
- Take Indomethacin SR capsules whole with food or milk to reduce stomach upset. Do not chew or crush the capsule.
- Do not exceed the prescribed dosage.
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools, vomiting blood) immediately.
- Inform your doctor about all other medications you are taking, especially blood thinners or other NSAIDs.
- Avoid alcohol while taking this medicine.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Indomethacin may cause dizziness, drowsiness, or blurred vision. Patients should be cautioned about driving or operating machinery if they experience these effects.
Lifestyle Advice
- Avoid excessive alcohol consumption, as it can increase the risk of stomach irritation and bleeding.
- Maintain adequate hydration, especially if you have kidney problems.
- Follow a balanced diet and engage in light exercise if your condition permits.
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