Side Effects of Indomethacin (Indocin)
Indomethacin, known as the common brand Indocin, is a NSAID used for pain relieving and anti-inflammation. Indocin works by reducing substances in the body that cause the pain and inflammation. Indocin is used to treat mild to moderate pain in adults associated with various types of arthritis, such as rheumatoid arthritis (autoimmune arthritis inflaming the joints) , osteoarthritis (joint desease that wears down mainly the cartilage and other joints), ankylosing spondylitis (arthritis affecting the spine), acute gouty arthritis (arthritis with those who have high uric acid) and acute painful shoulder (bursitis, tendinitis).
Serious Side Effects
The FDA reports that Indocin can cause serious side effects. They are:
- An increased risk of heart attack or stroke
- Tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines
- Serious skin reactions
These events may result in hospitalization or even death and can occur without any warning. A history of stomach ulcers, stomach or intestinal bleeding with use of NSAIDs, smoking, drinking alcohol, being of older age, and advanced liver disease increases the risk of experiencing an ulcer or bleeding.
Common Side Effects
Commonly reported side effects of indomethacin include headache, dizziness, heartburn (dyspepsia), low sodium level in blood (hyponatremia), and nausea (Indocin label reported by the FDA).
If these symptoms occur, the FDA advises to stop Indocin treatment and contact your healthcare provider. In addition, the FDA warns to stop using Indocin if these symptoms also happen:
- Severe allergic reactions (rash, hives, itching, difficulty breathing, swelling of the mouth, face, lips, or tongue)
- Tightness in the chest
- Slow heartbeat
- Shortness of breath
- Slurring of speech
- Blood in vomit or stool
- Dark or tarry stools
- Liver problems (nausea, fatigue, lethargy (lack of energy or enthusiasm), pruritus (severe itching of the skin), jaundice (yellowing of the skin) right upper abdominal tenderness, and other flu-like symptoms)
- Skin reactions (skin rash and blisters)
- Kidney problems (little or no urinating, painful or difficult urination)
- Swelling in your feet or ankles
- Seeling tired or short of breath
- Unusual bruising or bleeding
- Unusual weight gain
Some medicines may interact with Indocin. Anticoagulants, such as Warfarin, Heparin, or salicylates (arpirin) may increase the risk of bleeding. Angiotensin converting enzyme (ACE) inhibitors, such as Captopril, angiotensin receptor blockers, (Losartan), cyclosporine, or triamterene increase the risk of kidney problems. The risk of seizures increase with the usage of fluoroquinolones, such as Ofloxacin).
Indocin’s side effects may increase with the medications cyclophosphamide or probenecid. The severe drug reactions of antibiotics, aminoglycosides (Amikacin or Gentamicin), digitalis, digoxin, lithium, or anti-cancer medications (Methotrexate). In addition, the effectiveness of beta blockers (Metoprolol) or diuretics (Furosemide) may be decreased by Indocin.
Indocin should be avoided during pregnancy because congenital heart disease may occur in the newborn baby if Indocin is used during late pregnancy. Indocin may also cause drowsiness. Caution should be taken when engaging in activities requiring mental alertness and motor coordination, such as driving a car or operating machinery.
About Pharmacogenetic Testing
Pharmacogenetic testing developed from the sequencing of the human genome. Studies have shown gene variations have a role in how medications are metabolized based on an individual’s genetic profile. Because of gene variations, some patients may experience the severe side effects of a medication or respond to the medication positively.
Know Your Genetic Risk with the Rxight® Genetic Test
The Rxight® genetic test is accurate, reliable, and prompt that examines 18 genes in 60 alleles. Rxight® provides you an easy to understand gene analysis that shows how your body responds to over 200 prescription and over-the-counter (OTC) medications including Indocin.
Contributors to this Article:
Michael Sapko, MD, PhD; and Deborah Kallick, PhD, Medicinal Chemistry
Read more about Rxight® : What is Pharmacogenetics?