Liometacen (indomethacin): Uses, Dosage & Side Effects

What it's for (Indications)

This medicine is used to manage various pain syndromes including Cancer pain, chronic pain, Biliary and renal colic pain, Post-operative pain, rheumatoid arthritis (moderate to severe, including acute flares), osteoarthrosis (moderate to severe), ankylosing spondylitis (moderate to severe), musculoskeletal pain, acute Gouty arthritis, uretic rheumatism, acute painful shoulder (bursitis and/or tendinitis), and pain in trauma and injuries.

Dosage Information

Type	Guideline
Standard	Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. For moderate to severe rheumatoid arthritis (including acute flares of chronic disease), moderate to severe ankylosing spondylitis, and moderate to severe osteoarthritis, the dosage is 25 mg two or three times a day. For acute painful shoulder (bursitis and/or tendinitis), the dosage is 75 mg to 150 mg daily in 3 or 4 divided doses. For acute gouty arthritis, the dosage is 50 mg three times a day. Indomethacin suppositories 50 mg can be substituted for capsules, but there will be significant differences in blood levels; suppositories are not for oral or intravaginal use.

Type

Guideline

Standard

Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. For moderate to severe rheumatoid arthritis (including acute flares of chronic disease), moderate to severe ankylosing spondylitis, and moderate to severe osteoarthritis, the dosage is 25 mg two or three times a day. For acute painful shoulder (bursitis and/or tendinitis), the dosage is 75 mg to 150 mg daily in 3 or 4 divided doses. For acute gouty arthritis, the dosage is 50 mg three times a day. Indomethacin suppositories 50 mg can be substituted for capsules, but there will be significant differences in blood levels; suppositories are not for oral or intravaginal use.

Safety & Warnings

Common Side Effects

Common adverse reactions (incidence ≥ 3%) include headache, dizziness, dyspepsia, and nausea.
Other reported side effects include gastric bleeding, persistent headaches (requiring discontinuation), corneal deposits or eye (retina) disturbances, cardiovascular thrombotic events, gastrointestinal bleeding, ulceration and perforation, hepatotoxicity, hypertension, heart failure and edema, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, and hematologic toxicity.

Serious Warnings

Black Box Warning: WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS. Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Indomethacin is contraindicated in the setting of coronary artery bypass graft (CABG) surgery.
This medicine must be used with caution by patients with renal (kidney) or hepatic (liver) impairment, heart failure, and brain disorders.
Monitoring of the elderly and patients on long-term therapy, including regular eye tests, is recommended.
Research suggests that this medicine is not safe for use during pregnancy or breastfeeding; consult a doctor before use in these conditions.
NSAIDs, including indomethacin, can cause serious cardiovascular thrombotic events, GI bleeding, ulceration, and perforation, hepatotoxicity, hypertension, heart failure and edema, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, and hematologic toxicity.
The risk of serious cardiovascular events may occur early in treatment and may increase with duration of use.

How it Works (Mechanism of Action)

Indomethacin possesses analgesic, anti-inflammatory, and antipyretic properties. Its mechanism of action, similar to other NSAIDs, involves the inhibition of cyclooxygenase (COX-1 and COX-2), thereby decreasing prostaglandin synthesis. Prostaglandins are known to sensitize afferent nerves and mediate inflammation.