Indomethacin: Brands, Price & Uses in Bangladesh

Indomethacin is a potent non-steroidal anti-inflammatory drug (NSAID) of the indole acetic acid class, used to relieve pain, swelling, and inflammation in a range of musculoskeletal and inflammatory conditions.

Established / FDA-approved uses

• Moderate to severe rheumatoid arthritis (including acute flares of chronic disease)
• Moderate to severe osteoarthritis
• Ankylosing spondylitis
• Acute gouty arthritis (short-term use until the attack subsides)
• Acute painful shoulder (bursitis and/or tendinitis)

Guideline-supported / commonly accepted use

• Primary dysmenorrhea (painful menstrual cramps) — widely used, though this is not a core labeled indication in all markets.

Specialized hospital-only use

An intravenous formulation of Indomethacin is used in neonatal intensive care to promote closure of a hemodynamically significant patent ductus arteriosus (PDA) in premature infants. This use requires strict weight- and age-based dosing under specialist supervision and is not relevant to outpatient/oral therapy.

Indomethacin is a symptomatic treatment — it reduces pain and inflammation but does not alter the underlying course of arthritic disease.

Adult Dosing (by indication)

General Administration Advice

• Take Indomethacin with food, milk, or an antacid to reduce stomach upset.
• Use the lowest effective dose for the shortest duration consistent with the treatment goal, to minimize cardiovascular and gastrointestinal risk.
• Do not crush or chew sustained-release capsules; swallow whole.
• Take exactly as prescribed; do not increase the dose or frequency on your own, and consult your physician before stopping if you have been on it long term.

Renal/Hepatic Adjustment

Use with caution and at the lowest effective dose in mild-to-moderate renal or hepatic impairment; Indomethacin should be avoided in severe renal or hepatic impairment (see Contraindications and Precautions).

Most common (particularly notable with Indomethacin compared to other NSAIDs):

• Central nervous system: headache (the most frequently reported side effect), dizziness, vertigo, drowsiness, and occasionally confusion or mood changes — CNS effects occur more often with Indomethacin than with many other NSAIDs.
• Gastrointestinal: nausea, dyspepsia, abdominal pain, diarrhea or constipation.

Less common but serious (see Precautions and Warnings for full detail):

• Gastrointestinal ulceration, bleeding, or perforation.
• Cardiovascular thrombotic events (heart attack, stroke).
• Fluid retention, edema, and elevated blood pressure.
• Renal impairment.
• Elevated liver enzymes, rarely serious hepatic injury.
• Tinnitus or hearing disturbances.
• Blood disorders (e.g., low platelet or white cell counts) — rare.
• Serious skin reactions (e.g., Stevens-Johnson syndrome) — rare.