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Indocin

Indomethacin (USAN) or indometacin (INN) is a non-steroidal anti-inflammatory drug commonly used to reduce fever, pain, stiffness, and swelling. It works by inhibiting the production of prostaglandins, molecules known to cause these symptoms. It is marketed under many trade names, including Indocin, Indocid, Indochron E-R, and Indocin-SR. more...

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Chemical properties

Indomethacin is a methylated indole derivative and a member of the arylalkanoic acid class of NSAIDs.

Indications

Clinical indications for indomethacin include:

ankylosing spondylitis
rheumatoid arthritis
arthritic gout
osteoarthritis
juvenile arthritis
psoriatic arthritis
Reiter's syndrome
Paget's disease of bone
Bartter syndrome
pseudogout
dysmenorrhea (menstrual cramps)
pericarditis
bursitis
tendinitis
nephrogenic diabetes insipidus (prostaglandin inhibits vasopressin's action in the kidney)
fever and pain associated with malignant diseases (tumors, bony metastasis, lymphogranulomatosis)

Indomethacin has also been used clinically to delay premature labor, reduce amniotic fluid in polyhydramnios, and to treat patent ductus arteriosus.

Indomethacin is a potent drug with many serious side effects and should not be considered an analgesic for minor aches and pains or fever. The drug is more potent than Aspirin, but the usually tolerated doses of Indomethacin do not allow a superior efficiency compared to Aspirin. In mild to moderate pain a usual oral dose of Indomethacin proved as efficient as 600mg Aspirin.

Contraindications

acutely existing Ulcus ventriculi and/or duodeni, or history of Ulcus
allergy against Indomethacin, Aspirin, or other NSAIDs
patients with nasal polyps reacting with an angioedema to other NSAIDS
children under 2 years of age
severe preexisting renal and liver damage
caution : preexisting bone marrow damage (frequent blood cell counts indicated)
caution : bleeding tendencies of unknown origin (Indomethacin inhibits platelet aggregation)
caution : Morbus Parkinson, epilepsy, psychic disorders (Indomethacin may worsen these conditions)

Mechanism of action

Indomethacin is a nonselective inhibitor of cyclooxygenase (COX) 1 and 2, enzymes that participate in prostaglandin synthesis from arachidonic acid. Prostaglandins are hormone-like molecules normally found in the body, where they have a wide variety of effects, some of which lead to pain, fever, and inflammation.

Prostaglandins also cause uterine contractions in pregnant women. Indomethacin is an effective tocolytic agent, able to delay premature labor by reducing uterine contractions through inhibition of PG synthesis in the uterus and possibly through calcium channel blockade.

Indomethacin has 2 additional modes of actions with clinical importance:

Read more at Wikipedia.org

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4 things that are bad for young women's bones - Think Healthy
From Shape, 8/1/03 by Carol Potera

Endometriosis drugs/steroids Taking GnRH agonist drugs for six months was linked to a 6-15 percent decrease in spinal bone density in women under 25. The loss is reversible when therapy is stopped, but women who are prescribed these drugs for endometriosis before reaching peak bone mass in their mid-20s may never maximize their bone density, says Sanjay Agarwal, M.D., acting director of reproductive medicine at Cedars-Sinai Medical Center in Los Angeles. If you are under 25 and must take these drugs, make sure your doctor prescribes an add-back" estrogen therapy such as Prempro 5 to minimize their impact on your bones. Also, get plenty of calcium and weight-bearing exercise, and avoid smoking and nonessential steroid medications, which can cause bone loss. -- Mary Ellen Strote

Depo-Provera

A study conducted at Seattle-based Group Health Cooperative followed 440 women ages 18-39 for three years and found that women who used Depo-Provera lost 1.12 percent of the bone density in their hips each year, compared to 0.05 percent per year among women who didn't use the drug. However, women who stopped using Depo-Provera during the study had bone-density increases similar to nonusers' 30 months later. -- Karen Asp

Missed periods

If you haven't had a menstrual period for three or more months (and you're not pregnant), it could be a symptom of premature ovarian failure, a possible harbinger of bone disease, a National Institutes of Health study found. Estrogen and other hormones produced by the ovaries help maintain bone density. When the ovaries fail, the declining estrogen levels that result put younger women at higher risk for osteoporosis. "Missed periods are common in young women, so it's understandable that more than half of our patients weren't concerned at first," says lead researcher Lawrence Nelson, M.D. But despite their lack of initial concern, 67 percent of study participants had already experienced bone-density loss, which may be avoided with hormonereplacement therapy. -- R.G.

The wrong painkiller

If you have a bone fracture, your choice of painkiller may affect the healing process, animal research indicates. When drugs such as celecoxib (Celebrex) and rofecoxib (Vioxx) were given to animals with broken bones, the breaks weren't fully healed after two months, says Pat O'Connor, Ph.D., an orthopedic researcher at the UMDNJ-New Jersey Medical School in Newark. Both these drugs block the enzyme cox-2, which causes pain and inflammation but which also is crucial for bone healing, O'Connor explains. The prescription painkiller indomethacin (Indocin) delayed healing a week compared to using no painkillers. If you break a bone,, until more research is done, ask your doctor about the best pain medicine. -- C.P.

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