Indomethacin (rectal)

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) used in adults and children who are at least 14 years old to treat signs and symptoms from certain types of arthritis, including moderate to severe osteoarthritis, rheumatoid arthritis, gouty arthritis, or ankylosing spondylitis.

Indomethacin is also used to relieve shoulder pain caused by bursitis or tendonitis.

Indomethacin may also be used for other purposes that are not mentioned in this medication guide.

Indomethacin can raise your chances of having a deadly heart attack or stroke. Do not use indomethacin right before or after heart bypass surgery (coronary artery bypass graft, or CABG). Indomethacin may also lead to bleeding in the stomach or intestines, which can be life-threatening.

Indomethacin can raise your chances of having a fatal heart attack or stroke. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Indomethacin may also lead to bleeding in the stomach or intestines, which can be deadly. This can happen without warning, especially in older adults.

You should not use indomethacin if you are allergic to it, or if you have or have ever had:

• an asthma attack, hives, or a severe allergic reaction after taking aspirin or an NSAID; or
• a history of inflammation of the rectal lining or recent rectal bleeding.

Tell your doctor if you have or have ever had:

• congestive heart failure, heart disease, high blood pressure, high cholesterol, smoking, diabetes;
• a heart attack, stroke, or blood clot;
• bleeding problems;
• stomach ulcers or bleeding;
• depression, mood changes;
• seizures, epilepsy, Parkinson's disease;
• asthma;
• fluid retention; or
• liver or kidney disease.

It may be harder for you to get pregnant while you are using this medicine.

Do not use indomethacin during pregnancy unless your doctor tells you to. Using an NSAID in the last 20 weeks can harm the unborn baby or cause pregnancy complications.

Ask a doctor if it is safe to breastfeed while using this medicine.

Get emergency medical help if you have signs of an allergic reaction (hives, trouble breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Stop using indomethacin and seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath.

Indomethacin may cause serious side effects. Stop using indomethacin and call your doctor right away if you have:

• a skin rash, no matter how mild;
• changes in your vision;
• flu-like symptoms;
• neurological problems—tremors or shaking, seizures, new or worsening depression, confusion, or psychosis, drowsiness;
• high blood pressure—severe headache, blurred vision, pounding in your neck or ears;
• kidney or heart problems—swelling, urinating less, rapid weight gain, feeling tired or short of breath;
• signs of stomach bleeding—bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• liver problems—loss of appetite, nausea, vomiting, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• high blood potassium—nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement; or
• low red blood cells (anemia)—pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Indomethacin may also make asthma attacks worse in people who have asthma. Talk with your doctor about your own risk.

Older adults may be more likely to have serious stomach problems while taking medicine that contains an NSAID.

Common side effects of indomethacin may include:

• headache, dizziness;
• heartburn, stomach pain, gas; or
• nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the lowest dose that is effective in treating your condition.

Your dose needs may change if you switch to a different brand, strength, or form of indomethacin. Avoid medication errors by using exactly as directed on the label, or as prescribed by your doctor.

Do not take by mouth. Rectal medicine is for use only on your rectum.

Wash your hands before and after using rectal medicine. Try to empty your bowel and bladder first.

Remove the wrapper before inserting a suppository. Moisten suppository with water.

Gently insert the suppository into your rectum about 1 inch, pointed tip first. If unable to, you may insert the flat end first.

Stay lying down for a few minutes. You should feel no discomfort while the suppository melts. Avoid using the bathroom for at least an hour.

You may need medical tests to check your heart and kidney function. Your blood pressure will need to be checked often.

Tell your doctor if you have a planned surgery.

Call your doctor if your symptoms do not improve, or if they get worse. Indomethacin is not meant to be used long-term.

This medicine may affect the results of certain medical tests. Tell any doctor who treats you that you are using indomethacin.

Store in the refrigerator, do not freeze.

Use the medicine as soon as you can, but skip the missed dose if it is nearly time for your next dose. Do not use two doses at once.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

• Avoid taking aspirin or other NSAIDs unless your doctor tells you to.

• Avoid smoking and drinking alcohol. It may increase your risk of stomach bleeding.

• Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to indomethacin (such as aspirin, ketoprofen, ibuprofen, or naproxen).

• Avoid driving or hazardous activity until you know how indomethacin will affect you. Your reactions could be impaired.

Ask your doctor before using indomethacin if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.

Indomethacin can harm your kidneys, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, high blood pressure, or pain or arthritis (including Advil, Motrin, and Aleve).

Tell your doctor about all your other medicines, especially:

• aspirin;
• probenecid;
• a blood thinner—warfarin, Coumadin, Jantoven;
• medicine used to prevent blood clots—alteplase, clopidogrel, dipyridamole, ticlopidine, and others; or
• steroid medicine (such as prednisone).

This list is not complete. Other drugs may affect indomethacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.