Class: Other Nonsteroidal Anti-inflammatory Agents
CAS Number: 53-86-1
Brands: Indocin
- Cardiovascular Risk
Possible increased risk of serious (sometimes fatal) cardiovascular thrombotic events (e.g., MI, stroke).420 Risk may increase with duration of use.420 Individuals with cardiovascular disease or risk factors for cardiovascular disease may be at increased risk.420 (See Cardiovascular Effects under Cautions.)
Contraindicated for the treatment of pain in the setting of CABG surgery.420
- GI Risk
Increased risk of serious (sometimes fatal) GI events (e.g., bleeding, ulceration, perforation of the stomach or intestine).420 Serious GI events can occur at any time and may not be preceded by warning signs and symptoms.420 Geriatric individuals are at greater risk for serious GI events.420 (See GI Effects under Cautions.)
Introduction
Prototypical NSAIA; indoleacetic acetic acid derivative.301 341 420
Uses for Indomethacin
When used for inflammatory diseases, consider potential benefits and risks of indomethacin therapy as well as alternative therapies before initiating therapy with the drug.420 Use lowest effective dosage and shortest duration of therapy consistent with the patient's treatment goals.420
Inflammatory Diseases
Symptomatic treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.341 420
Symptomatic relief of acute gout and acute painful shoulder (i.e., bursitis and/or tendinitis).341 420
Management of juvenile rheumatoid arthritis† in children ≥2 years of age.420
Patent Ductus Arteriosus (PDA)
Treatment of PDA in premature neonates.301 302 303 304 305 306 308 309 310 311 312 313 314 316 318 319 320 322 323 324 325 326 Used to promote closure of a hemodynamically significant PDA (i.e., left-to-right shunt large enough to compromise cardiorespiratory status) in premature neonates weighing 500–1750 g when 36–48 hours of usual medical management (e.g., fluid restriction, diuretics, cardiac glycosides, respiratory support) is ineffective.301 306 307 313
Pericarditis
Reduction of pain, fever, and inflammation of pericarditis†;a however, other drugs (i.e., aspirin) generally are preferred.452
Indomethacin Dosage and Administration
General
For inflammatory diseases, consider potential benefits and risks of indomethacin therapy as well as alternative therapies before initiating therapy with the drug.420
Administration
Administer orally or rectally (for inflammatory diseases or pericarditis)341 420 or by IV infusion (for PDA).301
Oral Administration
In patients who have persistent night pain and/or morning stiffness, a large portion (maximum 100 mg) of the total daily dose may be given at bedtime.341 420
Conventional Capsules and Oral Suspension
Administer conventional capsules and oral suspension in 2–4 divided doses daily.420
Extended-release Capsules
Administer extended-release capsules once or twice daily.341
Extended-release capsules can be used as an alternative to conventional capsules: 75 mg once daily (extended-release) as an alternative to 25 mg 3 times daily (conventional); 75 mg twice daily (extended-release) as an alternative to 50 mg 3 times daily (conventional).341
Swallow extended-release capsules intact.341
Extended-release capsules are not recommended for treatment of acute gouty arthritis.341
Rectal Administration
Administer in 2–4 divided doses daily.420
Retain suppositories in rectum for ≥1 hour to ensure complete absorption.420
IV Administration
For solution and drug compatibility information, see Compatibility under Stability.
Administer by IV infusion.301
Avoid extravasation (irritating to extravascular tissues).301
Reconstitution
Reconstitute vial containing 1 mg of indomethacin with 1 or 2 mL of preservative-free 0.9% sodium chloride injection or sterile water for injection to provide a solution containing 1 mg/mL or 0.5 mg/mL, respectively.301 Further dilution is not recommended.301
Use of bacteriostatic water for injection containing benzyl alcohol is not recommended because of potential risk of benzyl alcohol exposure if administered to a neonate.301
Prepare solutions immediately before use; discard any unused solution.301
Rate of Administration
Optimum rate not established; may administer dose over 20–30 minutes.301
Dosage
Available as indomethacin and indomethacin sodium; dosage expressed in terms of indomethacin.301 341 420
To minimize the potential risk of adverse cardiovascular and/or GI events, use lowest effective dosage and shortest duration of therapy consistent with the patient's treatment goals.420 Adjust dosage based on individual requirements and response; attempt to titrate to the lowest effective dosage.420
Pediatric Patients
Inflammatory Diseases
Juvenile Rheumatoid Arthritis†
Oral
Children ≥2 years of age: Initially, 1–2 mg/kg daily in divided doses.341 420 Increase dosage until a satisfactory response is achieved, up to maximum dosage of 3 mg/kg daily or 150–200 mg daily (whichever is less) in divided doses; limited data support the use of a maximum dosage of 4 mg/kg daily or 150–200 mg daily (whichever is less) in divided doses.341 420 As symptoms subside, reduce dosage to the lowest effective level or discontinue the drug.341 420
PDA
IV
Each course of therapy consists of up to 3 doses administered at 12- to 24-hour intervals.301
Base dosage on neonate’s age at the time therapy is initiated.301
Age at First Dose | First Dose | Second Dose | Third Dose |
|---|---|---|---|
<48 hours | 0.2 mg/kg | 0.1 mg/kg | 0.1 mg/kg |
2–7 days | 0.2 mg/kg | 0.2 mg/kg | 0.2 mg/kg |
>7 days | 0.2 mg/kg | 0.25 mg/kg | 0.25 mg/kg |
If anuria or oliguria (urine output <0.6 mL/kg per hour) is present at the time of a second or third dose, withhold the dose until laboratory determinations indicate that renal function has returned to normal.301
If ductus arteriosus closes or is substantially constricted 48 hours or longer after completion of the first course, no further doses are necessary.301
If ductus reopens, a second course of 1–3 doses may be administered.301 Surgical ligation may be necessary if ductus is unresponsive to 2 courses of therapy.301
Pericarditis†
Oral
50–100 mg daily in 2–4 divided doses.a
Adults
Inflammatory Diseases
Osteoarthritis, Rheumatoid Arthritis, or Ankylosing Spondylitis
Oral
Conventional capsules or oral suspension: Initially, 25 mg 2 or 3 times daily.420 If needed, increase dosage by 25 or 50 mg daily at weekly intervals until a satisfactory response is obtained up to a maximum dosage of 150–200 mg daily.420
Extended-release capsules: Initially, 75 mg once daily.341 May increase dosage to 75 mg twice daily.341
Rectal
25 mg 2 or 3 times daily. If needed, increase dosage by 25 or 50 mg daily at weekly intervals until a satisfactory response is obtained up to a maximum dosage of 150–200 mg daily.420
Gout
Oral
Conventional capsules: 50 mg 3 times daily until pain is tolerable; then reduce dosage rapidly and discontinue.420
Painful Shoulder
Oral
Conventional capsules or oral suspension: 75–150 mg daily in 3 or 4 divided doses.420 Discontinue once symptoms have been controlled for several days; usual course of therapy is 7–14 days.420
Extended-release capsules: 75 mg once or twice daily.341 Discontinue once symptoms have been controlled for several days; usual course of therapy is 7–14 days.341
Rectal
75–150 mg daily in 3 or 4 divided doses.420 Discontinue once symptoms have been controlled for several days; usual course of therapy is 7–14 days.420
Pericarditis†
Oral
75–200 mg daily in 3 or 4 divided doses.a
Prescribing Limits
Pediatric Patients
Juvenile Rheumatoid Arthritis
Oral
Maximum 4 mg/kg or 150–200 mg daily, whichever is less.420
Adults
Inflammatory Diseases
Rheumatoid Arthritis, Osteoarthritis, or Ankylosing Spondylitis
Oral
Maximum 200 mg daily.420
Rectal
Maximum 200 mg daily.420
Special Populations
Geriatric Patients
Careful dosage selection recommended due to possible age-related decreases in renal function.341 420
Cautions for Indomethacin
Contraindications
Known hypersensitivity to indomethacin or any ingredient in the formulation.341 420
History of asthma, urticaria, or other sensitivity reaction precipitated by aspirin or other NSAIAs.341 420
Treatment of perioperative pain in the setting of CABG surgery.420
When administered rectally, history of proctitis or recent rectal bleeding.420
When used for PDA, known or suspected untreated infection; bleeding, especially active intracranial hemorrhage or GI bleeding; thrombocytopenia; coagulation defects; known or suspected necrotizing enterocolitis; substantial renal impairment; congenital heart disease if patency of the ductus arteriosus is necessary for pulmonary or systemic blood flow (e.g., pulmonary atresia, severe tetralogy of Fallot, severe coarctation of the aorta).301
Warnings/Precautions
Warnings
Cardiovascular Effects
Selective COX-2 inhibitors have been associated with an increased risk of cardiovascular events in certain situations.484 Several prototypical NSAIAs also have been associated with an increased risk of cardiovascular events.487 488 489 Current evidence suggests that use of indomethacin is associated with increased cardiovascular risk.487 488 489 490
Use NSAIAs with caution and careful monitoring (e.g., monitor for development of cardiovascular events), and at the lowest effective dosage for the shortest duration necessary.420
Short-term use to relieve acute pain, especially at low dosages, does not appear to be associated with increased risk of serious cardiovascular events (except immediately following CABG surgery).484
No consistent evidence that concomitant use of low-dose aspirin mitigates the increased risk of serious adverse cardiovascular events associated with NSAIAs.420 (See Specific Drugs under Interactions.)
Hypertension and worsening of preexisting hypertension reported; either event may contribute to the increased incidence of cardiovascular events.420 Use with caution in patients with hypertension; monitor BP.420 Impaired response to certain diuretics may occur.420 (See Specific Drugs under Interactions.)
Fluid retention and edema reported.341 420 Caution in patients with fluid retention or heart failure.341 420
Deterioration of circulatory hemodynamics reported in patients with severe heart failure and hyponatremia.341 420
GI Effects
Serious GI toxicity (e.g., bleeding, ulceration, perforation) can occur with or without warning symptoms; increased risk in those with a history of GI bleeding or ulceration, geriatric patients, smokers, those with alcohol dependence, and those in poor general health.420
Incidence of major GI bleeding reported in neonates receiving IV indomethacin in clinical studies similar to that in neonates receiving placebo; minor GI bleeding occurred more frequently in indomethacin-treated neonates.301
When used for inflammatory diseases in patients at high risk for complications from NSAIA-induced GI ulceration (e.g., bleeding, perforation), consider concomitant use of misoprostol;457 464 alternatively, consider concomitant use of a proton-pump inhibitor (e.g., omeprazole)457 464 or use of an NSAIA that is a selective inhibitor of COX-2 (e.g., celecoxib).464
Renal Effects
Direct renal injury, including renal papillary necrosis, reported in patients receiving long-term NSAIA therapy.341 420
Potential for overt renal decompensation.341 420 Increased risk of renal toxicity in adults with renal or hepatic impairment or heart failure, in patients with volume depletion, in geriatric patients, and in those receiving a diuretic, ACE inhibitor, or angiotension II receptor antagonist.420 486 (See Renal Impairment under Cautions.)
May precipitate renal insufficiency in neonates; increased risk in those with extracellular volume depletion, CHF, sepsis, or hepatic dysfunction or those receiving concomitant therapy with a nephrotoxic drug.301 If a substantial reduction in urine output occurs, withhold additional doses until output returns to normal.301 (See PDA under Dosage and Administration.)
Hyponatremia reported in neonates.301 302 303 306 314 324 325 326 329 348 371 Monitor renal function and serum electrolytes.301
Hyperkalemia reported in adults.341 420
Hematologic Effects
Potential for spontaneous intraventricular hemorrhage in neonates.301 Observe premature infants for signs of bleeding.301
Contraindicated in neonates who are bleeding and in those with thrombocytopenia or coagulation defects.301
Ocular Effects
Corneal deposits and retinal disturbances reported in patients receiving long-term therapy.341 420 Ophthalmic examination recommended in patients with blurred vision; periodic ophthalmic examinations recommended in patients receiving long-term therapy.341 420
CNS Effects
May aggravate depression or other psychiatric disturbances, epilepsy, or parkinsonism; use with caution in patients with these conditions.341 420
May cause drowsiness; may impair ability to perform activities requiring mental alertness.341 420
May cause headache.341 420 Discontinue the drug in patients in whom indomethacin-induced headache persists despite a reduction in dosage.341 420
Sensitivity Reactions
Hypersensitivity Reactions
Anaphylactoid reactions (e.g., anaphylaxis, angioedema) reported.341 420
Immediate medical intervention and discontinuance for anaphylaxis.341 420
Avoid in patients with aspirin triad (aspirin sensitivity, asthma, nasal polyps); caution in patients with asthma.341 420
Dermatologic Reactions
Serious skin reactions (e.g., exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis) reported; can occur without warning.420 Discontinue at first appearance of rash or any other sign of hypersensitivity (e.g., blisters, fever, pruritus).420
General Precautions
Hepatic Effects
Severe reactions including jaundice, fatal fulminant hepatitis, liver necrosis, and hepatic failure (sometimes fatal) reported rarely with NSAIAs.341 420
Elevations of serum ALT or AST reported.341 420
Monitor for symptoms and/or signs suggesting liver dysfunction; monitor abnormal liver function test results.341 420 Discontinue if signs or symptoms of liver disease or systemic manifestations (e.g., eosinophilia, rash) occur or if liver function test abnormalities persist or worsen.301 341 420
Hematologic Precautions
Anemia reported rarely.420 Determine hemoglobin concentration or hematocrit in patients receiving long-term therapy if signs or symptoms of anemia occur.420
May inhibit platelet aggregation and prolong bleeding time.341 420 When used for inflammatory diseases, use with caution in patients with coagulation defects.341 420
Other Precautions
Not a substitute for corticosteroid therapy; not effective in the management of adrenal insufficiency.420
May mask certain signs of infection.340 341 420
Obtain CBC and chemistry profile periodically during long-term use.420
Specific Populations
Pregnancy
Category C.420 Avoid use in third trimester because of possible premature closure of the ductus arteriosus.341 420
Lactation
Distributed into milk; use not recommended.341 420
Pediatric Use
Safety and efficacy established in neonates receiving the drug for PDA.301
Safety and efficacy of oral or rectal indomethacin not established in children ≤14 years of age.341 420
Indomethacin should not be used in children 2–14 years of age unless toxicity or lack of efficacy with other drugs justifies the risk.420
Adverse effects reported in children receiving indomethacin capsules generally comparable to those reported in adults.420 Hepatotoxicity, sometimes fatal, has been reported in pediatric patients with juvenile rheumatoid arthritis.420 Periodic assessment of liver function recommended.420
Geriatric Use
Caution advised.420 Geriatric patients appear to tolerate NSAIA-induced adverse effects less well than younger individuals.341 420 Fatal adverse GI effects reported more frequently in geriatric patients than younger adults.341 420
Possible confusion or, rarely, psychosis in geriatric patients.420
Substantially eliminated by the kidney; select dosage carefully and assess renal function periodically since geriatric patients more likely to have decreased renal function.341 420
Renal Impairment
Use not recommended in patients with advanced renal disease; close monitoring of renal function advised if used.420
Common Adverse Effects
With oral therapy, nausea, dyspepsia, headache, dizziness.341 420
With rectal administration, rectal irritation, tenesmus; adverse effects associated with oral administration possible.420
With IV therapy, bleeding,301 302 303 305 306 310 315 316 322 323 346 347 348 349 350 351 352 353 354 transient oliguria,301 302 303 306 309 314 315 324 325 326 329 346 347 348 350 353 354 355 357 358 359 371 increases in serum creatinine concentrations,301 302 303 306 314 324 325 326 329 348 371 hyponatremia,301 elevated serum potassium concentrations.301
Interactions for Indomethacin
Protein-bound Drugs
Possible pharmacokinetic interaction; observe for adverse effects if used with other protein-bound drugs.a
Drugs Excreted by the Kidney
Possible pharmacokinetic interaction with drugs that rely on adequate renal function for excretion.301 In neonates receiving IV indomethacin, consider dosage adjustment for drugs that rely on adequate renal function for excretion.301
Specific Drugs
Drug | Interaction | Comments |
|---|---|---|
ACE inhibitors | Reduced BP response to ACE inhibitor341 420 440 441 442 443 444 445 446 447 Possible deterioration of renal function in individuals with renal impairment420 | Monitor BP341 420 |
Aminoglycosides (amikacin, gentamicin) | Increased plasma aminoglycoside concentrations reported in neonates receiving IV indomethacin301 372 | Monitor serum aminoglycoside concentrations and renal function372 |
Angiotensin II receptor antagonists | Reduced BP response to angiotensin II receptor antagonist420 Possible deterioration of renal function in individuals with renal impairment420 | Monitor BP420 |
Antacids (aluminum- or magnesium-containing) | Slight reduction or delay in peak plasma indomethacin concentrationa | Clinical importance not establisheda |
Anticoagulants | Possible bleeding complications; pharmacodynamic interaction not observed in clinical studies 420 | Monitor anticoagulant activity;341 420 caution advised420 |
Alcohol | Bleeding time prolongeda | |
β-adrenergic blocking agents | Reduced BP response to β-adrenergic blocking agent341 420 | Monitor BP 420 |
Cyclosporine | Possible increase in cyclosporine toxicity341 420 | Use with caution; monitor renal function341 420 |
Digoxin | Increased serum concentration and half-life of digoxin301 341 369 370 420 | Monitor serum digoxin concentrations301 341 420 Consider digoxin dosage reduction in neonates; 369 370 monitor ECG301 369 370 |
Diuretics (furosemide, thiazides) | Reduced natriuretic effects301 341 420 Pharmacokinetic interaction with hydrochlorothiazide unlikely367 368 | Monitor for diuretic efficacy and renal failure420 Concomitant administration of furosemide used to therapeutic advantage in neonates301 324 |
Diuretics (potassium-sparing) | Increased serum potassium concentrations341 420 Acute renal failure reported in adults receiving triamterene341 366 420 | Should not be administered concomitantly with triamterene341 420 |
Hydantoins | Potential pharmacokinetic (protein binding) interactiona | Monitor for toxicitya |
Hydralazine | Reduced BP response to hydralazine393 | Monitor BP393 |
Lithium | Increased plasma lithium concentrations341 420 | Monitor for lithium toxicity341 420 |
Methotrexate | Possible increased plasma methotrexate concentrations420 | Caution advised341 420 |
NSAIAs | NSAIAs including aspirin: Potential for increased risk of GI toxicity with little or no increase in efficacy341 420 Aspirin: No consistent evidence that low-dose aspirin mitigates the increased risk of serious cardiovascular events associated with NSAIAs420 Aspirin: Decreased plasma indomethacin concentrations reported with concomitant aspirin (3.6 g daily) therapy341 420 Diflunisal: Increased plasma indomethacin concentrations and serious GI adverse effects reported341 420 | Concomitant use not recommended341 420 |
Potassium supplements | Increased serum potassium concentrations362 | Caution advised362 |
Prednisolone | Increased plasma concentrations of free prednisolone; total plasma prednisolone concentrations unchangeda | |
Probenecid | Increased plasma concentrations of indomethacin341 420 | Select and adjust indomethacin dosage with care; lower dosage may be adequate341 420 |
Sulfonamides | Potential pharmacokinetic (protein binding) interactiona | Monitor for toxicitya |
Sulfonylureas | Potential pharmacokinetic (protein binding) interactiona | Monitor for toxicitya |
Thrombolytic agents | Possible bleeding complicationsa | Caution adviseda |
Indomethacin Pharmacokinetics
Absorption
Bioavailability
Well absorbed from the GI tract.341 420 Almost completely absorbed following oral administration as conventional or extended-release capsules;341 420 bioavailability following rectal administration is 80–90% of that of the conventional capsule.420
Indomethacin extended-release capsules release 25 mg of drug initially and the remaining 50 mg over 12 hours.341
When administered with food, the commercially available conventional capsules and oral suspension are bioequivalent.420
Distribution
Extent
Crosses the placenta and blood-brain barrier.301
Concentrations in synovial fluid 20% of those in serum.a
Distributed into milk.341 420
Plasma Protein Binding
99% (in adults).341 420
Elimination
Metabolism
Metabolized in the liver.341 420
Elimination Route
Undergoes appreciable enterohepatic circulation.301 341 420 Following oral administration, excreted in the urine (60%) and feces (33%) as unchanged drug and metabolites.341 420
Half-life
Adults: 4.5 hours.341 420
Neonates <7 days of age: 20 hours.301
Neonates >7 days of age: 12 hours.301
Neonates weighing <1 kg: 21 hours.301
Neonates weighing >1 kg: 15 hours.301
Stability
Storage
Oral
Conventional or Extended-release Capsules
15–30°C.a 341
Suspension
<30°C; avoid temperatures >50°C.420 Protect from freezing.420
Rectal
Suppositories
<30°C; avoid temperatures >40°C (even transiently).420
Parenteral
Powder for Injection
<30°C; protect from light.301
Compatibility
For information on systemic interactions resulting from concomitant use, see Interactions.
Parenteral
Solution Compatibility
Reconstitute with preservative-free sterile water for injection or preservative-free 0.9% sodium chloride injection.301 Further dilution with IV solutions is not recommended.301
Drug Compatibility
Incompatible |
|---|
Pantoprazole sodium |
Compatible |
|---|
Furosemide |
Potassium chloride |
Sodium bicarbonate |
Sodium nitroprusside |
Incompatible |
Amino acid injection (TrophAmine) |
Calcium gluconate |
Cimetidine HCl |
Dobutamine HCl |
Dopamine HCl |
Gentamicin sulfate |
Levofloxacin |
Tobramycin sulfate |
Variable |
Dextrose injection |
ActionsActions
Inhibits cyclooxygenase-1 (COX-1) and COX-2.301 341 420 455 456 457 458 461 462 463
Pharmacologic actions similar to those of other prototypical NSAIAs; exhibits anti-inflammatory, analgesic, and antipyretic activity.301 341 420
Permits closure of the ductus arteriosus in premature neonates by inhibiting prostaglandin synthesis.301
Advice to Patients
Importance of reading the medication guide for NSAIAs that is provided each time the drug is dispensed.420
Risk of serious cardiovascular events with long-term use.420
Risk of GI bleeding and ulceration.341 420
Risk of serious skin reactions.420 Risk of anaphylactoid and other sensitivity reactions.420
Risk of hepatotoxicity.341 420
Risk of ocular toxicity.341 420
Potential for drug to impair mental alertness; use caution when driving or operating machinery until effects on individual are known.341 420
Importance of notifying clinician if signs and symptoms of a cardiovascular event (chest pain, dyspnea, weakness, slurred speech) occur.420
Importance of notifying clinician if signs and symptoms of GI ulceration or bleeding, unexplained weight gain, or edema develops.341 420
Importance of discontinuing indomethacin and contacting clinician if rash or other signs of hypersensitivity (blisters, fever, pruritus) develop.420 Importance of seeking immediate medical attention if an anaphylactic reaction occurs.341 420
Importance of discontinuing therapy and contacting clinician immediately if signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, upper right quadrant tenderness, flu-like symptoms) occur.341 420
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.341 420 Importance of avoiding indomethacin in late pregnancy (third trimester).341 420
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs.341 420
Importance of informing patients of other important precautionary information.341 420 (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Oral | Capsules | 25 mg* | Indocin | Merck |
Indomethacin Capsules | Clonmel, Mutual, Mylan, Par, Pliva, Sandoz, Teva | |||
50 mg* | Indocin | Merck | ||
Indomethacin Capsules | Clonmel, Mutual, Mylan, Par, Pliva, Sandoz, Teva | |||
Capsules, extended-release | 75 mg* | Indomethacin Extended-release Capsules | Inwood | |
Suspension | 25 mg/5 mL | Indocin (with alcohol 1% and sorbic acid) | Merck | |
Rectal | Suppositories | 50 mg* | Indomethacin Suppositories | G&W, PD-RX |
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Parenteral | For injection, for IV use only | 1 mg (of anhydrous indomethacin) | Indocin I.V. | Ovation |
Comparative Pricing
This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.
Indomethacin 25MG Capsules (MYLAN): 30/$15.99 or 60/$20.99
Indomethacin 50MG Capsules (TEVA PHARMACEUTICALS USA): 30/$15.99 or 60/$21.98
Indomethacin CR 75MG Controlled-release Capsules (SANDOZ): 30/$82.15 or 90/$208.97
Disclaimer
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thoroug
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