Indomethacin dosage

Eideriy Age appears to increase the possibility of adverse reactions to NSAIDs. The risk of serious ulcer disease is increased this risk appears to increase with dose. Ketorolac is cleared more slowly by the elderly use caution and reduce dosage. Pregnancy Category B (ketoprofen, naproxen, naproxen sodium, flurbiprofen, diclofenac, fenoprofen, ibuprofen, indomethacin, meclofenamate, sulindac). 

Probenecid can impair the renal active secretion of a variety of acidic compounds, including sulfinpyrazone, sulfonylureas, indomethacin, penicillin, sulfonamides, and 17-ketosteroids. If these agents are to be given concomitantly with probenecid, their dosage should be modified appropriately. Salicylates interfere with the clinical effects of both sulfinpyrazone and probenecid and should be avoided in patients treated with uricosuric agents. Uricosuric agents also can influence the volume of distribution and hepatic metabolism of a number of drugs. 

Following oral administration of indomethacin to chickens at a dosage of 2 mg/kg bw, significant levels of indomethacin residues were detected in liver, muscle, and fat of treated birds (101). However, 24 h after administration, tissue concentrations declined to very low levels and even undetectable in some animals. 

In addition to inhibiting prostaglandin synthase, indomethacin and other NSAIDs also inhibit urate crystal phagocytosis. Indomethacin is commonly used as initial treatment of gout as the replacement for colchicine. Three or four doses of 50 mg every 6 hours are given when a response occurs, the dosage is reduced to 25 mg three or four times daily for about 5 days. 

Because indomethacin may increase serum potassium concentrations, indomethacin and spironolactone should be administered concomitantly with caution. Potassium-sparing diuretics should be used with caution, and serum potassium should be determined frequently in patients receiving an angiotensin-converting enzyme (ACE) inhibitor (e.g., captopril). Concomitant administration with an ACE inhibitor may increase the risk of hyperkalemia. The dosage of spironolactone should be reduced, or the drug discontinued, as necessary. Patients with renal impairment may be at increased risk of hyperkalemia [65]. 

The problem with the aforementioned monolithic unit system is that it tends to be detained at the ileocecal junction, leading to drug loss before entry in the colon. To circumvent this problem, multiparticulate dosage forms were devised that passed freely through the ileocecal junction. In a recent study, a multiparticulate system, which was based on amidated pectin, was tested. ° Coating of the amidated pectin beads with chitosan significantly reduced the release of sulfamethoxazole and indomethacin in simulated gastric and intestinal juice compared with non-coated beads. 

Toxicity Indomethacin may cause renal damage or bone marrow depression. Short courses of glucocorticoids can cause behavioral changes and impaired glucose control. Be-cau.se colchicine can severely damage the liver and kidney, dosage must be carefully limited and monitored. Overdose is often fatal. 

Emori HW, Paulus H, Bluestone R, Champion GD, Pearson C. Indomethacin serum concentrations in man. Effects of dosage, food and antacid. AnnRheumDis 916) 35, 333-8. 

Imaizumi H, Nambu N, Nagai T (1980) Pharmaceutical interaction in dosage forms and processing. 18. Stability and several physical-properties of amorphous and crystalline forms of indomethacin. Chem Pharm Bull 28(9) 2565-2569 Ivanisevic I, Bates S, Chen P (2009) Novel methods forthe assessment of miscibility of amorphous drug-polymer dispersions. J Pharm Sd 98(9) 3373-3386 Janssens S, Van den Mooter G (2009) Review physical chemistry of solid dispersions. J Pharm Pharmacol 61(12) 1571-1586... 

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