Indomethacin + Paracetamol Pharmacology
Indomethacin + Paracetamol
Indomethacin
2.Vomiting
3.Anorexia
4.Diarrhoea
5.Gastrointestinal bleeding
6.Abdominal distress
7.Constipation
8.Peptic ulcer
9.Dyspepsia
10.Headache
11.Depression
12.Dizziness
13.Confusion
14.Somnolence
15.Ataxia
16.Psychoses
17.Vertigo
18.Rash
2.Peptic ulcer
3.Severe renal impairment
4.Suppositories in patients with proctitis and hemorrhoids.
2.Renal impairment
3.Cardiovascular diseases
4.Gastrointestinal diseases
5.Parkinsonism
6.Epilepsy
7.Psychiatric illness
8.Cautioned against driving, operating or activities requiring concentration
9.Avoid alcohol
NEONATES: used only to close the patent ductus arteriosus as IV form only
2.Ankylosing spondylitis
3.Osteoarthritis
4.Gouty arthritis
5.Dysmenorrhoea
6.Painful shoulder
7.Migraine
8.Closure of patent ductus arteriosus in premature infants
Beta-Blockers: Antihypertensive effect may be blunted.
Cyclosporine: Nephrotoxicity of both agents may be increased.
Digoxin: Serum digoxin levels may be increased by ibuprofen and indomethacin.
Hydantoins: Serum hydantoin levels increased resulting in increased pharmacological and toxic effects.
Lithium: Serum lithium levels may be increased.
Loop diuretics: Decreased effects.
Methotrexate: Risk of methotrexate toxicity (bone marrow suppression, nephrotoxicity, stomatitis) may be increased.
Salicylates: Displaces NSAIDs from serum binding sites resulting in decreased plasma concentrations of NSAIDs and increased incidence of GI effects.
Sympathomimetics: Indomethacin coadministration may result in increased blood pressure.
Thiazide diuretics: Naproxen and indomethacin may cause decreased antihypertensive and diuretic action.
Adult: 50 - 200 mg / day in 2 - 4 divided doses.
Rheumatoid arthritis, ankylosing spondylitis and Osteoarthritis: 50 - 75 mg / day in 2 - 3 divided doses with food or antacids. Dose can be gradually increased every week until sufficient response is obtained.
Maximum dose: 200 mg / day
Gouty arthritis: 150 mg / day in 3 divided doses until pain is tolerable. Then reduce the dose and suddenly stop the drug.
Dysmenorrhoea: 75 mg / day in 3 divided doses with food or antacids.
Painful shoulder: 75 -150 mg / day in 3 - 4 divided doses for 1 - 2 week
Migraine: 50mg 3 - 4 times daily
Children: 1 mg / kg / day in divided doses.
Maximum dose: 4 mg / kg / day in divided doses.
Children below 14 years: not recommended
Paracetamol
It is more active on cyclo-oxygenase enzyme in brain. Peripherally it is a poor inhibitor of prostaglandin synthesis.
Analgesic action: Paracetamol raises the pain threshold and produces analgesic effect.
Antipyretic action: Paracetamol lowers fever by direct action on the thermoregulatory centre in the Hypothalamus and block the effects of endogenous pyrogen.
Distribution: It is distributed mostly in the body in unbound form.
Metabolism: It is extensively metabolised in the liver.
Excretion: Excreted in the urine.
2. Abdominal distress
3. Allergic reactions
4. Rash
2. Renal impairment
3. Hypertension
NEONATES : Contraindicated
2. Acute gout
3. Migraine
Charcoal: Activated, administered immediately reduces absorption of paracetamol.
Domperidone and metochlopramide: Enhance absorption of paracetamol.
Alcohol: Chronic excessive ingestion of alcohol potentiates hepatotoxicity of paracetamol.
Zidovudine: Effects zidovudine may be decreased.
500 - 1000 mg in 3 times daily
Maximum dose: 4 g / day
For migraine: 500 mg to be taken at the first sign of migraine attack and repeated 4 - 6 hourly until suppress mild attacks.
Children:
60 mg / kg body weight /day in 4 divided doses.
Maintenance dose: 75 mg / kg orally every 4 - 6 hours for 2 - 3 days. Haemodialysis can be done in emergency conditions.
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Indomethacin + Paracetamol is a generic medicine name and there are several brands available for it. Some of the brands for indomethacin + paracetamol might be better known than indomethacin + paracetamol itself. If the pharmacy that's willing to deliver medicines to your home doesn't have indomethacin + paracetamol in stock, you can ask for one of the branded alternatives for indomethacin + paracetamol.