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DOSAGE
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Mild to moderate noninfectious anterior scleritis: 75 mg extended release PO BID for up to 14 days.
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About half of patients with scleritis will have an associated systemic condition, so chest X-ray, urinalysis, RF, anti-CCP antibody, ANCA etc. testing may be indicated.
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Short Term: Mild to moderate anterior scleritis often responds to short term NSAID therapy. If no response the NSAID should be discontinued and further options explored.
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A two week trial and taper of oral steroids may be attempted but if that fails, then long term therapy with an immunomodulator or biologic may be appropriate
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GENERIC
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indomethacin er
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SIZE
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25mg, 50mg, 75mg, 75mg ER (Extended Release). Also available as powders, suspensions, and suppositories.
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INDICATIONS
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Indocin is a prescription medicine used to treat the symptoms of inflammation and pain associated with osteoarthritis, rheumatoid arthritis, gouty arthritis or ankylosing spondylitis. Indocin may be used alone or with other medications.
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MECHANISM OF ACTION
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NSAID: Blocks production of prostaglandins by inhibiting cyclooxygenase.
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MICROBIOLOGY
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Indomethacin has analgesic, anti-inflammatory, and antipyretic properties. The mechanism of action of INDOCIN, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2). Indomethacin is a potent inhibitor of prostaglandin synthesis in vitro. Indomethacin concentrations reached during therapy have produced in vivo effects. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in inducing pain in animal models. Prostaglandins are mediators of inflammation. Because indomethacin is an inhibitor of prostaglandin synthesis, its mode of action may be due to a decrease of prostaglandins in peripheral tissues.
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CONTRAINDICATIONS & WARNINGS
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Known hypersensitivity to indomethacin. History of asthma, urticaria, or other allergic reactions to aspirin or other NSAIDs. Peptic ulcer, coronary artery bypass graft, pre-existing severe renal or liver damage.
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PEDIATRIC USE
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Safety and effectiveness in patients 14 years of age and younger not established.
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PREGNANCY
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C - Risk cannot be ruled out - prior to 30 weeks gestation D - Positive evidence of risk - starting at 30 weeks gestation Generally avoid NSAID's during the 3rd trimester. In published studies indomethacin at relatively low dossages produced maternal toxicity, death, increased fetal resorptions, and fetal malformations in pregnant mice.
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NOTE
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Other options include naproxen 500 mg bid, ibuprofen 600 mg to 800 mg tid or qid daily, and flurbiprofen 200 mg to 300 mg tid.
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BLACK BOX WARNING
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