Metindol

Drug name: Metindol

Other names used:

• Indocin SR®

Active Ingredients: Indomethacin

Therapeutic actions: Indomethacin belongs to a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). It works by blocking the production of a chemical (prostaglandin) which the body produces in response to injury or certain diseases. This prostaglandin would otherwise go on to cause swelling, pain and inflammation. All the medicines in this group reduce inflammation caused by the body's own immune system and are effective pain killers.

Indications: Metindol is used to treat:

• Abdominal pain associated with menstrual periods (dysmenorrhoea)
• Acute gout
• Inflammation of joints
• Muscle pain (myalgia)
• Pain
• Pain following surgery
• ankylosing spondylitis
• osteoarthritis
• soft tissue injuries such as tendinitis and bursitis.

Contraindications and cautions:
Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).
NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.
Do not use this medication if you are allergic to indomethacin, or if you have a history of allergic reaction to aspirin or other NSAIDs.

Before taking indomethacin tell your doctor if you are allergic to any drugs, or if you have:

• a history of heart attack, stroke, or blood clot;
• heart disease, congestive heart failure, high blood pressure;
• a history of stomach ulcers or bleeding;
• liver or kidney disease,
• a seizure disorder such as epilepsy;
• asthma;
• polyps in your nose;
• a bleeding or blood clotting disorder;
• if you smoke.

If you have any of these conditions, you may not be able to use indomethacin, or you may need a dosage adjustment or special tests during treatment.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking indomethacin during the last 3 months of pregnancy may result in birth defects. Do not take indomethacin during pregnancy unless your doctor has told you to. Indomethacin passes into breast milk and may affect a nursing baby. Do not take indomethacin without first talking to your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 14 years old without the advice of a doctor.

Adverse effects: Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

• Headache
• Heartburn or indigestion (dyspepsia)
• Nausea with or without vomiting
• Dizziness.
• Diarrhea
• Abdominal pain (or stomach pain)
• Constipation
• Spinning sensation (vertigo)
• Excessive tiredness
• Depression
• Fatigue
• Ringing in the ears (tinnitus).

Get emergency medical help by calling 911 as soon as possible if you experience any of the following symptoms:

• Chest pain
• Shortness of breath
• Weakness on one part of your body
• Slurred speech.

Other possible serious side effects of Metindol include, but are not limited to:

• Allergic reactions such as swelling of the face or body, blisters, unexplained skin rash, wheezing, or difficultly breathing
• Stomach or intestine problems, including bleeding, ulcers, or a hole (known as a perforation)
• Liver damage, which can cause nausea, fatigue, yellowing of the skin or white of the eyes, and excessive tiredness
• Increased liver enzymes, which may be a sign of liver failure or hepatitis
• Kidney problems, including kidney failure
• Fluid retention or unexplained weight gain
• Congestive heart failure
• Blurred vision.

Because Metindol can increase the causes for major or life-threatening bleeding, contact your doctor immediately if you notice any unusual bleeding or have any of the following symptoms:

• Bloody nose
• Black, tarry stools
• Blood in the urine or stools
• Vomiting blood
• Red or purple spots on the skin.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

Interactions: It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Especially pay attention to the following drugs:

• Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®), naproxen (Aleve®, Anaprox®, Naprosyn®, Naprelan®), diclofenac (Cataflam®, Voltaren®), oxaprozin (Daypro®), celecoxib (Celebrex®), etodolac (Lodine®, Lodine XL), meloxicam (Mobic®), and others
• Warfarin (Coumadin®, Jantoven®)
• Aspirin
• Lithium (Eskalith®, Lithane®, Lithonate®, Lithotabs®)
• Diuretics, such as torsemide (Demadex®), furosemide (Lasix®), hydrochlorothiazide
• Angiotensin-converting enzyme inhibitors (ACE inhibitors) such as lisinopril (Zestril®, Prinivil®), fosinopril (Monopril®), captopril (Capoten®), quinapril (Accupril®), benazepril (Lotensin®), enalapril (Vasotec®), and ramipril (Altace®)
• Beta blockers, such as metoprolol (Lopressor®), propranolol (Inderal®), atenolol (Tenormin®), and metoprolol (Toprol XL®)
• Methotrexate (Rheumatrex®, Trexall™)
• Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
• Diflunisal (Dolobid®)
• Corticosteroids, such as prednisone, hydrocortisone (Cortef®), dexamethasone (Decadron®, Dexone®, Hexadrol®), and many others
• Probenecid (Benemid®, Probalan®).

Several herbal and nutritional supplements can also interact with Indocin and may increase the risk of bleeding. Examples of these include (but are not limited to):

• Dong quai
• Feverfew
• Garlic
• Ginger
• Ginkgo biloba
• Ginseng
• St. John's wort
• Fish oil supplements.

Additional Information: DO NOT SHARE THIS MEDICINE with others. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT, as well as syringes and needles, if needed during treatment, out of the reach of children. Do not reuse needles, syringes, or other materials.