1 What is Indocin?

Brand: Indocin

Generic: Indomethacin

Indocin administered via intravenous route is used to treat patent ductus arteriosus (PDA) in very small or premature infants.

Patent ductus arteriosus is a congenital heart condition wherein the ductus arteriosus fails to close at birth.

In the developing fetus, ductus arteriosus (or simply ductus) is a blood vessel that allows blood from the right side of the heart to travel to the left side. Since the fetus has non-functioning lungs until birth, it allows blood from the right side of the heart to go into systemic circulation.

Ductus is not needed once the baby has been born. At birth, the ductus normally closes so that blood circulates in the lungs to allow respiration.

PDA means that the ductus remained open after birth. Because the heart’s left side generates more pressure, blood travels through the open ductus and goes to the lungs. This creates increased pressure in the lungs resulting in breathing difficulties in the infant.

Injection of Indomethacin in the veins causes closure of open ductus arteriosus. It is given to premature infants weighing around 500 grams to 1750 grams. Indomethacin is given if the ductus remains open 48 hours after birth and if other measures are performed and failed to close it.

Intravenous Indomethacin is a prescription drug and is given by infusing it in the veins. It is only given in a hospital setting with close monitoring.

2 What To Know Before Using

Before using Indocin, you must know all about the risks and complications associated with it.

The doctor will consider the following before prescribing intravenous Indomethacin:

The PDA must be clinically verified first before considering treatment with intravenous Indomethacin. There must be clear symptoms such as abnormal heart sounds and breathing difficulties. Previous treatments should have been done to close the ductus.

Tell the doctor if the infant has other health conditions. Indomethacin must be used with caution to infants with bleeding, blood clotting problems, infection, kidney, intestine, and liver conditions.

The doctor must be sure about the allergy history of the infant before giving Indomethacin.

Intravenous indomethacin is known to interact with several medicines. Tell all the medicines given to the baby before treatment. Here are the medicines that interact with Indomethacin:

  • Ketorolac
  • Abciximab
  • Anagrelide
  • Apixaban
  • Ardeparin
  • Argatroban
  • Beta Glucan
  • Bivalirudin
  • Certoparin
  • Cilostazol
  • Citalopram
  • Clopidogrel
  • Clovoxamine
  • Cyclosporine
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Desirudin
  • Digoxin
  • Duloxetine
  • Edoxaban
  • Enoxaparin
  • Eptifibatide
  • Erlotinib
  • Escitalopram
  • Femoxetine
  • Feverfew
  • Flesinoxan
  • Fluoxetine
  • Fondaparinux
  • Ginkgo
  • Gossypol
  • Heparin
  • Lepirudin
  • Levomilnacipran
  • Meadowsweet
  • Methotrexate
  • Milnacipran
  • Nadroparin
  • Nefazodone
  • Parnaparin
  • Paroxetine
  • Pemetrexed
  • Pentosan Polysulfate Sodium
  • Pentoxifylline
  • Potassium
  • Pralatrexate
  • Prasugrel
  • Protein C
  • Reviparin
  • Rivaroxaban
  • Sibutramine
  • Tacrolimus
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Vasopressin
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Zimeldine

Here is another list of medicines that interact with Indomethacin. However, these medicines may be necessary for treatment so the doctor may adjust doses or schedule intake times:

  • Acebutolol
  • Alacepril
  • Alprenolol
  • Amiloride
  • Amlodipine
  • Arotinolol
  • Atenolol
  • Azilsartan
  • Azilsartan Medoxomil
  • Azosemide
  • Befunolol
  • Bemetizide
  • Benazepril
  • Bendroflumethiazide
  • Benzthiazide
  • Bepridil
  • Betaxolol
  • Bevantolol
  • Bisoprolol
  • Bopindolol
  • Bucindolol
  • Bumetanide
  • Bupranolol
  • Buthiazide
  • Candesartan Cilexetil
  • Canrenoate
  • Captopril
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Chlorothiazide
  • Chlorpropamide
  • Chlorthalidone
  • Cilazapril
  • Clopamide
  • Cyclopenthiazide
  • Delapril
  • Desvenlafaxine
  • Dilevalol
  • Diltiazem
  • Dipyridamole
  • Enalapril
  • Enalaprilat
  • Eprosartan
  • Esmolol
  • Ethacrynic Acid
  • Felodipine
  • Flunarizine
  • Fosinopril
  • Furosemide
  • Gallopamil
  • Gentamicin
  • Glimepiride
  • Glipizide
  • Glyburide
  • Hydrochlorothiazide
  • Hydroflumethiazide
  • Imidapril
  • Indapamide
  • Irbesartan
  • Isradipine
  • Labetalol
  • Lacidipine
  • Landiolol
  • Levobunolol
  • Lidoflazine
  • Lisinopril
  • Lithium
  • Losartan
  • Manidipine
  • Mepindolol
  • Methyclothiazide
  • Metipranolol
  • Metolazone
  • Metoprolol
  • Moexipril
  • Nadolol
  • Nateglinide
  • Nebivolol
  • Nicardipine
  • Nifedipine
  • Nilvadipine
  • Nimodipine
  • Nipradilol
  • Nisoldipine
  • Nitrendipine
  • Olmesartan Medoxomil
  • Oxprenolol
  • Penbutolol
  • Pentopril
  • Perindopril
  • Pindolol
  • Piretanide
  • Polythiazide
  • Pranidipine
  • Propranolol
  • Quinapril
  • Ramipril
  • Repaglinide
  • Sotalol
  • Spirapril
  • Spironolactone
  • Talinolol
  • Tasosartan
  • Telmisartan
  • Temocapril
  • Tertatolol
  • Timolol
  • Tolazamide
  • Tolbutamide
  • Torsemide
  • Trandolapril
  • Triamterene
  • Trichlormethiazide
  • Valsartan
  • Verapamil
  • Warfarin
  • Xipamide
  • Zofenopril

3 Proper Usage

To use Indocin properly, you must follow all instructions given by your doctor.

The doctor determines the dose of intravenous Indomethacin based on the infant’s body weight. The doctor or nurse will prepare and administer the medicine. Because intravenous Indomethacin is infused into the vein and treatment requires close monitoring, you can only have it in the hospital.

Intravenous Indomethacin is usually given one to three times if there are no adverse reactions. The interval between the doses is usually 12 to 24 hours, and the baby is usually closely monitored. If the ductus re-opens, the doctor may order another round of one to three doses of intravenous Indomethacin.

The infant is closely monitored throughout treatment. If adverse drug reactions occurred, administration of intravenous Indomethacin must be stopped.

If the ductus remains open after two rounds of intravenous Indomethacin infusion, surgery may be necessary to close it.

4 Precautions To Take

Before using Indocin, there are some precautions you must take.

Indomethacin tends to mask signs and symptoms of infection, which is a possibility because newborns often do not have robust immune systems yet. Watch out for signs and symptoms of infection like fever and chills. If those symptoms are present, call the doctor immediately.

Indomethacin may cause increase risk of bleeding. Check the baby for any unusual bleeding or bruising, dark urine and black stools. If those symptoms are present, call the doctor immediately.

Indomethacin may cause reduced urine output, which can increase chances of kidney complications. The baby has to undergo several blood and urine tests to check the health of the kidneys during treatment.

Liver complications can occur during Indomethacin treatment. Call the doctor if your baby experienced symptoms like abdominal tenderness, clay colored stools, dark urine, reduced feeding, fever, itching, vomiting, skin rash, swelling of the feet and lower legs, or yellowing of eyes and skin.

Do not give any medicine, including over-the-counter drugs and supplements without permission from your doctor.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Indocin.

Intravenous Indomethacin may cause serious side effects. Call your doctor or nurse if your baby experienced the following:

  • Pain in the abdomen
  • Fruity odor of breath
  • Passing out black or tarry stools
  • Coma
  • Constipation
  • Convulsions
  • Passing out less urine than normal
  • Difficulty breathing
  • Very fast or irregular heartbeat
  • Loss of appetite for feeding
  • Vomiting
  • Swelling of the face, ankles or hands
  • Vomiting of blood or material that looks like coffee grounds
  • Weight loss
  • Chills
  • Cold pale skin
  • Noisy rattling breathing
  • Seizures
  • Shakiness
  • Swelling of the abdomen
  • Troubled breathing
  • Unusual bleeding or bruising

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