Indomethacin Dosage

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for Ankylosing Spondylitis

Immediate-release: 25 mg orally every 8 to 12 hours. Dosage may be increased by 25 or 50 mg increments every week to a maximum daily dose of 150 to 200 mg. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Extended-release: 75 mg orally once a day. Dosage may be increased to 75 mg orally twice a day.

Rectal: 50 mg rectally every 8 to 12 hours.

Usual Adult Dose for Osteoarthritis

Immediate-release: 25 mg orally every 8 to 12 hours. Dosage may be increased by 25 or 50 mg increments every week to a maximum daily dose of 150 to 200 mg. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Extended-release: 75 mg orally once a day. Dosage may be increased to 75 mg orally twice a day.

Rectal: 50 mg rectally every 8 to 12 hours.

Usual Adult Dose for Rheumatoid Arthritis

Immediate-release: 25 mg orally every 8 to 12 hours. Dosage may be increased by 25 or 50 mg increments every week to a maximum daily dose of 150 to 200 mg. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Extended-release: 75 mg orally once a day. Dosage may be increased to 75 mg orally twice a day.

Rectal: 50 mg rectally every 8 to 12 hours.

Usual Adult Dose for Acute Gout

50 mg orally or rectally 3 times a day until the gouty attack has resolved, usually 2 to 3 days. Indomethacin should be given with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Adult Dose for Bursitis

75 to 150 mg daily in 3 to 4 divided doses. Give with food, immediately after meals, or with antacids to reduce gastric irritation. The usual course of therapy is 7 to 14 days.

Usual Adult Dose for Tendonitis

75 to 150 mg daily in 3 to 4 divided doses. Give with food, immediately after meals, or with antacids to reduce gastric irritation. The usual course of therapy is 7 to 14 days.

Usual Adult Dose for Cluster Headache

Immediate-release: 25 to 50 mg orally 3 times a day. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Extended-release: 75 mg orally once or twice a day.

Rectal: 50 mg rectally 2 to 3 times a day.

Usual Pediatric Dose for Patent Ductus Arteriosus

Indomethacin IV:

Less than 48 hours:
First dose: 0.2 mg/kg IV.
Second dose: 0.1 mg/kg IV.
Third dose: 0.1 mg/kg IV.
Doses are given at 12 to 24 hour intervals.

2 to 7 days:
First dose: 0.2 mg/kg IV.
Second dose 0.2 mg/kg IV.
Third dose: 0.2 mg/kg IV.
Doses are given at 12 to 24 hour intervals.

Greater than 7 days:
First dose: 0.2 mg/kg IV.
Second dose: 0.25 mg/kg IV.
Third dose: 0.25 mg/kg IV.
Doses are given at 12 to 24 hour intervals.

Usual Pediatric Dose for Rheumatoid Arthritis

2 to 14 years: 2 mg/kg/day given in divided doses. Titrate dose upward to a maximum of 4 mg/kg/day or 200 mg per day. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Pediatric Dose for Pain

1 to 2 mg/kg/day in 2 to 4 divided doses. Maximum daily dose 4 mg/kg. Give with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Pediatric Dose for Bartter Syndrome

0.5 to 2 mg/kg/day in divided doses, given with food, immediately after meals, or with antacids to reduce gastric irritation.

Usual Pediatric Dose for Gitelman Syndrome

Case Report (n=3): 1 to 2 mg/kg/day given in three divided doses. Maximum doses of 4 mg/kg/day have been used if poor growth observed.

Usual Pediatric Dose for Langerhans' Cell Histiocytosis

Study (n=10)
Greater than 2 years: 1 to 2.5 mg/kg/day given in 2 to 3 divided doses for an average time of 6 weeks (range: 2 to 16 weeks).

Renal Dose Adjustments

A lower daily dosage should be anticipated to avoid excessive drug accumulation in patients with significantly impaired renal function.

Liver Dose Adjustments

Pediatric patients on indomethacin should be monitored closely and periodic assessment of liver function is recommended. Keep dose at the lowest level to control symptoms.

Dose Adjustments

If the ductus arteriosus closes or is significantly reduced in size after an interval of 48 hours or more from completion of the first course of indomethacin IV, no further doses are necessary. If the ductus arteriosus reopens, a second course of 1 to 3 doses may be given, each dose separated by a 12 to 24 hour interval.

In patients diagnosed with rheumatoid arthritis who have pain at night or morning stiffness, 100 mg of the total daily dose, orally or rectally, may be given at bedtime for relief. In acute flares it may be necessary to increase dose by 25 or 50 mg daily.

A 22-year study of 442 neonates treated with indomethacin for patent ductus arteriosus (PDA) who were also being treated with synthetic or natural surfactant for respiratory distress syndrome (RDS) has shown an increased total dosing requirement for indomethacin of about 0.1 mg/kg when using a synthetic surfactant and about 0.3 mg/kg when using a natural surfactant. Dosing guidelines established prior to the availability of surfactant would be expected to result in relatively poor response rates for PDA closure. The authors caution that only a controlled study of indomethacin dosing requirements in neonates with RDS, with or without surfactant treatment, which can adequately account for all other variables, can provide conclusive answers about the need to change dosing strategies.

Precautions

Intravenous injections of indomethacin should be administered with caution to avoid extravasation or leakage because it may be irritating to tissue.

If indomethacin is used in pediatric patients 2 years of age or older, such patients should be monitored closely and periodic assessment of liver function is recommended.

Safety and effectiveness have not been established in pediatric patients less than 14 years of age.

Dialysis

Data not available

Other Comments

If no improvement in symptoms is seen within 2 to 4 weeks of the start of indomethacin therapy, an alternative NSAID should be considered.

Hide
(web1)