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The frequency and severity of side effects and the availability of better tolerated alternatives make indometacin today a drug of second choice. Its use in acute gout attacks and in dysmenorrhea is well-established because in these indications the duration of treatment is limited to a few days only, therefore serious side effects are not likely ...
Indometacin farnesil is a prodrug of the nonsteroidal anti-inflammatory drug (NSAID) indometacin, designed to reduce the occurrence of side-effects by esterification of the carboxyl group on indometacin with farnesol.
NSAIDs with less side effects are more preferred in migraine therapy. [11] Prevention of pancreatitis. Rectal NSAIDs such as diclofenac and indomethacin are administered for the prevention of pancreatitis due to endoscopic retrograde cholangiopancreatography (ERCP). [12] ERCP is a technique for treating liver and pancreatic disease. [7]
Hemicrania continua generally responds only to indomethacin 25–300 mg daily, which must be continued long term. Unfortunately, gastrointestinal side effects are a common problem with indomethacin, which may require additional acid-suppression therapy to control. [10]
Indomethacin, ketoprofen, and piroxicam use appear to lead to the highest rate of gastric adverse effects, while ibuprofen (lower doses) and diclofenac appear to have lower rates. [ 17 ] Certain NSAIDs, such as aspirin, have been marketed in enteric-coated formulations that manufacturers claim reduce the incidence of gastrointestinal ADRs.
NSAIDs (such as indomethacin) and calcium channel blockers (such as nifedipine) are the most likely to delay delivery for 48 hours, with the least amount of maternal and neonatal side effects. [46] Otherwise, tocolysis is rarely successful beyond 24 to 48 hours because current medications do not alter the fundamentals of labor activation. [47]
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