What is the most important information I should know about Indocin?

• Take Indocin with food, milk, or an antacid to lessen stomach upset.
• Do not break, crush, or chew the sustained-release formulations of Indocin (e.g., Indocin SR). Swallow them whole.
• Contact your doctor if you experience blood in vomit or bloody, black, or tarry stools. These symptoms could indicate damage to the stomach or intestines, which could be dangerous.
• Many over-the-counter cough, cold, allergy, and pain medicines contain aspirin or other medicines similar to Indocin (such as ibuprofen, ketoprofen, and others). Before taking any prescription or over-the-counter medicine, talk to your doctor and pharmacist.
• Avoid alcohol or use it with moderation. If you drink more than three alcoholic beverages a day, Indocin may increase the risk of dangerous stomach bleeding. Talk to your doctor before taking Indocin if you drink more than 3 alcoholic beverages a day.

What is Indocin?

• Indocin is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Indocin works by reducing hormones that cause inflammation and pain in the body.
• Indocin is used to reduce the pain, inflammation, and stiffness caused by many conditions, such as osteoarthritis, rheumatoid arthritis, gout, ankylosing spondylitis, tendinitis, and bursitis.
• Indocin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking Indocin?

• Before taking Indocin, tell your doctor if you
  • have an allergy to aspirin or any other NSAIDs,
  • have an ulcer or bleeding in the stomach,
  • drink more than three alcoholic beverages a day,
  • have liver or kidney disease,
  • have a coagulation (bleeding) disorder,
  • have congestive heart failure,
  • have fluid retention,
  • have heart disease, or
  • have high blood pressure.
• You may not be able to take Indocin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Do not use Indocin suppositories without first talking to your doctor if you have a history of inflammation of the rectum (proctitis) or if you have recently had rectal bleeding.
• It is not known whether Indocin taken early in pregnancy will be harmful to an unborn baby. Indocin must not be taken late in pregnancy (the third trimester) because it can affect the baby's heart. Do not take Indocin without first talking to your doctor if you are pregnant or could become pregnant during treatment.
• Indocin passes into breast milk and may affect a nursing baby. Do not take Indocin without first talking to your doctor if you are breast-feeding a baby.

How should I take Indocin?

• Take Indocin exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
• Take each dose with a full glass of water.
• Take Indocin with food, milk, or an antacid to lessen stomach upset.
• Do not break, crush, or chew the sustained-release formulations of Indocin (e.g., Indocin SR). Swallow them whole.
• Shake the suspension well before measuring a dose. To ensure that you get a correct dose, measure the suspension with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
• Use the suppositories rectally as directed by your doctor. If you do not know how to properly use the suppository, ask your nurse, doctor, or pharmacist for instructions. Do not take the suppositories by mouth.
• Store Indocin at room temperature away from moisture and heat. The suppositories and suspension can be stored at room temperature or in the refrigerator.

What happens if I miss a dose?

• If you are taking Indocin on a regular schedule, take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose.
• If you are taking Indocin as needed, take the missed dose if it is needed, then wait the recommended or prescribed amount of time before taking another dose.

What happens if I overdose?

• Seek emergency medical attention if an overdose is suspected.
• Symptoms of an Indocin overdose may include nausea, vomiting, stomach pain, dizziness, drowsiness, headache, ringing in the ears, blurred vision, seizures, sweating, numbness or tingling, little or no urine production, and slow breathing.

What should I avoid while taking Indocin?

• Avoid prolonged exposure to sunlight. Indocin may increase the sensitivity of the skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.
• Avoid alcohol or use it with moderation. If you drink more than three alcoholic beverages a day, Indocin may increase the risk of dangerous stomach bleeding. Talk to your doctor before taking Indocin if you drink more than 3 alcoholic beverages a day.
• Many over-the-counter cough, cold, allergy, and pain medicines contain aspirin or other medicines similar to Indocin (such as ibuprofen, ketoprofen, and others). Before taking any prescription or over-the-counter medicine, talk to your doctor and pharmacist.

What are the possible side effects of Indocin?

• Contact your doctor if you experience blood in vomit or bloody, black, or tarry stools. These symptoms could indicate damage to the stomach or intestines, which could be dangerous.
• If you experience any of the following serious side effects, stop taking Indocin and seek medical attention or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • muscle cramps, numbness, or tingling;
  • ulcers (open sores) in the mouth;
  • rapid weight gain (fluid retention);
  • seizures;
  • decreased hearing or ringing in the ears;
  • yellowing of the skin and eyes (jaundice); or
  • abdominal cramping, indigestion, or heartburn.
• Other, less serious side effects may be more likely to occur. Continue to take Indocin and talk to your doctor if you experience
  • dizziness or headache;
  • nausea, gaseousness, diarrhea, or constipation;
  • depression;
  • fatigue or weakness;
  • dry mouth; or
  • irregular menstrual periods.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Indocin?

• Before taking Indocin, tell your doctor if you are taking any of the following drugs:
  • aspirin or another salicylate (form of aspirin) such as salsalate (Disalcid), diflunisal (Dolobid), choline salicylate-magnesium salicylate (Trilisate, Tricosal, others), and magnesium salicylate (Doan's, others);
  • another nonsteroidal anti-inflammatory drug (NSAID) such as diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Motrin, Advil, others), ketoprofen (Orudis, Orudis KT), ketorolac (Toradol), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn, Anaprox, others), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), or tolmetin (Tolectin);
  • an over-the-counter cough, cold, allergy, or pain medicine that contains aspirin, ibuprofen, Indocin, or ketoprofen;
  • an anticoagulant (blood thinner) such as warfarin (Coumadin);
  • a steroid such as prednisone (Deltasone);
  • insulin or an oral diabetes medicine such as glipizide (Glucotrol), glyburide (Diabeta, Micronase), and others;
  • probenecid (Benemid);
  • lithium (Eskalith, Lithobid, others); or
  • bismuth subsalicylate in drugs such as Pepto-Bismol.
• You may not be able to take Indocin, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with Indocin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.