INDOMETHACIN (Indocin) is a synthetic, nonsteroidal anti-inflammatory, analgesic and antipyretic agent that has been used in the treatment of rheumatoid arthritis, gout, osteoarthritis, and other inflammatory conditions since 1965. Unlike corticosteriods, it has no effect on pituitary or adrenal function. Its anti-inflammatory potency has been shown to be 10 to 85 times that of phenylbutazone and 4 times that of hydrocortisone.1 Its analgesic activity is such that 50 mg of indomethacin is equal to 300 mg of aspirin.2 The recommended dosage ranges from 50 to 300 mg/day.
Gastrointestinal symptoms such as nausea, vomiting, dyspepsia, and peptic ulcer make up a major portion of the side effects of this drug especially when given at the higher dosage. Lovgren and Allander reported peptic ulcer formation in four of 18 patients, two of whom died from massive hemorrhage.3 This may have been due to the dosage used (300 mg/day) and/or