Indomethacin Dosing and Administration

Dosing Recommendations

For HIV-associated pruritus, the recommended dose is 25 mg three times daily orally, which may cause gastric intolerance in some patients 3
The American College of Rheumatology recommends continuing indomethacin until pain is controlled, then rapidly reducing to complete cessation for acute gout treatment 2

The National Comprehensive Cancer Network recommends baseline assessment of blood pressure, BUN, creatinine, liver function tests, CBC, and fecal occult blood, and follow-up monitoring every 3 months for long-term use 4
The National Comprehensive Cancer Network and MMWR Recommendations and Reports suggest using indomethacin with caution in patients over 60 years of age, with history of peptic ulcer disease or significant alcohol use, with cardiovascular disease or risk factors, and with renal or hepatic impairment 4, 6
Gastrointestinal effects, such as gastric upset, nausea, risk of peptic ulcer or GI bleeding, are common adverse effects of indomethacin 4, 6
Renal effects, such as fluid retention or worsened renal function, and cardiovascular effects, such as hypertension, are also possible adverse effects of indomethacin 4
Discontinuing indomethacin is recommended if BUN or creatinine doubles, or if hypertension develops or worsens, and if liver function tests increase to three times the upper limit of normal 4
Consider proton pump inhibitors for GI protection in high-risk patients 2