| indomethacin (U.S.N.L.M.) | ||
|---|---|---|
| Dosing/ ( mild to moderate noninfectious anterior scleritis) |
75 mg extended release p.o. b.i.d. for up to 14 days. | |
| About half of patients with scleritis will have an associated systemic condition, so chest X-ray, urinalysis, RF, anti-CCP antibody, ANCA etc. testing may be indicated. | ||
| Quantities | 25, 50, 75mg capsule and 75mg extended release capsule Also available as powders, suspensions, and suppositories. |
|
| Cost | 16.78 / 30 extended release capsules / 75mg | |
| Class | NSAID | |
| Action | Blocks production of prostaglandins by inhibiting cyclooxygenase. Also triggers anti-inflammatory NRF2 protein. |
|
| Short Term Usage | Mild to moderate anterior scleritis often responds to short term NSAID therapy. If no response the NSAID should be discontinued and further options explored. |
|
| A two week trial and taper of oral steroids may be attempted but if that fails then long term therapy with an immunomodulator or biologic may be appropriate. |
||
| Contraindications | Known hypersensitivity to indomethacin. History of asthma, urticaria, or other allergic reactions to aspirin or other NSAIDs. Peptic ulcer, coronary artery bypass graft, pre-existing severe renal or liver damage. |
|
| Warnings | hover for →
Black Box Warning
BOXED WARNING |
|
| Pediatric use | Safety and effectiveness in patients 14 years of age and younger not established. | |
| Pregnancy | C - Risk cannot be ruled out - prior to 30 weeks gestation D - Positive evidence of risk - starting at 30 weeks gestation Generally avoid NSAID's during the 3rd trimester. In published studies indomethacin at relatively low dossages produced maternal toxicity, death, increased fetal resorptions, and fetal malformations in pregnant mice. |
|
| . Other options include naproxen 500 mg bid, ibuprofen 600 mg to 800 mg tid or qid daily, and flurbiprofen 200 mg to 300 mg tid. | ||