Matters needing attention
1. Common adverse reactions include gastrointestinal reactions (nausea, vomiting, abdominal pain, diarrhea, ulcers, and sometimes gastric bleeding and perforation). Taking this capsule after meals can reduce gastrointestinal reactions.
2. Incidence of central nervous system symptoms (headache, dizziness, etc.). ) is not low (20% ~ 50%). Stop taking the medicine if the headache persists.
3. Can cause liver function damage (jaundice, elevated transaminase).
4. Hematopoietic system suppression (granulocytopenia, occasionally aplastic anemia).
5. Allergic reaction: common rashes and asthma. Cross-allergy to acetylsalicylic acid is prohibited for those who are allergic to the latter.
6. It is reported that the combination with aminopterin can cause renal function damage.
7. Patients with peptic ulcer, paralysis agitans, psychosis, epilepsy, bronchial asthma, renal insufficiency and pregnant women are prohibited; Children are sensitive to this product, and those who die after using this product because of stimulating potential infection should not use it.
8. External ointment is only suitable for undamaged skin surface, not for skin injury or open wound.
drug interaction
(1) Long-term use of this product with acetaminophen can increase renal side effects. When combined with other non-steroidal anti-inflammatory drugs, the incidence of digestive tract ulcer increases.
(2) At the same time, aspirin or other salicylic acid drugs can not increase the curative effect, but the gastrointestinal side effects are obviously increased, which can increase the bleeding tendency. (3) Drinking alcohol or combining with corticosteroids and adrenocorticotropic hormone can increase the tendency of gastrointestinal ulcer or bleeding.
(4) When combined with heparin, oral anticoagulant and thrombolytic agent, there is a potential risk of increasing bleeding tendency.
(5) When combined with triamcinolone acetonide, the gastric function can be decreased.
(6) When combined with colchicine and sulpirone, it can increase the risk of gastrointestinal ulcer and bleeding.
Dietary taboo
1, avoid taking indomethacin with fruit juice or cold drinks.
The fruit acid of fruit juice or refreshing beverage can easily lead to premature decomposition or dissolution of drugs, which is not conducive to the absorption of drugs in the small intestine and greatly reduces the efficacy. Moreover, indomethacin can stimulate gastric mucosa, while fruit acid can aggravate the stimulation to gastric wall and even cause gastric mucosal bleeding.
2. Do not take indomethacin before and after drinking.
Because alcohol can increase gastric acid secretion, both of them can accelerate the blood flow of gastric mucosa. If used together, it will aggravate the damage of gastric mucosa and lead to gastric bleeding.
3. Take indomethacin and avoid eating acidic food.
Because indomethacin is an organic acid drug, it has a direct stimulating effect on gastric mucosa, and it is taken at the same time with acidic foods (vinegar, sauerkraut, pickles, fish, hawthorn, bayberry, etc.). ) can increase the stimulation to the stomach.
4. Indomethacin should not be taken before meals.
Indomethacin can stimulate gastric mucosa. If you take it on an empty stomach before meals, the drug will directly contact with the gastric mucosa and aggravate the gastrointestinal reaction, so you should take it after meals.
5, avoid taking indomethacin in tea.
Because tea contains tannic acid, caffeine and theophylline, caffeine can promote gastric acid secretion and aggravate indomethacin's damage to the stomach.
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Drug taboo
1, indomethacin and aspirin should not be used together.
Aspirin can reduce the absorption of indomethacin in gastrointestinal tract, reduce the blood concentration, weaken the effect, and enhance its stimulation to digestive tract, which may cause bleeding, so the two drugs should be avoided or used with caution. Patients with gastric ulcer should be forbidden to share.
2. Indomethacin should not be combined with phenylbutazone or prednisone.
Because indomethacin is a non-steroidal analgesic, practice has proved that it can enhance the ulcer-causing effect of phenylbutazone and corticosteroids, so it is generally not suitable to use it together.
3, active digestive tract ulcer, renal insufficiency, allergic to non-steroidal anti-inflammatory drugs, tremor paralysis, epilepsy, mental patients, pregnant women, lactating women and children.
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Side effects of indomethacin
First, allergic reaction: after taking the medicine, it can cause numbness in the mouth, tongue and limbs, sudden discomfort, headache and nausea, unfavorable language, trembling all over, uncontrollable and even syncope. Some have systemic angioedema and rash. There are also patients with asthma-like attacks. Therefore, anyone with allergies and asthma should not use indomethacin. The allergic reaction occurred more than 1 ~ 2 hours after taking the medicine, and some of them lasted for 3 days.
Digestive system: Indomethacin has obvious stimulation and ulcer effect on gastrointestinal tract, and there is a risk of gastrointestinal mucosal erosion and ulcer bleeding. In addition to the direct stimulation of drugs, its mechanism is that indomethacin inhibits the synthesis of prostate, and the gastric mucosal barrier is destroyed, leading to mucosal inflammation, necrosis and ulcer. Therefore, people with gastrointestinal history should not take indomethacin. Patients who need to use indomethacin for a long time should have regular fecal occult blood tests. In addition, indomethacin can also cause temporary jaundice and elevated transaminase, but to a lesser extent.
Third, the circulatory system: indomethacin can reduce the antihypertensive effect of diuretics such as furosemide, and can offset the antihypertensive effect of propranolol, thus raising blood pressure. In addition, indomethacin can significantly inhibit the synthesis of prostaglandin and make the fetal arterial catheter close ahead of schedule, so it is not suitable for hypertension and pregnant women.
4. Blood system: Indomethacin can inhibit the function of hematopoietic system and induce agranulocytosis and aplastic anemia; It will cause thrombocytopenia, affect the function of platelets, and lead to bleeding. In addition, indomethacin can produce hemolytic anemia through autoimmunity. It is forbidden for those with bleeding tendency.
5. Urinary system: Some people treat chronic glomerulonephritis with indomethacin, which leads to an increase in urine protein and aggravation of facial edema. After stopping taking the drug for a few days, the symptoms get better. Neonates receiving large doses of indomethacin can cause mild renal insufficiency, which is characterized by decreased urine volume and temporary increase of serum creatinine. Therefore, most scholars believe that people with renal insufficiency should use it with caution.
Nervous system: mental disorders such as forehead headache, dizziness, individual restlessness, stiff limbs, speech disorder, crying and laughing endlessly, and difficulty in opening eyes and mouth may occur. Get better after stopping the drug.
7. Others: tinnitus, deafness, corneal opacity, eye movement disorder and diplopia may occur, which will disappear after drug withdrawal, and may lead to infertility or premature birth of women of childbearing age, and increase complications of premature birth.