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Indomethacin is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Indomethacin works by reducing hormones that cause inflammation and pain in the body.

Indomethacin is used to treat pain or inflammation caused by many conditions such as arthritis, gout, ankylosing spondylitis, bursitis, or tendinitis.

Indomethacin may also be used for purposes not listed in this medication guide.

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

This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use indomethacin. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking indomethacin. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Do not drink alcohol while taking indomethacin. Alcohol can increase the risk of stomach bleeding caused by indomethacin. Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar toindomethacin (such as ibuprofen, ketoprofen, or naproxen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen.

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

Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Do not use this medication if you are allergic to indomethacin, or if you have a history of allergic reaction to aspirin or other NSAIDs.

Before taking indomethacin tell your doctor if you are allergic to any drugs, or if you have:

• a history of heart attack, stroke, or blood clot;
• heart disease, congestive heart failure, high blood pressure;
• a history of stomach ulcers or bleeding;
• liver or kidney disease,
• a seizure disorder such as epilepsy;
• asthma;
• polyps in your nose;
• a bleeding or blood clotting disorder; or
• if you smoke.

If you have any of these conditions, you may not be able to use indomethacin, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking indomethacin during the last 3 months of pregnancy may result in birth defects. Do not take indomethacin during pregnancy unless your doctor has told you to. Indomethacin passes into breast milk and may affect a nursing baby. Do not take indomethacin without first talking to your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 14 years old without the advice of a doctor.

How should I take Indocin (indomethacin)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take indomethacin with food or milk to lessen stomach upset. Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

If you take indomethacin for a long period of time, your doctor may want to check you on a regular basis to make sure this medication is not causing harmful effects. Do not miss any scheduled visits to your doctor.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using indomethacin.

Store indomethacin at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

What happens if I miss a dose?

If you are taking indomethacin 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 indomethacin 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 you think you have used too much of this medicine. Symptoms of an indomethacin overdose may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, fainting, or coma.

Indocin (indomethacin) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking indomethacin and seek medical attention or call your doctor at once if you have any of these serious side effects:

• chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;
• black, bloody, or tarry stools;
• coughing up blood or vomit that looks like coffee grounds;
• swelling or rapid weight gain;
• urinating less than usual or not at all;
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
• bruising, severe tingling, numbness, pain, muscle weakness.

Keep taking indomethacin and talk to your doctor if you have any of these less serious side effects:

• upset stomach, mild heartburn, diarrhea, constipation;
• bloating, gas;
• dizziness, nervousness, headache;
• skin rash, itching;
• blurred vision; or
• ringing in your ears.

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 (indomethacin)?

Before taking indomethacin, tell your doctor if you are taking any of the following drugs:

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac (Voltaren), etodolac (Lodine), flurbiprofen (Ansaid), ibuprofen (Advil, Motrin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others;
• a blood thinner such as warfarin (Coumadin);
• cyclosporine (Gengraf, Neoral, Sandimmune);
• diflunisal (Dolobid);
• digoxin (digitalis, Lanoxin);
• diuretics (water pills) such as furosemide (Lasix);
• lithium (Eskalith, Lithobid);
• methotrexate (Rheumatrex, Trexall);
• probenecid (Benemid);
• steroids (prednisone and others); or
• a beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others.

If you are using any of these drugs, you may not be able to use indomethacin or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect indomethacin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Indocin

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Medrol, a corticosteroid drug, is used to reduce inflammation and improve symptoms in a variety of disorders, including rheumatoid arthritis, acute gouty arthritis, and severe cases of asthma. Medrol may be given to people to treat primary or secondary adrenal cortex insufficiency (inability of the adrenal gland to produce sufficient hormone). It is also given to help treat the following disorders:

Severe allergic conditions (including drug-induced allergic states)
Blood disorders (leukemia and various anemias)
Certain cancers (along with other drugs)
Skin diseases (including severe psoriasis)
Connective tissue diseases such as systemic lupus erythematosus
Digestive tract diseases such as ulcerative colitis
High serum levels of calcium associated with cancer
Fluid retention due to nephrotic syndrome (a condition in which damage to the kidney causes loss of protein in urine)
Various eye diseases
Lung diseases such as tuberculosis
Worsening of multiple sclerosis

Most important fact about Medrol

Medrol lowers your resistance to infections and can make them harder to treat. Medrol may also mask some of the signs of an infection, making it difficult for your doctor to diagnose the actual problem.

How should you take Medrol?

Take Medrol exactly as prescribed. It can be taken every day or every other day, depending on the condition being treated.

Do not abruptly stop taking Medrol without checking with your doctor. If you have been using Medrol for a long time, the dose should be reduced gradually.

Medrol may cause stomach upset. Take Medrol with meals or snacks.

–If you miss a dose…

If you take your dose once a day, take it as soon as you remember. Then go back to your regular schedule. If you don’t remember until the next day, skip the one you missed. Do not take 2 doses at once.

If you take it several times a day, take it as soon as you remember. Then go back to your regular schedule. If you don’t remember until your next dose, double the dose you take.

If you take your dose every other day, and you remember it the same morning, take it as soon as you remember and go back to your regular schedule. If you don’t remember until the afternoon, do not take it until the following morning, then skip a day and go back to your regular schedule.

–Storage instructions…

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor immediately. Only your doctor can determine whether it is safe for you to continue taking Medrol.

• More common side effects may include:
  Abdominal swelling, allergic reactions, bone fractures, bruising, congestive heart failure, cataracts, convulsions, Cushingoid symptoms (moon face, weight gain, high blood pressure, emotional disturbances, growth of facial hair in women), face redness, fluid and salt retention, headache, high blood pressure, increased eye pressure, increased sweating, increase in amounts of insulin or hypoglycemic medications needed, inflammation of the pancreas, irregular menstruation, muscle wasting and weakness, osteoporosis, poor healing of wounds, protruding eyes, stomach ulcer, suppression of growth in children, symptoms of diabetes, thin, fragile skin, tiny red or purplish spots on the skin, vertigo

Long-term use of Medrol may cause cataracts, glaucoma (increased eye pressure), and eye infections.

Large doses of Medrol may cause high blood pressure, salt and water retention, and potassium and calcium loss. It may be necessary to restrict your salt intake and take a potassium supplement.

Medrol may reactivate dormant cases of tuberculosis. If you have inactive tuberculosis and must take Medrol for an extended period of time, your doctor will prescribe anti-TB medication as well.

Medrol should be used cautiously if you have an underactive thyroid, liver cirrhosis, or herpes simplex (virus) infection of the eye.

This medication may aggravate existing emotional problems or cause new ones. You may experience euphoria (an exaggerated sense of well-being) and difficulty sleeping, mood swings, or mental problems. If you have any changes in mood, contact your doctor.

People taking corticosteroids, such as Medrol, have developed Kaposi’s sarcoma, a form of cancer.

Medrol should also be taken with caution if you have any of the following conditions:

Diverticulitis or other inflammatory conditions of the intestine
High blood pressure
Certain kidney diseases
Active or dormant peptic ulcer
Myasthenia gravis (a muscle weakness disorder)
Osteoporosis (brittle bones)
Threadworm
Ulcerative colitis with impending danger of infection

Long-term use of Medrol can slow the growth and development of infants and children.

Use aspirin cautiously with Medrol if you have a blood-clotting disorder.

Avoid exposure to chickenpox and measles.

Special information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, tell your doctor immediately. There is no information about the safety of Medrol during pregnancy. Babies born to mothers who have taken doses of Medrol (corticosteroids) during pregnancy should be carefully watched for adrenal problems. Medrol may appear in breast milk and could affect a nursing infant. If Medrol is essential to your health, your doctor may advise you to stop breastfeeding until your treatment with Medrol is finished

Recommended dosage

The starting dose of Medrol tablets may vary from 4 milligrams to 48 milligrams per day, depending on the specific problem being treated.

Once you’ve shown a satisfactory response, the doctor will gradually lower the dosage to the smallest effective amount. If you are taking Medrol for an extended period, the doctor may instruct you to take the drug only every other day, at twice your daily dosage.

For a worsening of multiple sclerosis, the dosage is 160 milligrams a day for one week, then 64 milligrams every other day for a month

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Medrol, seek medical treatment immediately.

Medrol

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Pyridostigmine affects chemicals in the body that are involved in the communciation between nerve impulses and muscle movement.

Pyridostigmine is used to treat the symptoms of myasthenia gravis. It is also used in military personnel who have been exposed to nerve gas.

Pyridostigmine may also be used for purposes other than those listed in this medication guide.

How should I take Mestinon (Pyridostigmine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Measure the liquid form of pyridostigmine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor’s instructions about how much medicine to take and when to take it.

Your doctor may occasionally change your dose to make sure you get the best results from this medication. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking pyridostigmine. You may need to stop using the medicine for a short time.

Store pyridostigmine at room temperature away from moisture and heat.

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