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About - Indomethacin

By mouth: Treats pain. This is an NSAID.

Injection: Used in premature babies born with heart disease such as patent ductus arteriosus.

Rectal route: Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain and help relieve symptoms of arthritis (e.g., osteoarthritis and rheumatoid arthritis) or gout, such as inflammation, swelling, stiffness, and joint pain.

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Results: 1 to 20 of 35

Fluid restriction and prophylactic indomethacin versus prophylactic indomethacin alone for prevention of morbidity and mortality in extremely low birth weight infants

Respiratory and long‐term neurosensory outcomes are common morbidities among extremely low birth weight (ELBW),(birth weight less than 1000 g) survivors. Patent ductus arteriosus (PDA), a connection between vessels of the heart, is one of the known causes of respiratory morbidity. Indomethacin (a drug given early to close PDA) prophylaxis studies fail to show an improvement in the incidence of respiratory and long‐term outcomes, although there is a 50% reduction in the incidence of PDA. The addition of fluid restriction to indomethacin therapy might prove helpful. However, our review found no studies to answer this question.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Indometacin in use as a single dose for treating acute postoperative pain

Indometacin is a non‐steroidal anti‐inflammatory drug (NSAID) used for treating postoperative pain. This review found only one small study of women with post‐episiotomy pain where the effectiveness of the drug (taken by mouth) was compared with a placebo. Conclusions about the effectiveness of orally administered indometacin cannot be made until more studies are undertaken.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

No evidence for efficacy and safety of indomethacin for treatment of mild to moderate Alzheimer's disease

Extensive evidence implicates inflammatory processes in the pathogenesis of Alzheimer's disease. Non‐steroidal anti‐inflammatory drugs such as indomethacin have been proposed for the treatment of patients with Alzheimer's disease. Only one study met criteria for inclusion. In this one selected trial, authors did not carry out statistical analyses on the absolute change from baseline, but on the percentage change from the baseline score. Taking into account the difficulties in evaluating a single trial, at present there is no indication for treatment of mild to moderate Alzheimer's disease with indomethacin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Dopamine versus no treatment to prevent renal dysfunction in indomethacin‐treated preterm newborn infants

Dopamine has not been shown to prevent adverse effects of indomethacin on the kidneys of preterm babies. Indomethacin is a drug used in preterm babies to prevent brain hemorrhage or to help close off PDA (patent ductus arteriosus ‐ when a channel between the lungs and heart does not close off after birth as it should). Indomethacin often causes fluid retention and reduced flow of urine, which can sometimes cause deterioration in kidney (renal) function. The drug dopamine is sometimes used along with indomethacin to try and prevent negative impact on the kidneys. The review found there is not enough evidence from trials to show there is any value in giving dopamine to babies being treated with indomethacin.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Prophylactic intravenous indomethacin for preventing mortality and morbidity in preterm infants

Patent ductus arteriosus (PDA) occurs when an artery near the heart and lungs, which should close off soon after birth, stays open. Babies born preterm (premature) who have a PDA are at higher risk of severe illness and death. Indomethacin, a drug more commonly used for muscle and bone pain in adults, when given to preterm infants can help close a PDA. This review found evidence that giving all preterm infants (especially very preterm infants) indomethacin on the first day after birth reduced their risk of developing a PDA and the complications associated with PDA (including brain damage due to bleeding into the brain). However, despite these short term effects, the trials found evidence that indomethacin does not increase survival or reduce disability in the longer term.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Continuous infusion versus intermittent bolus doses of indomethacin for patent ductus arteriosus closure in symptomatic preterm infants

Patent ductus arteriosus (PDA) occurs when an artery near the heart and lungs stays open and does not close off after birth. Babies born early (preterm) have an increased risk of complications and death due to PDA. Indomethacin has been used to close the PDA; however, it can reduce blood flow in organs such as brain, kidneys and intestine. There is no agreement on the ideal dose and duration of treatment with indomethacin. In order to reduce the adverse effects of indomethacin on blood flow, some investigators have recommended administering the same total dose as a continuous infusion over 36 hours. In this review, the analysis of the two eligible trials found that the data was insufficient to reach a conclusion regarding the effectiveness of the 36‐hr continuous infusion method. The blood flow lowering side‐effects of indomethacin were reduced by the continuous infusion method, but there was insufficient data to recommend this administration method versus the traditional method.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Furosemide for prevention of morbidity in indomethacin‐treated infants with patent ductus arteriosus

There is no strong evidence of benefit from routine use furosemide, a loop diuretic, in preterm babies receiving indomethacin for treatment of patent ductus arteriosus. A blood vessel (ductus arteriosus), which is required for blood circulation for the fetus in the womb, closes soon after birth in babies born around the expected date of delivery (term infants). Babies born early (preterm) may develop symptoms if they do not close that blood vessel after birth. Preterm infants who have symptoms due to the ductus arteriosus may receive therapy (indomethacin) for closing that vessel. Indomethacin may decrease kidney function and the amount of urine. Furosemide, a medication which reduces body water (diuretic), might help limit the effects of indomethacin on the kidney. This review analyzed the effects of furosemide on preterm babies receiving indomethacin to close the ductus arteriosus. The review of trials found not enough evidence to recommend routine use of furosemide in preterm infants who receive indomethacin for closing a ductus arteriosus.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Indomethacin for asymptomatic patent ductus arteriosus in preterm infants

Indomethacin for very preterm or small babies with signs of PDA but no symptoms can prevent PDA, but more research is needed on long‐term outcomes. A common complication for very preterm (premature) or very small babies is PDA (patent ductus arteriosus). PDA is an open channel between the lungs and heart which should have closed after birth, and can cause life‐threatening complications. Indomethacin is often given to all babies at risk to prevent PDA, but it can cause adverse effects. It can also be given only to those babies who have early signs of PDA, but who have not yet developed symptoms. The review of trials found that this selective use of indomethacin can prevent PDA and has short‐term benefits, but more research is needed on longer term outcomes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Prolonged versus short course of indomethacin for the treatment of patent ductus arteriosus in preterm infants

The ductus arteriosus is a blood vessel that connects the aorta and pulmonary artery. The ductus arteriosus is normally present in the fetus. It allows the majority of the output of the right side of the heart to bypass the lungs and supply the body of the fetus and placenta in‐utero. In most term infants the patent ductus arteriosus (PDA) closes within days of birth, first by contraction of a muscular layer to achieve functional closure and then by endothelial remodeling. If the ductus arteriosus persists, blood is shunted from the aorta to the pulmonary circulation, which can cause overloading of the pulmonary circulation and reduced perfusion of the brain, gut and kidneys. In preterm infants, closure may be delayed or fail to occur, due in part to circulating vasodilatory prostaglandins. Indomethacin inhibits prostaglandin synthesis and it is used to treat PDA in preterm infants. Although indomethacin is successful in closing the PDA in the majority of cases, the ductus will re‐open in up to 35% of infants who initially respond to the drug and a more prolonged course of indomethacin has been studied to achieve higher rates of ductal closure. Important side effects of indomethacin include renal dysfunction, decreased platelet aggregation, and necrotizing enterocolitis (NEC). Where indomethacin fails, the ductus arteriosus may be surgically ligated if clinically indicated. Five randomized trials are included in this review. These studies were published between 1988 and 2000 and included a total of 431 preterm and low birth weight infants. Indomethacin was given intravenously in four trials and orally in one, in total amounts of 0.6 to 1.6 mg/kg for the prolonged course (six to eight doses) and 0.3 to 0.6 mg/kg for the short course (two to three doses). There was no significant benefit of prolonged indomethacin administration on failure of the PDA to close after completion of allocated treatment (four studies, 361 infants). Prolonged course of indomethacin compared to the short course did not reduce the rate of PDA re‐opening after initial closure (three studies, 322 infants), rate of PDA re‐treatment (five studies, 431 infants), or ligation rate (four studies, 310 infants). The prolonged course was associated with decreased incidence of renal function impairment (three studies, 318 infants). However, a prolonged indomethacin course increased the risk of NEC (four studies, 310 infants). The number of deaths was no different.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants

A common complication for very preterm (premature) or very small babies is PDA. PDA is an open vascular channel between the lungs and the heart. It should close after birth, but sometimes remains open because of the baby's immature stage of development. PDA can lead to life‐threatening complications. The usual treatment for PDA has been indomethacin, a medicine that will successfully close the PDA in the majority of babies, but can cause serious side effects. Another option is the drug ibuprofen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Surgical versus medical treatment with cyclooxygenase inhibitors for symptomatic patent ductus arteriosus in preterm infants

The way an infant's blood is circulated changes soon after birth. Initially, premature infants have an opening (a patent ductus arteriosus, PDA) between the large blood vessel to the lungs and the large blood vessel that carries oxygenated blood to the rest of the body. Early symptomatic treatment of PDA, when clinical signs first appear, helps reduce the amount of time an infant needs assisted breathing (mechanical ventilation) and the likelihood of chronic lung disease and damaging inflammation of the gut (necrotising enterocolitis). Standard therapy includes restricting fluids, diuretics and cyclooxygenase inhibitors like indomethacin or ibuprofen. The PDA is closed surgically if these medical treatments do not work. Only one randomised controlled study could be included in this review (including 154 preterm infants that needed breathing support). Indomethacin and surgery gave similar benefits. There were no differences in deaths during the hospital stay, chronic lung disease, necrotising enterocolitis, cerebral or other bleeding. Surgery was more effective in closing the PDA (three needed to treat for one to benefit) but it was associated with complications (pneumothorax and retinopathy of prematurity). The one study found was carried out over 30 years ago. Clinical practice has changed a great deal and surgical closure of a PDA is safer. Therefore, whether the results of the study are applicable today is debatable. Updates of this review in July 2007 and February 2012 did not identify any additional randomised controlled studies for inclusion, but three observational studies indicated an increased risk for one or more of the following outcomes associated with PDA ligation: chronic lung disease, retinopathy of prematurity and neurosensory impairment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Inhaled non‐steroid anti‐inflammatories (NSAIDs) for children and adults with bronchiectasis

The airways of patients with bronchiectasis are characterised by chronic inflammation. The anti‐inflammatory effects of inhaled non‐steroid anti‐inflammatory drugs (NSAIDs) may be beneficial in patients with bronchiectasis. However, the short and long‐term benefits in both adults and children require investigation, in addition to the potential side effects of the long‐term use of NSAIDs. For this review we found one small study that reported an improvement in sputum production and dyspnoea (shortness of breath) in adults with chronic lung disease (chronic bronchitis, bronchiectasis or diffuse panbronchiolitis) who received inhaled indomethacin compared to the placebo group. There was no significant improvement in lung function (forced expiratory volume in one second (FEV1) and vital capacity (VC)). However, the small scale of this study and the collective analysis of data from the three disease states made it difficult to draw any solid conclusions on the benefit of using NSAIDs to treat adults with bronchiectasis. There were no studies identified on the use of NSAIDs in children with bronchiectasis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Drugs for preventing headache after a lumbar puncture

Lumbar puncture is an invasive procedure that medical personnel use to get a sample of cerebrospinal fluid for diagnostic purposes (e.g. to diagnose meningitis or subarachnoid haemorrhage) by inserting a needle into the lower spinal region. It can also be used to inject medications such as anaesthetics and analgesics (to perform regional anaesthesia), chemotherapy or radiological contrast agents.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Interleukin‐1 inhibitors for acute gout

Gout results from the deposition of crystals of uric acid in and around joints. The main treatments for gout are drugs that lower uric acid blood levels and resolve the crystal deposits. Acute gout flares result in significant pain and disability and treatment aims at reducing the pain and resolving the arthritis quickly.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Paracetamol (acetaminophen) for patent ductus arteriosus in preterm and low‐birth‐weight infants

A common complication for very preterm (premature) or very small babies is a PDA (patent ductus arteriosus). PDA is an open channel between the lungs and heart. It should close after birth, but sometimes remains open because of the baby's premature stage of development. A PDA can lead to life‐threatening complications. The usual treatment for PDA has been indomethacin or ibuprofen. Recently paracetamol (acetaminophen), a commonly used drug to treat fever or pain in children and infants, has been suggested as an alternative to ibuprofen, with potentially fewer side effects. A number of case reports and case series have suggested that paracetamol may be an attractive alternative for the closure of a PDA.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Cyclo‐oxygenase (COX) inhibitors for treating preterm labour

Not enough evidence on whether cyclo‐oxygenase (COX) inhibitors administered to women in threatened premature labour may reduce the risk of babies being born too early.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Ibuprofen for the prevention of patent ductus arteriosus in preterm and/or low birth weight infants

PDA is a common complication for very preterm (premature) or very small babies. PDA is an open vessel that channels blood from the lungs to the body. It should close after birth, but sometimes remains open because of the baby's premature stage of development. PDA can lead to life‐threatening complications. Indomethacin is successful in causing PDA closure, but can cause serious adverse effects. Another option is the drug ibuprofen, which can be given to try and prevent PDA. This updated review of trials found that ibuprofen can prevent PDA, but does not confer any other short‐term or long‐term benefits.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Aspirin, steroid and non‐steroidal anti‐inflammatory drugs use for treating Alzheimer's disease

Inflammation may play an important role in the development of Alzheimer’s disease. There is also some evidence from community surveys that people receiving anti‐inflammatory drugs for various medical conditions may be less likely to develop Alzheimer's disease. Fourteen studies met our inclusion criteria for this review and none of the exclusion criteria. Aspirin, steroid and non‐steroidal anti‐inflammatory drugs (NSAIDs) (traditional and the selective cyclooxygenase‐2 (COX‐2) inhibitors) showed no significant benefit in the treatment of Alzheimer's disease. Therefore, the use of these drugs cannot be recommended for the treatment of Alzheimer's disease.         

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Combinations of tocolytic drugs for inhibiting preterm labour

Preterm birth (birth before 37 weeks) is the single largest cause of deaths and ill health for newborn babies and a major cause of complications for pregnant women. Tocolytic agents include a wide range of drugs that can slow or stop labour contractions so as to prolong pregnancy and potentially improve the health outcomes for the baby. Using a combination of two or more tocolytic drugs may improve the length of time the pregnancy is prolonged over using a single tocolytic drug or no intervention, without adversely affecting the mother or baby or worsening drug side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Interventions to treat erythema nodosum leprosum, a complication of leprosy

Leprosy remains a public health issue in poorer parts of the world. In 2007 there were approximately 255,000 new cases reported worldwide. Leprosy (or Hansen's disease) is a chronic infectious disease. The skin and peripheral nerves of people with leprosy contain leprosy bacteria. Leprosy can be cured with a combination of antibiotics. The immune system plays an important role in leprosy and determines if and how the disease will develop. The response of the immune system to the antigens of the leprosy bacteria may cause periods of inflammation in the skin and nerves, called reactions. Reactions are the main cause of acute nerve damage and disability in leprosy and occur in about one third of people with leprosy. One type of reaction is erythema nodosum leprosum (ENL), a serious and often chronic complication of leprosy caused by the immune system. People with ENL have red, painful swellings in the skin and often feel ill due to fever and general malaise. There are several treatments for ENL, including the oral drugs prednisolone, thalidomide, and clofazimine. We undertook a systematic review on this topic as it was not clear which treatments were most beneficial.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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