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Indomethacin (Indocin) is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. However, its use comes with important safety warnings and potential risks. Please review the following information carefully and consult your healthcare provider if you have any concerns.

• Cardiovascular Risks: Indomethacin may increase the risk of heart attack, stroke, and blood clots, particularly with long-term use or in individuals with pre-existing heart conditions. Do not use indomethacin immediately before or after heart bypass surgery. If you experience symptoms such as chest pain, shortness of breath, weakness on one side of the body, or difficulty speaking, seek emergency medical assistance.

• Gastrointestinal Bleeding: The drug can cause serious and potentially fatal stomach or intestinal bleeding and ulcers. This risk is heightened in older adults, those with a history of stomach issues, or individuals who consume alcohol or smoke. Seek immediate medical attention if you notice persistent stomach pain, black or bloody stools, or vomit resembling coffee grounds.

• Blood Pressure and Heart Failure: Indomethacin may elevate blood pressure and increase the risk of heart failure due to fluid retention. If you have a history of heart problems or are taking blood pressure medication, discuss the safety of this drug with your healthcare provider.

• Liver Concerns: Although rare, indomethacin can cause severe liver damage. Be vigilant for symptoms such as stomach swelling, abdominal pain, yellowing of the skin or eyes, changes in stool color, nausea, vomiting, confusion, or dark urine. Promptly seek medical evaluation if these occur.

• Kidney Function and Electrolyte Imbalance: Indomethacin may impair kidney function and elevate potassium levels, especially when used with certain blood pressure medications. If you have kidney issues, heart failure, or liver problems, discuss the risks with your healthcare provider. Notify them if you experience changes in urination frequency.

• Allergic Reactions: Severe allergic reactions, including anaphylaxis, can occur. If you have a known allergy to aspirin or other NSAIDs, inform your provider. Seek immediate medical help if you develop hives, rash, swelling, or breathing difficulties.

• Respiratory Risks: Indomethacin may induce severe asthma attacks in susceptible individuals. Avoid use if you have a history of asthma triggered by NSAIDs or aspirin. Seek urgent care if you experience throat tightness or breathing difficulties.

• Nervous System and Mental Health: The medication may exacerbate neurological or mental health conditions, such as epilepsy or depression. Report any changes in mental health, seizures, or worsening of neurological symptoms to your provider.

• Pregnancy Risks: Indomethacin can harm an unborn baby, particularly during the latter half of pregnancy. If you are pregnant or planning to become pregnant, discuss alternative treatments with your healthcare provider.

Contraindications: Do not use indomethacin if you have a history of asthma, hives, or allergic reactions to NSAIDs, or if you have recently undergone coronary artery bypass graft surgery (CABG).

For any uncertainties or concerns, always consult your healthcare provider to ensure safe use of indomethacin.

Common side effects:

• Headaches
• Nausea
• Upset stomach
• Dizziness
• Diarrhea
• Constipation
• Stomach pain
• Sleepiness

Less common but important to monitor:

• Increased blood pressure

Serious side effects:

• Hearing changes (ringing in the ears)
• Mental or mood changes (confusion or hallucinations)
• Difficulty swallowing
• Swelling of the ankles or feet
• Unusual tiredness
• Sudden weight gain
• Severe liver disease
• Persistent nausea or vomiting
• Loss of appetite
• Dark urine
• Severe stomach pain
• Yellowing of the eyes or skin
• Serious kidney issues
• Decreased urine output
• Muscle cramps
• Very serious allergic reaction
• Fever
• Swollen lymph nodes
• Rash
• Severe dizziness
• Trouble breathing
• Serious skin reactions (skin reddening, peeling, or blisters)

Interactions with high risk of serious adverse effects and should be avoided:

• Ketorolac

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Abciximab
• Acenocoumarol
• Amiloride
• Amitriptyline
• Citalopram
• Prednisone
• Dexamethasone
• Warfarin
• Enoxaparin
• Furosemide
• Hydrochlorothiazide
• Clopidogrel
• Dabigatran
• Ibuprofen
• Aspirin