Indocin (Indomethacin) Side Effects

Indomethacin is a prescription non-steroidal anti-inflammatory drug (NSAID) known by its brand name, Indocin. While this medication is not a cure, it helps relieve pain caused by arthritis, gout, tendonitis, and bursitis. It also helps reduce inflammation, swelling, and stiffness. 

Indomethacin is available as both an immediate release capsule, an extended-release capsule, a suppository, or a liquid.

When taking any medication, whether over-the-counter or prescription, there is a risk for side effects. Not everyone will experience side effects, but those who do will most commonly experience side effects when starting a new medication, stopping a long-term medication, or when the dose is changed.

Female health care provider holding an orange medicine container while explaining the prescription to a male patient.
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Common Side Effects

If you are experiencing a side effect of this medication, please call the health care provider who prescribed the medication. Depending on the severity of the side effect, you may need a simple dose adjustment or switch to another medication. 

The most common side effect reported are headaches, followed by: 

  • Dizziness
  • Indigestion
  • Vomiting
  • Diarrhea
  • Decreased appetite
  • Upper abdominal pain
  • Hyponatremia 
  • Constipation
  • Rectal irritation
  • Always feeling the need to empty your bowels
  • Ringing or unexplained noise in one or both ears
  • Feeling discouraged, sad, or empty

Serious Side Effects

While any side effect can feel serious when you are experiencing one, a serious side effect is classified by the potential to become life-threatening, lead to hospitalization, disability, or create permanent damage. 

If you feel you are experiencing a serious side effect, don't hesitate to check in with your pharmacist or prescribing health care provider. If you are experiencing life-threatening symptoms, call 911 immediately.

Some of the more serious side effects of indomethacin are:

  • Unexplained weight gain
  • Shortness of breath
  • Tightness in chest
  • Difficulty breathing or swallowing
  • Noisy, rattling breathing
  • Swelling in the abdomen, ankles, feet, hands, or legs
  • Swelling of the face, tongue, lips, throat, or eyes
  • Numbness in hands, feet, or lips
  • Fever
  • Blisters
  • Rash
  • Hives
  • Intense itching
  • Hoarse throat
  • Pale skin
  • Fast heartbeat
  • Excessive fatigue
  • Lack of energy
  • Unusual bleeding or bruising
  • Stomach pain
  • Nausea
  • Double vision
  • Loss of bladder control
  • Difficulty urinating
  • Fainting

Symptoms of an Overdose

The following symptoms indicate a potential overdose. It is essential to call 911 and get help immediately if you are experiencing these symptoms.

  • Confusion about who you are, where you are, or the date and time
  • Severe headache, possibly the worse headache you've ever experienced
  • An unusually strong feeling of sluggishness or drowsiness

Warnings

Black Box Warning

Indomethacin does come with a black box warning. The black box warning is the most severe level of warnings issued by the FDA. This warning alerts both patients and health care providers of any serious risks associated with taking the medication.

The FDA issued a black box warning on potential problems with the stomach and an increased heart risk with indomethacin. All NSAIDs, including indomethacin, run a risk of creating problems in the stomach, specifically with an increased risk of bleeding or developing an ulcer. In some cases, these side effects can be fatal.

NSAIDs like indomethacin are also known to increase heart attack risk, heart failure, or stroke. Factors such as how long you take the medication, the dose you take, or a history of heart issues may increase your risk.

Interactions

With any medication, vitamin, or supplement, there is a risk of interactions. Like side effects, they can range anywhere from mild to severe or life-threatening. It is essential you speak with your health care provider or pharmacist about any medication, vitamin, or supplement you take so they can prescribe a medication least likely to cause an interaction.

The best way to take Indocin is with food. Taking an NSAID with food reduces the risk of nausea, bleeding in the gastrointestinal system, and ulcers.

A few known interactions when taking indomethacin:

  • Other NSAID Medications: Taking another NSAID such as ibuprofen, naproxen, or aspirin can be dangerous while taking Indocin. Taking two medications from the same category increases your chance of an overdose as well as other side effects.
  • Alcohol: Drinking alcohol while taking an NSAID such as indomethacin increases your risk for side effects—specifically bleeding in your stomach and intestines.
  • Age: If you are older than 65 years of age, talk to your doctor or pharmacist about the risks of taking this medication. In most cases, there is a similar but safer medicine to use in place of Indocin.
  • Asthma: If you have asthma, primarily if you are known to have aspirin-sensitive asthma, you should inform your doctor before taking Indocin. Taking this medication may cause a fatal reaction.
  • Heart Conditions: If you have a history of heart problems or high blood pressure, indomethacin might not be the right medication for you. This medication is known to increase the risk of heart attack and stroke. It may also raise your blood pressure to a dangerous level.
  • Gastrointestinal Issues: If you have a history of stomach ulcers or bleeding anywhere in the GI tract, there is an increased risk for new or worsening ulcers, swelling, and bleeding in the gastrointestinal system.
  • Rectal Irritation: If you have a history of rectal irritation or rectal bleeding, inform your health care provider—especially if you intend to take indomethacin in suppository form. 
  • Kidney Problems: This medication can cause your kidneys to work harder. If your kidneys work too hard, they may become damaged or have difficulty getting enough blood flow. If you experience any swelling in your feet or ankles, shortness of breath, or change in urine, contact your health care provider.
  • Pregnancy: This medication is not safe for pregnant women since it can affect the baby's heart's development.

A Word From Verywell

Talk to your doctor about any side effects you may be experiencing. If these side effects are bothersome, you may be able to try another medication that is less likely to cause you problems. Call your pharmacist or health care provider if you notice any unusual problems while taking Indocin.

At Verywell, our goal is to provide you with accurate and relevant information. However, there is no guarantee all complications and interactions are listed. Always take time to speak with your health care provider about possible interactions or concerns about taking any medication.

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Article Sources
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  1. MedlinePlus. Indomethacin. Updated November 15, 2020.

  2. Food and Drug Administration. Highlights of prescribing information for Indocin. Updated March 2019.

  3. Goldstein JL, Cryer B. Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategiesDrug Healthc Patient Saf. 2015;7:31-41. doi:10.2147/DHPS.S71976