What Is the Difference Between Indocin (Indomethacin) and Ibuprofen?

Indocin and ibuprofen both provide relief from pain caused by arthritis

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Arthritis is a disease that causes inflammation in the joints, which can lead to pain, stiffness, and swelling. About 23% of adults in the United States have some form of arthritis.

That leaves many people searching for the best pain relief for arthritis. Unfortunately, there’s no way to completely eliminate the pain from arthritis. However, using non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain from arthritis by about 30%—the same amount of pain relief that people with arthritis get from opioids.

Indocin and ibuprofen are two common NSAIDs that can be used to treat arthritis. Indocin is a brand name of the prescription NSAID indomethacin. Ibuprofen is an NSAID that is sold over the counter (OTC) under many brand names, including Advil and Motrin. It can also be prescribed, usually at a higher dose or in combination with other medications. 

Although both Indocin and ibuprofen are used to treat arthritis, there are some differences and precautions to be aware of. Here’s what you should know about using these NSAIDs to treat arthritis. 

woman taking pills for arthritis pain

Grace Cary / Getty Images

How Indocin and Ibuprofen Are Similar

Indocin and ibuprofen are both used to treat arthritis. They reduce inflammation and swelling and also help control pain.

NSAIDs like Indocin and ibuprofen are both recommended by the American Academy of Family Physicians (AAFP) for the treatment of moderate to severe arthritis. For people with mild arthritis symptoms, the AAFP recommends beginning treatment with acetaminophen, sold under the brand name Tylenol.  

Since Indocin and ibuprofen are both NSAIDs, they share many of the same side effects, including an increased risk for stroke and internal bleeding.

How Indocin and Ibuprofen Are Different

One of the primary differences is how widely available Indocin and ibuprofen are. While anyone can purchase and take ibuprofen, your practitioner will need to write you a prescription for Indocin. Your healthcare provider may also recommend a high dose of ibuprofen—more than 400 mg—which is available by prescription only. 

Another major difference is in how often the medications have to be taken. Indocin is a long-acting medication that only needs to be taken once or twice per day. Many people like the convenience of only needing to remember one pill. 

Ibuprofen, on the other hand, has to be taken three to four times per day, and your dose might involve multiple pills. However, some people like using an OTC medication to manage occasional flare-ups, without committing to taking a prescription medication daily. 

While both Indocin and ibuprofen are used to treat osteoarthritis—the most common type of arthritis—Indocin can also be used to treat gout, a form of arthritis characterized by acute episodes of intense swelling and pain in one or a few joints.

Lifestyle Modifications When Taking NSAIDs

Each medication also has some lifestyle effects that you should discuss with your practitioner. For example, you shouldn’t drink alcohol if you’re taking Indocin. In addition, people who are older than 75 should talk to their healthcare provider before taking Indocin.

Which Is Better for Arthritis Pain? 

Indocin and ibuprofen provide similar pain relief when used in arthritis patients. A study that compared the drugs found that they were similarly effective, but patients preferred Indocin, although the study authors did not say why. However, patients on Indocin had a slightly higher risk of stomach bleeding, a possible side effect of both medications. 

When you’re considering whether to use Indocin or ibuprofen, it’s best to consider your lifestyle and talk with your healthcare provider about which medication would be best for you. Think about whether you’d like to take just one medication a day, or whether you’d rather not have to be on prescriptions. 

Difference in Cost

Depending on whether you are insured or not, the cost of the medication may also factor into your decision. For the uninsured, or if your insurance charges you a co-pay for prescription drugs, ibuprofen may be the cheaper treatment option, since it is an OTC medication. Without insurance, generic indomethacin is roughly four times more expensive than ibuprofen per dose.

Is It Safe to Take Indocin and Ibuprofen? 

Indocin and ibuprofen are both considered safe medications. However, there are certain things to be aware of. It’s important that you never take Indocin and ibuprofen together, unless you have specifically been told to do so by a medical professional. Taking more than on NSAID medication at a time can increase your risk of complications from NSAIDS. 

NSAID Warnings

Before you start taking Indocin or ibuprofen to treat your arthritis, you should familiarize yourself with the risks of taking NSAIDs. This class of medications is widely used, but it also has some potentially very serious side effects. 

People in the following categories should speak with their healthcare provider before using NSAIDs.

  • People with a history of cardiovascular disease. NSAIDs can increase the risk for heart attack and stroke, so people who have a history of cardiovascular disease, or who are at increased risk for heart attack or stroke, should speak with a health care professional before using NSAIDs. People who smoke, have diabetes, or who have a family history of heart attack or stroke should also speak with a medical professional before using NSAIDs. 
  • People with a history of ulcers or bleeding. NSAIDs can increase your risk of ulcers and stomach bleeding, so should be avoided by people who have experienced these conditions. 
  • Pregnant people. NSAIDs should not be used by people who are more than 20 weeks pregnant, since the medications have been linked to kidney and heart problems for the fetus. If you are pregnant, talk to your healthcare provider before using NSAIDs. 

Although people with a history of stomach bleeding are more likely to experience gastrointestinal bleeding while on NSAIDs, bleeding can happen to anyone. If you are on NSAIDs, you should be familiar with the signs of gastrointestinal bleeding. These include:

  • Nausea
  • Blood in the stool or vomit
  • Black, tarry stool

If you experience these symptoms, reach out to your healthcare provider immediately. 

A Word From Verywell

Arthritis can significantly impact your life, making it difficult to work, exercise, or enjoy your downtime. Lifestyle changes like staying active can help keep arthritis symptoms at bay, but if you are experiencing moderate arthritis pain, NSAID medications—including Indocin and ibuprofen—can both provide relief. 

Both medications are similarly effective and are generally well tolerated. Your healthcare provider can help you decide whether Indocin or ibuprofen is right for you. 

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Diseases Control and Prevention. Arthritis.

  2. Smith, R.S. Comparative pain reduction of oral non-steroidal anti-inflammatory drugs and opioids for knee osteoarthritis: systematic analytic review. Osteoarthritis and Cartilage. February 1, 2016. doi:10.1016/j.joca.2016.01.135

  3. MedlinePlus. Indocin.

  4. MedlinePlus. Ibuprofen.

  5. Sinusus, Keith. Osteoarthritis: diagnosis and treatment. American Academy of Family Physicians.

  6. McArthur, A.W. A comparative study of indomethacin and ibuprofen. Medical Journal of Australia.

  7. Food and Drug Administration. Highlights of prescribing information: Indocin.

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.