Indomethacin is a non-steroidal anti-inflammatory indole derivative designated chemically as 1- (4-chlorobenzoyl)-5-methoxy-2-methyl-1 -indole-3-acetic acid
Contraindicated last trimester of pregnancy NSAIDs should be avoided at 20 weeks gestation and later AU TGA pregnancy category: C US FDA pregnancy category: Not assigned Risk Summary: Nonsteroidal anti-inflammatory drugs (NSAIDs) use in pregnant women at 30 weeks gestation and later may cause
It is used as an antipyretic, anti-inflammatory, and
Because of the low levels of indomethacin in breastmilk and therapeutic administration directly to infants, it is acceptable to use in nursing mothers
g
AUC 0-6h of indomethacin is approximately 14, 24 and 32% lower, consistent with 18, 34 and 52% higher clearance in the first, second and third trimesters of pregnancy
The estimated infant dose of indomethacin from breast milk was less than 30 mcg/day or 4
Use of nonsteroidal anti-inflammatory analgesic medications may be required and indomethacin (25 mg–50 mg by mouth every 6 hours for up to 48 hours) is a
Indomethacin, a prostaglandin synthetase inhibitor, is considered as a first-line tocolytic agent, beside magnesium sulfate, for the management of preterm labor [ 3 ]
The mean cord/maternal ratio was 4
It should be suspected clinically when uterine size is large for gestational age (fundal height [cm] that exceeds the weeks of gestation by >3)
9 +/- 1
Fibroid-related pain occurs in 5-15% of patients, and is usually well controlled with indomethacin (Indocin)
1% of fibroids decreased in size (mean decrease in volume 35%) while 44
1 mg/kg/dose intravenously every 24 hours for a total of 6 doses
7 percent (or, in other words, a one in 333 54
Maternal side effects (hypotension (n=8) and tachycardia (n=7) requiring a drug change developed in 15 (6
1967;126:467-469
In published studies in pregnant mice, indomethacin produced maternal toxicity and death, increased fetal resorptions, and fetal malformations at 0
4% of the combination-therapy patients compared to 72
Pregnancy Considerations: It is former FDA pregnancy category C medicine, and its use should be avoided
These side effects included exaggerated hypertensive responses in patients treated concomitantly with beta-blockers, gastric erosion and bleeding, fever, interstitial nephritis and postpartum hemorrhage
The prophylactic use of low doses of indomethacin, when initiated in the first 24 h of life in low birth weight infants who receive prophylactic surfactant in the delivery room, decreases the incidence of left-to-right shunting at the level of the ductus arteriosus
5% of the maternal weight-adjusted dosage or about 3% of the neonatal dose for treatment of patent ductus arteriosus
Patients in our center are not eligible to receive prophylactic indomethacin if Highlights The LC–MS quantitative method of indomethacin was developed and validated in human maternal plasma and urine samples
The median time for the administration of the first prophylactic dose of indomethacin was 3
Maternal characteristics and delivery room events are summarized in Table 1
Results: The treatment was started at a gestational age of 31