Indocid
In brief
- Indocid (indometacin) is a prescription-only medicine in the UK.
- Indocid (indomethacin) is used for inflammatory conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute gouty arthritis and short-term pain relief; it is a non‑steroidal anti‑inflammatory drug (NSAID) that non‑selectively inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis and thereby inflammation, pain and fever.
- Usual adult dosages: osteoarthritis/RA/ankylosing spondylitis 25 mg two to three times daily, titrating as tolerated up to a maximum of about 200 mg/day; acute gout typically 50 mg three times daily until relief; for pain 25–50 mg two to three times daily—adjust only under physician guidance.
- Available forms include capsules (25 mg, 50 mg), sustained-release capsules (75 mg) and rectal suppositories (100 mg).
- Onset of effect is typically within 30–60 minutes for oral forms; in acute gout pain reduction is often noticeable within 2–4 hours with substantial improvement over 3–5 days.
- Duration of action for immediate‑release formulations is usually around 4–6 hours (plasma half‑life ~4–5 hours); extended/sustained‑release preparations can provide effects over 12–24 hours depending on formulation.
- Avoid or limit alcohol while taking Indocid because alcohol increases the risk of gastrointestinal irritation, bleeding and potential liver toxicity when combined with NSAIDs.
- The most common side effect is gastrointestinal upset (nausea, heartburn, abdominal pain); other frequent reactions include headache, dizziness and occasionally more serious effects such as GI bleeding, renal impairment or elevated liver enzymes.
- Would you like to try Indocid without a prescription?
Legal status and availability in the UK
Indocid is a prescription-only medicine (POM) in the UK.
In our online pharmacy, Indocid is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.
Basic Indocid information
- INN (international nonproprietary name): Indometacin
- Brand names available in the United Kingdom: Indocid, generic indometacin
- ATC code: M01AB01
- Forms and dosages: Capsules 25 mg and 50 mg, sustained-release capsules 75 mg, suppositories 100 mg
- Manufacturers in the United Kingdom: Merck Sharp & Dohme, Sandoz, Sun Pharma, Apotex and other generic manufacturers
- Registration status in the United Kingdom: Prescription-only medicine (POM)
- OTC / Rx classification: Prescription-only medicine (POM)
What Indocid is used for
Indocid (indometacin) is a non-steroidal anti-inflammatory drug (NSAID) that non-selectively inhibits cyclo-oxygenase (COX) enzymes, reducing prostaglandin synthesis and therefore inflammation, pain and fever.
Osteoarthritis, rheumatoid arthritis and ankylosing spondylitis are among the chronic inflammatory conditions treated with indometacin. Acute gouty arthritis is a key short-term indication, where it is commonly prescribed for rapid relief of pain and swelling.
Frequent patient concerns include stomach upset, sleepiness and potential interactions with medicines for blood pressure or mood.
Available forms
| Form | Strengths | Counselling point |
|---|---|---|
| Capsules | 25 mg, 50 mg | Swallow whole with food to reduce GI upset. |
| Sustained-release capsules | 75 mg | Swallow whole; do not crush or open. |
| Suppositories | 100 mg | Insert rectally; useful if oral medicines cannot be tolerated. |
Store below 30°C. Suppositories should be protected from temperatures above 40°C to avoid melting.
Dosing
Typical dosing for chronic inflammatory disease starts at 25 mg two to three times daily and may be increased by 25-50 mg as tolerated, with a usual maximum of 200 mg per day.
For acute gout, a common regimen is 50 mg three times daily until the flare settles, with short-term use only and a maximum of 200 mg per day.
Pain and inflammation from injury are treated with 25-50 mg two to three times daily, adjusted by the prescriber.
| Indication | Usual adult dose | Max dose |
|---|---|---|
| Osteoarthritis / rheumatoid arthritis / ankylosing spondylitis | 25 mg two to three times daily; increase as tolerated | Up to 200 mg/day |
| Acute gouty arthritis | 50 mg three times daily until relief | Up to 200 mg/day (short-term) |
| Pain / inflammation | 25-50 mg two to three times daily | As directed by the prescriber |
How to take Indocid
- Take oral indometacin with or immediately after food to reduce the risk of stomach upset, unless the prescriber directs otherwise.
- Swallow capsules whole; do not crush sustained-release capsules.
- For suppositories, wash hands, lie on your side, gently insert the suppository into the rectum and remain lying down for a few minutes to avoid expulsion.
- If a dose is missed, take it as soon as remembered unless it is close to the next dose; do not double up.
In an overdose, seek immediate medical care (NHS 111, or 999 in an emergency).
Special populations
Elderly patients should start at the lower end of the dosing range and be monitored closely for gastrointestinal bleeding, renal decline, hypertension and fluid retention.
Paediatric use is not routine and should be managed only under specialist care.
Pregnancy and breastfeeding: indometacin is generally avoided, particularly in the third trimester because of the risk of premature closure of the ductus arteriosus.
Patients with liver or kidney impairment often require dose reduction or avoidance in advanced disease because of the risk of accumulation and toxicity. Renal function, liver function tests and blood pressure should be monitored in high-risk patients and those on long-term therapy.
Contraindications
Absolute contraindications
- Hypersensitivity to indometacin or other NSAIDs.
- Active gastrointestinal bleeding or peptic ulcer disease.
- Severe hepatic, renal or cardiac insufficiency.
- Aspirin/NSAID-induced asthma, urticaria or allergic-type reactions.
Relative contraindications and monitoring
- Hypertension, fluid retention and congestive heart failure.
- Bleeding disorders or concurrent anticoagulant therapy.
- Concomitant lithium, methotrexate, certain antihypertensives and diuretics.
- History of peptic ulcer disease, or older age with higher GI risk.
Side effects
Common mild effects include gastrointestinal upset, nausea, vomiting, dizziness, headache and heartburn, which are often dose-dependent and may improve with food.
Moderate-to-serious reactions include gastrointestinal bleeding or ulceration, hepatitis, worsening hypertension, renal impairment, oedema and severe skin reactions.
| Frequency | Effect | What to do |
|---|---|---|
| Common | GI upset, nausea, headache, dizziness | Take with food; seek advice if persistent. |
| Uncommon/serious | GI bleeding, hepatitis, renal impairment | Seek urgent medical review for black stools, severe abdominal pain or jaundice. |
| Occasional | Hypertension, oedema | Blood pressure and weight should be monitored; tell your prescriber. |
Use the lowest effective dose for the shortest possible duration; a PPI for gastroprotection may be considered for patients at increased GI risk.
Drug interactions
Anticoagulants and antiplatelet agents increase the risk of bleeding when combined with indometacin.
ACE inhibitors, ARBs and diuretics may have reduced antihypertensive effect, and the combination increases the risk of renal impairment.
Lithium and methotrexate concentrations can rise when used with NSAIDs and should prompt monitoring of drug levels.
Concurrent SSRI or SNRI use can increase bleeding risk.
Indocid compared with other NSAIDs
Indometacin is recognised for particular efficacy in acute gout flares, often producing meaningful pain reduction within 2-4 hours and resolution in 3-5 days when used appropriately.
For chronic osteoarthritis or rheumatoid disease, gastrointestinal, cardiovascular and renal risk should be weighed when choosing between indometacin, diclofenac, naproxen or COX-2 selective agents such as celecoxib. Patients with high GI risk may benefit from a COX-2 selective option plus gastroprotection, depending on cardiovascular profile.
Counselling points
Take with food and avoid alcohol to reduce GI upset and bleeding risk. Use a short course for gout and have chronic therapy reviewed regularly.
Stop and seek urgent medical attention for black stools, severe abdominal pain, jaundice or breathlessness.
Delivery across the United Kingdom
| City | Region | Delivery time |
|---|---|---|
| London | England | 9–21 days |
| Birmingham | England | 9–21 days |
| Manchester | England | 9–21 days |
| Glasgow | Scotland | 9–21 days |
| Leeds | England | 9–21 days |
| Sheffield | England | 9–21 days |
| Liverpool | England | 9–21 days |
| Newcastle Upon Tyne | England | 9–21 days |
| Bristol | England | 9–21 days |
| Nottingham | England | 9–21 days |
| Belfast | Northern Ireland | 9–21 days |
| Cardiff | Wales | 9–21 days |
| Edinburgh | Scotland | 9–21 days |
| Swansea | Wales | 9–21 days |
| Leicester | England | 9–21 days |
