Side-effects of indomethacin.

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Abstract
Side effects in patients treated with indomethacin at 2 dosage levels are compared and the literature briefly reviewed. Side effects occurred in 37.1% of patients receiving a low dosage of 1.1 mg/kg/day in capsules. They occurred in 41-45% of cases of rheumatoid arthritis, ankylosing spondylitis, and gout, and in 25% of cases of osteo-arthrosis. The incidence of dyspepsia was 8%. The incidence of side effects had been 61.7% before the reduction from 2.9 mg/kg/day to the lower dosage. High dosage was associated with more severe, polysymptomatic reactions, headache being the dominant complaint. On low dosage, reactions frequently consisted of single, relatively mild symptoms the most usual complaint being giddiness. On the low dosage, over 75% of all reactions consisted of mild transient giddiness or muzziness. Side effects in this series were transient, resolving on reduction or withdrawal of the drug. Side effects were more common in patients with a history of previous intolerance, in particular dyspepsia, and more common in females than in males. Side effects were less common in osteoarthrosis than in rheumatoid arthritis, ankylosing spondylitis, and gout. This is probably because the frequency decreased with increasing age. There is little evidence of hepatic or renal toxicity in the literature and none of irreversible bone marrow depression, but indomethacin should be administered with great caution, if at all, to patients with a history of psychiatric illness, uremia, or recent peptic ulceration.