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Indication & Dosage |
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| Oral |
| CHRONIC MUSCULOSKELETAL AND JOINT DISORDERS |
| Adult:
Initially, 25 mg bid-tid, increased if necessary by 25-50 mg daily at wkly intervals to 150-200 mg daily. |
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| Oral |
| ACUTE GOUT |
| Adult:
150-200 mg daily in divided doses until signs and symptoms disappear. |
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| Oral |
| MILD TO MODERATE PAIN IN PATIENTS WITH DYSMENORRHOEA |
| Adult:
75 mg daily. |
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| Oral |
| ALLEVIATION OF NIGHT PAIN AND MORNING STIFFNESS |
| Adult:
Up to 100 mg/day, on retiring. May also be given as rectal suppository. Total combined oral and rectal doses should not exceed 200 mg/day. |
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| Oral |
| JUVENILE RHEUMATOID ARTHRITIS |
| Adult:
2-14 yr: start with 1-2 mg/kg/day in divided doses. Max: 3 mg/kg/day or 150-200 mg/day, whichever is lower. |
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| Intravenous |
| CLOSURE OF PATENT DUCTUS ARTERIOSUS |
| Adult:
Given as 3 IV doses at 12-24 hr intervals. First dose: start with 0.2 mg/kg. Second and third doses (based on neonatal age at first dose): if <48 hr old, use 0.1 mg/kg/dose; if 2-7 days old, use 0.2 mg/kg/dose; if >7 days old, use 0.25 mg/kg/dose. Withhold treatment if urine output is <0.6 ml/kg/hr. Infuse each dose over 20-30 min. Second course of 1-3 doses may be repeated if ductus arteriosus remains open or re-opens 48 hr after the first course. Surgery may be required if neonate is unreponsive to 2 courses of treatment. |
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| Ophthalmic |
| PREVENTION OF MIOSIS DURING CATARACT SURGERY |
| Adult:
As 0.5 or 1% solution: Instill 2 drops, repeat 2 hr later on the day before surgery, followed by 2 drops 3 hr before and 2 drops 1 hr before procedure. May instill up to 6 times/day post-operatively to prevent cystoid macular oedema, continue treatment until inflammatory signs have resolved |
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| Administration |
Should be taken with food. |
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| Precautions |
Hypertension; congestive heart failure; fluid retention; epilepsy, parkinsonism, psychiatric disorders; may affect performance of skilled tasks. Prolonged treatment duration may increase risk of CV thrombotic events. Monitor ophthalmologic, blood, electrolytes and renal function regularly; lactation. |
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Potentially Life-threatening
Adverse Drug Reactions |
GI upsets, headache, dizziness, tinnitus, lightheadedness, depression, insomnia, psychiatric disturbances, peripheral neuropathy, blurred vision, confusion; hyperglycaemia, hyperkalaemia. |
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| Adverse Drug Reactions |
Renal failure. |
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| Interactions |
ncreased risk of hyperkalaemia when used with ACE inhibitors or potassium sparing diuretics; increased risk of nephrotoxicity with ACE inhibitors, ciclosporin and tacrolimus; increased risk of bleeding with warfarin and other NSAIDs. Concurrent use may increase plasma concentration of digoxin, lithium and metrotrexate. Concurrent use with probenecid may cause indometacin toxicity. Aluminum- or magnesium-containing antacids may delay absorption. |
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