Side-effects of indomethacin.

Boardman, Philip; Hart, F. Dudley

doi:10.1136/ard.26.2.127

Cited by 116 publications

(29 citation statements)

References 14 publications

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“…The side effects of indomethacin that have been common in patients on longer-term therapy, headache, awkwardness, and gastrointestinal distress, for example,31 37 did not occur in this study. Also not encountered in the present study, but a potential complication of indomethacin therapy in postoperative patients and one that we have occasionally encountered in clinical practice, was the masking of an underlying infectious cause of fever.…”

Section: Discussionmentioning

confidence: 72%

Unexplained in-hospital fever following cardiac surgery. Natural history, relationship to postpericardiotomy syndrome, and a prospective study of therapy with indomethacin versus placebo.

Livelli¹,

Johnson²,

McEnany³

et al. 1978

Circulation

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In Part I of this study, the in-hospital course of 219 patients who had undergone a cardiac operation is analyzed. Fever (greater than or equal to 37.8 degrees C, rectal) was present after postoperative day 6 in 159 patients (73%) and was of unexplained cause in 118. Fever decay in the population of unexplained fever patients was exponential. All patients with unexplained postoperative fever were afebrile by postoperative day 19. In-hospital pericardial rub and pleuritic chest pain, widening of the mediastinum on chest film, and pleural effusion were not specifically associated with unexplained postoperative fever. In Part II, 67 patients with unexplained postoperative fever were given indomethacin (100 mg per day) or placebo for 7 days by a randomized, double-blind protocol. Indomethacin resulted in a shorter duration of fever (2.4 vs 3.5 days, P is less than 0.01) and in a shorter duration of chest pain, malaise, and myalgias compared to placebo. Sixty-seven percent of the patients in Part I and all of the patients in Part II were contacted 2-8 months following hospital discharge. Five percent had experienced an illness that we considered to be acute pericarditis, but its occurrence was unrelated to whether the patient had had in-hospital unexplained postoperative fever, in-hospital rub or chest pain, or in-hospital administration of indomethacin.

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Section: Discussionmentioning

confidence: 72%

Unexplained in-hospital fever following cardiac surgery. Natural history, relationship to postpericardiotomy syndrome, and a prospective study of therapy with indomethacin versus placebo.

Livelli¹,

Johnson²,

McEnany³

et al. 1978

Circulation

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“…However, doses of indomethacin necessary to accomplish this result are large, ranging upward from 200 mg/day, for 5 or 6 days (lo), and in our experience produce very frequent central nervous system and gastrointestinal side effects. Boardman and Hart (11) noted that more than 60% of their patients on relatively high doses of indomethacin (mean of 2.9 mg/ kg/day) had side effects, and of these, more than two-thirds had toxic effects within 48 hours after instituting therapy. Our results are similar.…”

Section: Lndomethacinmentioning

confidence: 99%

The treatment of gout

Wallace

1972

Arthritis & Rheumatism

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Gout is usually the most treatable of the arthritides. Acute attacks, if caught early enough, can 'be eradicated rapidly and completely. Recurrences can be prevented, and tophi dissolved. The drugs capable of producing these effects are well known. The purpose of this brief review of the therapy of gout is to consider both the basic principles of treatment and some of the newer aspects of the clinical pharmacology of these agents.Traditionally, the treatment of gout is divided into three parts: a) control of the acute episode, b) prevention of subsequent attacks, and c) dissolution of tophaceous deposits by reducing the serum urate level to normal. This subdivision of therapy is still conceptually valid.

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“…Although Indo is a widely used non-steroidal anti-inflammatory drug, this is the first time oral Indo has been used continuously before, during and after periodic IL-2 therapy to treat human cancer. However, Indo has several known side effects in humans such as skin rashes, confusion, tinitis, gastric ulceration and bleeding [36]. In the recent clinical trial, some patients had an adverse sensitivity to Indo, thus reducing their capacity to tolerate the optimal or escalated doses needed to achieve effective inhibition of prostaglandin synthesis [32,33].…”

Section: Discussionmentioning

confidence: 99%

Immunotherapy of mammary adenocarcinoma metastases in C3H/HeN mice with chronic administration of cyclo-oxygenase inhibitors alone or in combination with IL-2

et al. 1992

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In this study the efficacy of treatment of two cyclo-oxygenase inhibitors, ibuprofen (Ibu) and indomethacin (Indo), are compared in the immunotherapy of metastasis designed to reverse prostaglandin E2 (PGE2)-mediated inactivation of interleukin-2 (IL-2)-dependent host killer cell lineages. These agents were tested either alone for the prevention of metastasis or in combination with IL-2 for the eradication of established metastasis. C3H/HeN mice were placed on chronic oral Ibu (CIbT; 200 and 600 micrograms/ml of water) or Indo (CIT; 10 micrograms/ml) 5 days after s.c. transplantation of 5 x 10(5) metastatic C3L5 mammary carcinoma for the prevention of spontaneous lung metastases. They showed intolerance to Indo at a dosage of 14 micrograms/ml, which was well tolerated by other mouse strains in previous studies, but tolerated the Ibu dosages used. Control and treated mice were killed on day 30 to score metastatic lung colonies, to evaluate killer activity in splenocytes against natural killer (NK)-sensitive YAC-1 lymphoma or NK-resistant C3L5 adenocarcinoma and 8911 lymphoma targets, and to phenotype the surface markers of killer cells. CIbT and CIT alone at the above dosage significantly reduced the number of lung colonies, retarded local tumor growth and restored NK activity of splenic killer cells expressing AGM-1+, Thy-1-, Lyt-2- phenotype. To treat established lung metastasis, mice bearing 15-day C3L5 transplants were given CIbT or CIT alone or in combination with two 4-day rounds (days 20-23, 31-34) of IL-2 (15,000 Cetus units, i.p. every 8 h) and were killed on day 35 to score lung colonies and characterize splenic killer cells. CIbT or CIT alone reduced the number of spontaneous lung metastases and restored anti-YAC-1 killer function of splenocytes with NK-like phenotype (AGM-1+, Thy-1-, Lyt-2-); some anti-C3L5 killer function was also generated in the high dose Ibu group and the killer cell showed AGM-1+, Thy-1+ and Lyt-2+ phenotype. Combined therapies with CIbT or CIT plus IL-2 were more effective in reducing metastases and promoting killer cell function, the best results being achieved with high dose Ibu+IL-2. All killer cells expressed AGM-1 and Thy-1. In addition, C3L5 killer cells also expressed Lyt-2, suggesting T-cell stimulation. PGE2 synthesis in the host was inhibited by at least 50% in mice subjected to CIbT or CIT.(ABSTRACT TRUNCATED AT 400 WORDS)

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Side-effects of indomethacin.

Cited by 116 publications

References 14 publications

Unexplained in-hospital fever following cardiac surgery. Natural history, relationship to postpericardiotomy syndrome, and a prospective study of therapy with indomethacin versus placebo.

Unexplained in-hospital fever following cardiac surgery. Natural history, relationship to postpericardiotomy syndrome, and a prospective study of therapy with indomethacin versus placebo.

The treatment of gout

Immunotherapy of mammary adenocarcinoma metastases in C3H/HeN mice with chronic administration of cyclo-oxygenase inhibitors alone or in combination with IL-2

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