|Reviewed by Dr David Knight|
Indomethacin, an indole derivative, is one of the most potent inhibitors of the cyclo-oxygenase pathway. Inhibits the action of prostaglandin synthetase, and thus inhibits the synthesis of the prostaglandin E series. Indomethacin is a potent vasoconstrictor and decreases cerebral, gastrointestinal, and renal blood flow.
Very variable absorption from gastrointestinal tract (10-90%). Indomethacin solutions very susceptible to chemical decomposition. High binding (95%) to human plasma protein. No displacement of bilirubin from albumin at usual therapeutic levels. Hepatic metabolism, elimination via biliary tract and kidneys. Elimination half-life is approximately 30 hours (range 15-50 hours). Individual differences in rate of distribution, drug metabolism, rate of renal and biliary excretion, and re-entry of drug into the circulation by enterohepatic recirculation all contribute to the variability in plasma clearance.