Indomethacin for the treatment of hemorrhoids

Treatment of hemorrhoids must be comprehensive, so it requires the use of several medications with different mechanisms of action. Proctologists often prescribe Indomethacin for hemorrhoids, since the action of the drug is aimed at stopping the inflammatory process, which helps eliminate the main symptoms of the disease. The drug is available in various pharmacological forms, making it a universal remedy for the treatment of both internal and external hemorrhoids. Indomethacin helps to quickly relieve pain, reduce swelling of damaged tissues and relieve a burning sensation in the rectum.

Nosological classification (ICD-10)

• H60 Otitis externa
• H66 Suppurative and unspecified otitis media
• H70 Mastoiditis and related conditions
• J01 Acute sinusitis
• J02.9 Acute pharyngitis, unspecified
• J03.9 Acute tonsillitis, unspecified (angina agranulocytic)
• J04 Acute laryngitis and tracheitis
• K08.8.0* Toothache
• M06.9 Rheumatoid arthritis, unspecified
• M08 Juvenile arthritis
• M10 Gout
• M13.8 Other specified arthritis
• M45 Ankylosing spondylitis
• M77.9 Enthesopathy, unspecified
• M79.0 Rheumatism, unspecified
• M79.2 Neuralgia and neuritis, unspecified
• N30 Cystitis
• N41 Inflammatory diseases of the prostate gland
• N70 Salpingitis and oophoritis
• N94.6 Dysmenorrhea, unspecified
• R51 Headache

Reviews

Ekaterina, 32 years old As prescribed by the proctologist, I started using Indomethacin suppositories 2 times a day for 10 days. I noticed improvements in my well-being after just 3 uses. At the end of the course, the pain, discomfort and burning sensation in the rectum went away. This is a good drug that I always use during an exacerbation of the disease.

Dmitry, 45 years old Completed a course of treatment with Indomethacin suppositories, after 10 days all symptoms of hemorrhoids disappeared. However, on the 5th day of treatment, I noticed discomfort in the abdomen and a slight headache, but did not stop administering the suppositories, since the result of their action exceeded the negative manifestations.

Mikhail, 29 years old I turned to the proctologist already at the second stage of hemorrhoids, since previously it had not caused me much discomfort. During the examination, the doctor discovered small anal fissures in me, for the treatment of which he prescribed Indomethacin ointment. I would like to note that I was pleased with the cost of the drug; it was inexpensive. After 2 effective uses of the ointment, not only the cracks healed, but also the pain and discomfort in the anal area decreased.

Composition and release form

Indomethacin 50 Berlin-Chemie

in a blister pack 5 pcs.; in a cardboard pack there are 2, 6 or 10 packs.

Indomethacin 100 Berlin-Chemie

in a blister pack 5 pcs.; in a cardboard pack there are 2, 6 or 10 packs.

Features of application

Treatment of hemorrhoids with the drug should be carried out according to the instructions for its use in combination with other antihemorrhoidal drugs.

Its effect on the site of inflammation depends on the pharmacological forms of Indomethacin:

• Capsules. Designed for rapid relief of inflammatory phenomena. They are covered with a shell that easily dissolves in the intestines. The capsules contain additional substances that enhance the effect of the drug. The patient needs to take capsules 3-4 times a day.
• Suppositories. They are recommended for use in the internal form of the disease, when the source of inflammation is localized directly in the rectum. Candles contain starch and solid fats and are produced in torpedo-shaped shape. The suppositories must be administered 2 times a day, in the morning and before bedtime.
• Ointment. Intended for external use when the inflammatory process is localized around the anus. Promotes rapid regeneration of anal fissures. For easy application of the ointment, it contains paraffin, dimexide, and wax. Apply the ointment with light movements 3 times a day.

The duration of use of the drug depends on the severity of the clinical picture, as well as the stage and severity of the disease.

Contraindications

Hypersensitivity, “aspirin asthma”, gastric and duodenal ulcers, ulcerative colitis, bleeding (intracranial, gastrointestinal), congenital heart defects (coarctation of the aorta, pulmonary atresia, tetralogy of Fallot), impaired color vision, cirrhosis of the liver with portal hypertension , diseases of the optic nerve, bronchial asthma, heart failure, edema, arterial hypertension, hemophilia, hypocoagulation, liver failure, chronic renal failure, hearing loss, vestibular apparatus pathology, glucose-6-phosphate dehydrogenase deficiency; blood diseases; proctitis, hemorrhoids; pregnancy, breastfeeding period, childhood and adolescence up to 18 years.

With caution - hyperbilirubinemia, thrombocytopenia, epilepsy, parkinsonism, depression, children and old age.

Who is the drug allowed or prohibited?

Indomethacin suppositories are intended for short-term treatment of acute or chronic pain syndrome that occurs against the background of inflammatory, degenerative processes in the musculoskeletal region:

• for osteoarthritis;
• bursitis;
• tendinitis;
• gouty or rheumatoid arthritis;
• ankylosing spondylitis.

The medicine is contraindicated in patients:

• with individual intolerance to the component composition;
• allergies to acetylsalicylic acid;
• ulcer or perforation of the gastrointestinal tract;
• bleeding in the digestive tract;
• failure of the liver, kidneys, heart;
• nasal polyps;
• proctitis, hemorrhoids.

Indomethacin suppositories are not prescribed to minors under 14 years of age, in the 3rd trimester of gestation and during breastfeeding.

Side effects

From the digestive system: NSAID gastropathy, abdominal pain, nausea, vomiting, heartburn, anorexia, diarrhea, liver dysfunction (increased blood bilirubin, liver transaminases). With long-term use in large doses, ulceration of the gastrointestinal mucosa occurs.

From the nervous system: headache, dizziness, insomnia, agitation, irritability, fatigue, drowsiness, depression, peripheral neuropathy.

From the senses: hearing loss, tinnitus, taste disturbance, diplopia, blurred vision, corneal clouding, conjunctivitis.

From the cardiovascular system: heart failure, tachyarrhythmia, increased blood pressure.

From the urinary system: impaired renal function, proteinuria, hematuria, interstitial nephritis, nephrotic syndrome, papillary necrosis.

From the hemostatic system: bleeding (gastrointestinal, gingival, uterine, hemorrhoidal), thrombocytopenia.

Allergic reactions: skin rash, itching, urticaria, Quincke's edema, bronchospasm; rarely - Lyell's syndrome, erythema nodosum, anaphylactic shock.

Laboratory indicators: agranulocytosis, leukopenia, hyperglycemia, glucosuria, hyperkalemia, aplastic anemia, autoimmune hemolytic anemia.

Other: aseptic meningitis (more often in patients with autoimmune diseases), increased sweating, edema syndrome.

Local reactions: burning, itching, heaviness in the anorectal area, exacerbation of hemorrhoids.

How to properly administer suppositories for hemorrhoids

To achieve a therapeutic effect from the action of suppositories, it is necessary to prepare the rectal canal. So that the active substance of the drug can be completely absorbed, it is recommended to do an enema, as well as carry out hygienic measures in the anus.

The procedure for inserting a suppository must be carried out in a lateral position

Indomethacin suppositories must be administered in the following order:

1. First remove the medicine from the refrigerator so that the candle warms up and softens.
2. Take a position on your side with your knees brought up to your stomach.
3. Using gentle movements, insert the suppository into the anal canal.
4. Lie down for 20–30 minutes to completely dissolve the candle.

If the administration of a suppository is indicated once a day, then it is better to place it before going to bed at night. This will help the active substance penetrate the rectal mucosa faster.

Thus, Indomethacin is an effective drug that quickly relieves the symptoms of hemorrhoids during an exacerbation. However, the medicine must be used as prescribed by the attending physician, as it has many contraindications and side effects.

Interaction

Reduces the effectiveness of uricosuric drugs, antihypertensive and diuretics (saluretics); enhances the effect of indirect anticoagulants, antiplatelet agents, fibrinolytics, side effects of mineralocorticosteroids, estrogens, and other NSAIDs; enhances the hypoglycemic effect of sulfonylurea derivatives.

Combined use with paracetamol increases the risk of nephrotoxic effects. Ethanol, colchicine, glucocorticosteroids - increase the risk of developing gastrointestinal complications accompanied by bleeding.

Increases the concentration of lithium, methotrexate and digoxin in the blood. Cyclosporine and gold preparations increase the nephrotoxicity of indomethacin. Cefamandole, cefoperazone, valproic acid - increase the risk of developing hypoprothrombinemia and the risk of bleeding. Reduces the elimination of penicillins. Potentiates the toxic effect of zidovudine.

Overdose symptoms

The abstract indicates that the rectal use of suppositories causes the appearance of non-standard symptoms in exceptional cases. Intoxication manifests itself:

• severe cephalalgia;
• dyspeptic disorders;
• disturbances of orientation in space and memory;
• loss of sensitivity;
• convulsive syndrome.

Help with overdose consists of supportive and restorative procedures. Hemodialysis is not performed.

Analogs

If non-standard symptoms develop during therapeutic procedures, it is recommended to replace the drug. A list of popular analogues of suppositories with indomethacin is presented:

• Adolor;
• Airtalom;
• Bioran;
• Voltaren;
• Diklakom;
• Dicloran;
• Diclofenac;
• Ibuprofen;
• Ketalgin;
• Ketanov;
• Ketorol;
• Nise;
• Naklofen;
• Ortofen;
• Piroxicam;
• Rapten.

These drugs are available in different forms, but all have a similar spectrum of action and belong to the NSAID subgroup. The replacement of the main medication is carried out by the attending physician, based on diagnostic data and the reasons for the forced discontinuation of suppositories with indomethacin.

Pharmacological properties

All forms of release have anti-inflammatory and antipyretic properties. The drug is aimed at suppressing the phase of exudate release - liquid released into the tissue from small vessels during inflammation. This relieves pain, reduces swelling, and speeds up recovery in the postoperative period. For persistent pain that accompanies hemorrhoids, it is characterized by a pronounced analgesic effect.

Indomethacin is not an antibiotic, but complements antimicrobial therapy in order to interrupt the inflammatory reaction process and normalize body temperature. The metabolic process occurs in the liver, with 70% of the drug excreted through the kidneys and only 30% through the intestines. The substance is quickly absorbed.

Indomethacin drugs are used both for hemorrhoids and in the treatment of diseases of other systems:

• inflammation of peripheral nerves;
• diseases of the musculoskeletal system;
• inflammatory processes of the reproductive system;
• infectious and inflammatory diseases of the ENT organs;
• ophthalmological operations;
• urinary tract diseases.

Indomethacin during pregnancy

During pregnancy and breastfeeding, it is permissible to use Indomethacin suppositories for hemorrhoids, but only as prescribed by a doctor. Taking capsules and suppositories is a topic of debate between doctors around the world. The instructions include periods of pregnancy and lactation as contraindications.

Some doctors will sometimes prescribe this drug if the benefits outweigh the perceived risks. This is possible only during the first trimester. From the middle of the second trimester, the use of indomethacin is strictly prohibited due to the increased risk of impaired functioning of the child’s kidneys and vascular system.

The active substance remains in breast milk, which makes its intake undesirable. In the baby’s body, it leads to the development of “newborn jaundice.” While taking the drug during lactation, breastfeeding is suspended.