Indomethacin: what it treats, how to take it, side effects
Last updated September 3, 2026.
Indomethacin is the heavyweight NSAID - it stops the body's production of the substance that causes pain, fever, and inflammation. You may know it as Indocin. It is the drug many doctors reach for when a gout attack needs hard intervention, and it demands more respect than its over-the-counter cousins.
What does it treat?
Moderate to severe pain, tenderness, swelling, and stiffness from osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; shoulder pain from bursitis and tendinitis; and - with the immediate-release forms - acute gout attacks, the severe joint pain and swelling that come from crystal buildup.
How do you take it?
Capsules or liquid two to four times a day, extended-release capsules once or twice - always with food, immediately after meals, or with antacids, because this one is rough on an empty stomach. Swallow the extended-release capsule whole; shake the liquid before each use. Your doctor may start low and raise no more than once a week, or start average and step down once symptoms are controlled - follow the specific plan. Missed dose: take it when you remember unless the next one is close; never double up.
Side effects to know
- Common: headache, dizziness, vomiting, diarrhea, constipation, and ringing in the ears.
- Serious - call your doctor immediately or get emergency care: chest pain, shortness of breath, weakness on one side, or slurred speech (the NSAID heart and stroke picture - 911); vomiting blood or material like coffee grounds, or black tarry stools (bleeding); unexplained weight gain or swelling of the abdomen, ankles, or feet; fever with rash, swollen lymph nodes, or facial swelling; unusual bleeding or bruising; yellowing skin or eyes; cloudy, discolored, or bloody urine; and blurred vision or other sight problems.
Who should not take it?
The NSAID class rules in full: not after a recent heart attack unless your doctor directs it, never right before or after coronary bypass surgery, and with honest caution if you have heart disease, smoke, or have high cholesterol, blood pressure, or diabetes. The ulcer-and-bleeding risk climbs with age, long use, poor health, and heavy alcohol - and blood thinners, aspirin, other NSAIDs, oral steroids, and SSRI or SNRI antidepressants all multiply it. Flag asthma with nasal polyps, heart failure, epilepsy or Parkinson's disease, depression or other mental illness, and liver or kidney disease. Around 20 weeks of pregnancy or later it can harm the fetus.
When is it an emergency?
Chest pain, one-sided weakness, slurred speech, or trouble breathing is a 911 call. Vomiting blood, black stools, or vision changes mean same-day care. For an overdose, call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
What a Pymander AI doctor consult looks like
Illustrative example, not a real member's messages.
Common questions
Why do doctors pick indomethacin for gout attacks?
Because it is strong and proven there. MedlinePlus lists acute gouty arthritis among its specific uses for the immediate-release forms - the drug hits the inflammation behind the crystal pain hard, and started early in an attack, relief typically builds over a few days. It treats the attack, not the uric acid underneath; that longer game is a separate conversation with your doctor.
Why do I have to take indomethacin with food?
Stomach protection. MedlinePlus says to take it with food, immediately after meals, or with antacids - this is one of the harsher NSAIDs on an empty stomach, and the food rule is part of the dose. The stomach warning behind it is serious: ulcers and bleeding can develop at any time during treatment, without warning symptoms.
Why does indomethacin warn about heart attacks?
Every non-aspirin NSAID carries the class warning: higher risk of heart attack and stroke than non-users, possibly without warning, climbing with long-term use. A recent heart attack or upcoming bypass surgery makes it a no unless your doctor directs it. Indomethacin's strength cuts both ways - the reason it works on gout is the reason the warnings deserve reading.
Can I drink alcohol while taking indomethacin?
Skip it. MedlinePlus names heavy alcohol use among the factors that raise the NSAID ulcer-and-bleeding risk - and if you are taking it for gout, alcohol raises uric acid and feeds the attack itself. Both directions point the same way for the course.
Why did my doctor mention my eyes on indomethacin?
Blurred vision and other sight problems are on the serious-effects list - report them immediately rather than waiting them out. The drug can also worsen depression and other mental illness and needs caution with epilepsy and Parkinson's, which is why the history questions before prescribing run long.
What happens if I miss a dose of indomethacin?
Take it as soon as you remember, unless it is almost time for the next one - then skip it and never double up. During a gout attack the doses are short-course, so steady spacing with meals is what turns the inflammation around - set a reminder at breakfast, lunch, and dinner.