What is colchicine and how does it work for gout. How to take colchicine safely and manage potential side effects. What are the alternatives to colchicine for treating gout flares and preventing attacks.

Understanding Colchicine: The Green Pill for Gout

Colchicine is a medication commonly prescribed to treat and prevent gout attacks. It comes in the form of a small green pill that has become closely associated with gout management. While colchicine has been used for centuries to treat gout, it has gained renewed attention as an effective option for controlling this painful form of arthritis.

What is colchicine and how does it work?

Colchicine is an anti-inflammatory medication that works by reducing the build-up of uric acid crystals in the joints. These crystals are responsible for the intense pain, swelling, and redness associated with gout attacks. By interfering with the inflammatory response to uric acid crystals, colchicine can help relieve gout symptoms and prevent future flares.

Proper Usage and Dosage of Colchicine

Taking colchicine correctly is crucial for maximizing its benefits while minimizing potential side effects. The typical dosage for treating an acute gout attack is 1.2 mg followed by 0.6 mg an hour later. For ongoing prevention, a lower daily dose is usually prescribed.

How should colchicine be taken?

• Take colchicine exactly as prescribed by your doctor
• It can be taken with or without food, but taking it with food may help reduce stomach upset
• Do not exceed the recommended dose, as this increases the risk of side effects
• Inform your doctor of all other medications you are taking to avoid potential interactions

Potential Side Effects and Precautions

While colchicine can be highly effective for gout management, it is not without potential side effects. Common side effects include gastrointestinal issues like nausea, vomiting, and diarrhea. In rare cases, more serious side effects can occur.

What are the most common side effects of colchicine?

1. Diarrhea
2. Nausea
3. Abdominal pain
4. Vomiting
5. Muscle pain

It’s important to contact your healthcare provider if you experience severe or persistent side effects. Additionally, colchicine may interact with certain medications and should be used with caution in patients with liver or kidney disease.

Alternatives to Colchicine for Gout Treatment

While colchicine is a popular choice for gout management, it is not the only option available. Other medications and lifestyle changes can also be effective in treating and preventing gout attacks.

What are some alternatives to colchicine for gout?

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen
• Corticosteroids such as prednisone
• Uric acid-lowering medications like allopurinol or febuxostat
• Dietary changes to reduce purine intake
• Weight loss and increased physical activity

The Role of Diet in Gout Management

While medication like colchicine plays a crucial role in gout treatment, dietary changes can also significantly impact the frequency and severity of gout attacks. Certain foods and beverages are known to trigger gout flares or increase uric acid levels in the body.

Which foods should be avoided or limited in a gout-friendly diet?

• Red meat and organ meats
• Seafood high in purines (e.g., sardines, anchovies, mussels)
• Alcoholic beverages, especially beer
• Sugary drinks and foods high in fructose
• Processed foods and refined carbohydrates

On the other hand, incorporating certain foods into your diet may help manage gout symptoms and reduce the risk of flares. These include low-fat dairy products, whole grains, fruits (especially cherries), and vegetables. Staying well-hydrated by drinking plenty of water is also crucial for gout management.

Lifestyle Modifications to Complement Colchicine Treatment

In addition to medication and dietary changes, certain lifestyle modifications can help improve the effectiveness of colchicine and overall gout management. These changes can contribute to reducing uric acid levels and minimizing the frequency of gout attacks.

How can lifestyle changes help manage gout?

1. Maintain a healthy weight through diet and exercise
2. Stay hydrated by drinking plenty of water
3. Limit alcohol consumption, especially beer and spirits
4. Engage in regular low-impact exercise
5. Manage stress through relaxation techniques or meditation
6. Get adequate sleep to support overall health

By incorporating these lifestyle changes alongside colchicine treatment, many individuals with gout find they can better control their symptoms and reduce the frequency of flares.

Monitoring and Long-term Management of Gout with Colchicine

Effective gout management often requires ongoing monitoring and adjustment of treatment strategies. While colchicine can be highly effective for many patients, its use should be regularly evaluated by a healthcare provider to ensure optimal results and minimize potential risks.

What should be considered in long-term gout management with colchicine?

• Regular check-ups to assess treatment effectiveness
• Monitoring of uric acid levels through blood tests
• Adjusting dosage based on symptoms and side effects
• Considering combination therapy with uric acid-lowering medications
• Evaluating kidney and liver function periodically

Long-term use of colchicine may require dose adjustments or additional medications to maintain its effectiveness. It’s crucial to maintain open communication with your healthcare provider about any changes in symptoms or concerns about the medication.

Understanding the Mechanism of Action: How Colchicine Fights Gout

To fully appreciate the role of colchicine in gout treatment, it’s helpful to understand its mechanism of action within the body. This knowledge can provide insight into why colchicine is effective and how it differs from other gout medications.

How does colchicine work at the cellular level?

Colchicine primarily works by interfering with the inflammatory response triggered by uric acid crystals in the joints. Specifically, it:

1. Inhibits the migration of neutrophils (a type of white blood cell) to affected areas
2. Prevents the release of inflammatory chemicals from these cells
3. Disrupts the formation of inflammasomes, which are protein complexes involved in inflammation
4. Reduces the production of lactic acid in the affected joint, which can contribute to pain

By targeting these specific aspects of the inflammatory process, colchicine can effectively reduce the pain, swelling, and redness associated with gout attacks. This targeted approach also explains why colchicine can be effective even in small doses.

Colchicine in Combination Therapy for Gout

While colchicine is often used as a standalone treatment for gout, it can also be part of a comprehensive treatment plan that includes other medications. Combination therapy can be particularly effective for patients with frequent or severe gout attacks.

What are common combination therapies involving colchicine?

• Colchicine with uric acid-lowering drugs (e.g., allopurinol or febuxostat)
• Colchicine with NSAIDs for acute attack management
• Colchicine with corticosteroids in severe cases

The choice of combination therapy depends on various factors, including the severity of gout, frequency of attacks, and individual patient characteristics. Your healthcare provider will determine the most appropriate treatment strategy based on your specific situation.

Colchicine Beyond Gout: Other Medical Applications

While colchicine is primarily known for its role in gout treatment, research has revealed its potential in managing other medical conditions. This versatility has led to increased interest in colchicine’s therapeutic applications beyond gout.

What other conditions might benefit from colchicine treatment?

1. Familial Mediterranean Fever (FMF)
2. Behçet’s disease
3. Pericarditis
4. Coronary artery disease
5. Certain skin conditions like psoriasis

The anti-inflammatory properties of colchicine make it a potential candidate for treating various inflammatory conditions. However, its use in these applications may be off-label and should only be done under close medical supervision.

The History and Evolution of Colchicine Use

Colchicine has a rich history in medicine, with its use dating back thousands of years. Understanding its evolution provides context for its current role in modern gout treatment.

How has colchicine use evolved over time?

• Ancient use: Derived from the autumn crocus plant, used in traditional medicine
• 19th century: Isolated and purified for medicinal use
• 20th century: Mechanism of action discovered, leading to more targeted use
• Present day: Refined dosing strategies and combination therapies

The long history of colchicine use has allowed for extensive research and refinement of its application in gout treatment. This wealth of experience contributes to its continued relevance in modern rheumatology.

Patient Education and Self-Management with Colchicine

Effective gout management with colchicine involves more than just taking medication as prescribed. Patient education and self-management strategies play a crucial role in optimizing treatment outcomes and minimizing risks.

What are key aspects of self-management for patients taking colchicine?

1. Understanding the importance of adherence to prescribed dosage
2. Recognizing early signs of a gout attack to initiate prompt treatment
3. Being aware of potential side effects and when to seek medical attention
4. Maintaining a gout-friendly diet and lifestyle
5. Keeping track of gout attacks and triggers
6. Regular communication with healthcare providers about treatment efficacy

Empowering patients with knowledge about their condition and treatment can lead to better overall management of gout and improved quality of life. Healthcare providers should prioritize patient education as part of the comprehensive treatment plan.

Future Directions in Gout Treatment: Beyond Colchicine

While colchicine remains a cornerstone of gout treatment, ongoing research continues to explore new therapeutic avenues. These developments may offer additional options for patients who don’t respond well to current treatments or experience significant side effects.

What are some emerging treatments for gout?

• Novel uric acid-lowering medications targeting specific enzymes
• Biologic therapies targeting inflammatory pathways
• Gene therapies aimed at addressing underlying genetic factors
• Personalized medicine approaches based on individual patient characteristics

As our understanding of gout pathophysiology advances, new treatment options may emerge to complement or potentially replace traditional therapies like colchicine. However, these developments are still in various stages of research and clinical trials.

In conclusion, colchicine, the green pill for gout, remains a valuable tool in the management of this painful condition. Its long history of use, combined with modern understanding of its mechanism of action, has solidified its place in gout treatment protocols. While it’s not without potential side effects, proper usage under medical supervision can significantly improve quality of life for many gout sufferers. As research continues, we may see even more refined approaches to using colchicine, as well as new complementary or alternative treatments. For now, a combination of medication, dietary changes, and lifestyle modifications offers the best approach for most patients dealing with gout.

What is it and where is it used?

Medically reviewed by Drugs.com. Last updated on Aug 29, 2022.

Excipient (pharmacologically inactive substance)

What is it?

Microcrystalline cellulose (C6h20O5)n is refined wood pulp. It is a white, free-flowing powder. Chemically, it is an inert substance, is not degraded during digestion and has no appreciable absorption. In large quantities it provides dietary bulk and may lead to a laxative effect.

Microcrystalline cellulose is a commonly used excipient in the pharmaceutical industry. It has excellent compressibility properties and is used in solid dose forms, such as tablets. Tablets can be formed that are hard, but dissolve quickly. Microcrystalline cellulose is the same as cellulose, except that it meets USP standards.^[1]

It is also found in many processed food products, and may be used as an anti-caking agent, stabilizer, texture modifier, or suspending agent among other uses. According to the Select Committee on GRAS Substances, microcrystalline cellulose is generally regarded as safe when used in normal quantities. ^[2][3][4]

List of medications using Microcrystalline Cellulose

• Acetaminophen and Hydrocodone Bitartrate 325 mg / 5 mg
• Acetaminophen and Hydrocodone Bitartrate 325 mg / 10 mg
• Acetaminophen and Hydrocodone Bitartrate 325 mg / 7.5 mg
• Acetaminophen and Hydrocodone Bitartrate 325 mg / 10 mg
• Acetaminophen and Oxycodone Hydrochloride 325 mg / 10 mg
• Acetaminophen and Oxycodone Hydrochloride 325 mg / 5 mg
• Alprazolam 0.5 mg
• Alprazolam 2 mg
• Alprazolam 1 mg
• Amphetamine and Dextroamphetamine 20 mg
• Clonazepam 0.5 mg
• Cyclobenzaprine Hydrochloride 10 mg
• Cyclobenzaprine Hydrochloride 10 mg
• Oxycodone Hydrochloride 10 mg
• Oxycodone Hydrochloride 5 mg
• Oxycodone Hydrochloride 30 mg
• Oxycodone Hydrochloride 15 mg
• Percocet 325 mg / 10 mg
• Tramadol Hydrochloride 50 mg
• Trazodone Hydrochloride 50 mg

References

1. [1]Dave RH. Overview of pharmaceutical excipients used in tablets and capsules. Drug Topics (online). Advanstar. 10/24/2008 http://drugtopics.modernmedicine.com/drugtopics/Top+News/Overview-of-pharmaceutical-excipients-used-in-tabl/ArticleStandard/Article/detail/561047. Accessed 08/19/2011
2. FDA’s SCOGS database; Microcrystalline cellulose, Report No. 25, 1979.; ID Code: 9004-57-3; Accessed July 28, 2011.
3. Food and Agricultural Organization of the United Nations. Corporate Document Repository. Compendium of Food Additive Specifications, Addendum 5. Microcrystalline cellulose. http://www.fao.org/docrep/W6355E/w6355e0l.htm Accessed July 28, 2011
4. US Dept of Agriculture, Agricultural Marketing Service. Cellulose processing. Executive Summary. Accessed 7/28/2011.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Side Effects, Dosage & More

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

• Heart risk: Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs may increase your risk of heart attack, heart failure, or stroke. This risk may be higher if you’re taking it long term, at high doses, or if you already have heart problems or risk factors for heart disease, such as high blood pressure. Don’t take indomethacin for pain before, during, or after heart bypass surgery. This may increase your risk for a heart attack or stroke. Talk to your doctor if you take indomethacin and will have surgery soon.
• Stomach problems. NSAIDs like indomethacin may increase your risk of serious side effects, including stomach bleeding or ulcers. These events may be fatal. They may happen at any time without symptoms. Seniors have a higher risk for serious stomach problems.

1. Indomethacin oral capsule is available only as a generic drug.
2. It is also available as an oral liquid suspension and rectal suppository.
3. Indomethacin is used to reduce inflammation, pain, and fever. It’s used to treat rheumatoid arthritis, osteoarthritis, gouty arthritis, and shoulder pain.

Indomethacin oral capsule is a prescription drug that’s only available as a generic drug. It’s also available as an oral liquid and a rectal suppository.

Why it’s used

Indomethacin is used to reduce inflammation, pain, and fever. It’s most commonly used to treat:

• moderate to severe rheumatoid arthritis
• moderate to severe ankylosing spondylitis
• moderate to severe osteoarthritis
• acute painful shoulder (bursitis or tendinitis)
• acute gouty arthritis (immediate-release only)

This drug may be used as part of a combination therapy. That means you need to take it with other drugs.

How it works

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking an enzyme in your body that leads to inflammation. Blocking the enzyme helps to reduce inflammation and pain.

Indomethacin can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking indomethacin. This list does not include all possible side effects.

For more information on the possible side effects of indomethacin, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

Most common side effects

The most common side effects that occur with indomethacin include:

• nausea
• vomiting
• heartburn
• diarrhea
• stomach pain
• constipation
• headache
• dizziness
• tiredness
• ringing in your ears

Serious side effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 911 or go to the nearest emergency room right away.

• Heart attack. Symptoms may include:
  • chest pain
  • shortness of breath
  • discomfort in your upper body
• Stroke. Symptoms may include:
  • face drooping
  • arm weakness
  • difficulty speaking
• High blood pressure. Symptoms may include:
  • a dull headache
  • dizzy spells
  • nosebleeds
• Heart failure. Symptoms may include:
  • swelling of your ankles or feet
  • sudden weight gain
  • tiredness
• Kidney problems. Symptoms may include:
  • changes in your urine volume
  • swelling of your feet or ankles
  • shortness of breath
• Stomach or intestinal bleeding. Symptoms may include:
  • bright-red- or black-colored stool
  • tar-like stool
  • red-colored vomit
• Low red blood cell (anemia) count. Symptoms may include:
  • shortness of breath
  • weakness
  • pale-colored skin
  • fast heartbeat
• Severe skin rash with blisters. You may also have a fever.
• Severe allergic reaction. Symptoms may include:
  • trouble breathing
  • swelling of your throat, tongue, or lips
• Liver problems. Symptoms may include:
  • yellowing of your skin or the whites of your eyes
  • nausea
  • fatigue
  • itching
  • flu-like symptoms such as muscle aches, chills, and tiredness
• Asthma attacks

The indomethacin dosage your doctor prescribes will depend on several factors, which include:

• the type and severity of the condition you’re using indomethacin to treat
• your age
• the form of indomethacin you take
• other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and Strengths

Generic:

• Form: oral immediate-release capsule
• Strengths: 25 mg and 50 mg

• Form: oral extended-release capsule
• Strengths: 75 mg

Dosage for moderate to severe rheumatoid arthritis

Adult dosage (ages 18 years and older)

• Immediate-release capsule: Indomethacin is usually dosed 2 to 3 times per day and starts at a dose of 25 mg. Your doctor may increase your dose by 25 or 50 mg per day. The maximum dose is 200 mg per day.
• Extended-release capsule: The dose is 75 mg once or twice per day. The maximum dose is 150 mg per day.

Child dosage (ages 2–17 years)

• Immediate-release capsule:
  • Indomethacin dosing for children is based on weight. Your doctor will determine the right dose for your child.
  • A starting dose may be 1–2 mg/kg per day divided into 2–4 doses.
  • The maximum dose is 3 mg/kg per day or 200 mg per day, whichever is less.
• Extended-release capsule: A safe and effective extended-release capsule dosage hasn’t been established for this age group.

Dosage for moderate to severe ankylosing spondylitis

Adult dosage (ages 18 years and older)

• Immediate-release capsule: Indomethacin is usually dosed 2 to 3 times per day and starts at a dose of 25 mg. Your doctor may increase your dose by 25 mg or 50 mg per day. The maximum dose is 200 mg per day.
• Extended-release capsule: The dose is 75 mg once or twice per day. The maximum dose is 150 mg per day.

Child dosage (ages 2–17 years)

• Immediate-release capsule:
  • Indomethacin dosing for children is based on weight. Your doctor will determine the right dose for your child.
  • A starting dose may be 1 to 2 mg/kg per day divided into 2 to 4 doses.
  • The maximum dose is 3 mg/kg per day or 200 mg per day, whichever is less.
• Extended-release capsule: A safe and effective extended-release capsule dosage hasn’t been established for this age group.

Dosage for moderate to severe osteoarthritis

Adult dosage (ages 18 years and older)

• Immediate-release capsule: Indomethacin is usually dosed 2 to 3 times per day and starts at a dose of 25 mg. Your doctor may increase your dose by 25 mg or 50 mg per day. The maximum dose is 200 mg per day.
• Extended-release capsule: The dose is 75 mg once or twice per day. The maximum dose is 150 mg per day.

Child dosage (ages 2–17 years)

• Immediate-release capsule:
  • Indomethacin dosing for children is based on weight. Your doctor will determine the right dose for your child.
  • A starting dose may be 1 to 2 mg/kg per day divided into 2 to 4 doses.
  • The maximum dose is 3 mg/kg per day or 200 mg per day, whichever is less.
• Extended-release capsule: A safe and effective extended-release capsule dosage hasn’t been established for this age group.

Dosage for acute painful shoulder (bursitis or tendinitis)

Adult dosage (ages 18 years and older)

• Immediate-release capsule: 75 mg to 150 mg in 3 or 4 divided doses per day for 7 to 14 days
• Extended-release capsule: 75 mg once or twice per day. The maximum dose is 150 mg per day

Child dosage (ages 2–17 years)

• Immediate-release capsule:
  • Indomethacin dosing for children is based on weight. Your doctor will determine the right dose for your child.
  • A starting dose may be 1 to 2 mg/kg per day divided into 2 to 4 doses.
  • The maximum dose is 3 mg/kg per day or 200 mg per day, whichever is less.
• Extended-release capsule: A safe and effective extended-release capsule dosage hasn’t been established for this age group.

Dosage for acute gouty arthritis (immediate-release capsule only)

Adult dosage (ages 18 years and older)

The dose is usually 50 mg 3 times per day until your pain level reduces.

Child dosage (ages 2–17 years)

• Indomethacin dosing for children is based on weight. Your doctor will determine the right dose for your child.
• A starting dose may be 1 to 2 mg/kg per day divided into 2 to 4 doses.
• The maximum dose is 3 mg/kg per day or 200 mg per day, whichever is less.

Indomethacin oral capsule is a short-term drug treatment. It should be used for the shortest possible time to treat the problem. It comes with risks if you don’t take it as prescribed.

If you stop taking it: If you don’t take your medication, your pain and swelling may get worse.

If you take too much: If you take too much indomethacin, you may experience side effects like nausea, vomiting, very bad headaches, confusion, and convulsions. You’ll also be at a higher risk for stomach problems and bleeding.

What to do if you miss a dose: If you forget to take your dose, take it as soon as possible. If it’s almost time for your next dose, wait until then and take a single dose. Don’t double the dose to try to catch up. This could result in toxic side effects.

How to tell if the drug is working: You may be able to tell indomethacin is working if you have reduced pain, fever, swelling, and tenderness.

This drug comes with various warnings.

FDA warning: Heart risk and stomach problems

• Indomethacin has a Black Box Warning. This is the most serious warning from the Food & Drug Administration (FDA). Though the medication can still be sold and used, a black box warning alerts doctors and patients to potentially dangerous effects.
• Heart risk. Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs may increase your risk of heart attack, heart failure, or stroke. This risk may be higher if you’re taking it long term, at high doses, or if you already have heart problems or risk factors for heart disease, such as high blood pressure. Don’t take indomethacin for pain before, during, or after heart bypass surgery. This may increase your risk for a heart attack or stroke. Talk to your doctor if you take indomethacin and will have surgery soon.
• Stomach problems. NSAIDs like indomethacin may increase your risk of serious side effects, including stomach bleeding or ulcers. These events may be fatal. They may happen at any time without symptoms. Seniors have a higher risk for serious stomach problems.

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Kidney problems warning

Indomethacin may harm your kidneys if you take it for a long time. Call your doctor if you have symptoms of kidney damage, such as:

• changes in your urine volume
• swelling of your feet or ankles
• shortness of breath

Dangerous skin reactions warning

Indomethacin can cause a skin reaction that can be fatal. Call your doctor if you have signs of a skin reaction, such as blistering, peeling, or swelling of your skin. You may also have a fever.

Pregnancy warning

Don’t use indomethacin if you’ve been pregnant for more than 29 weeks. Using it during this time can cause problems with the fetus’s heart.

Allergies

Indomethacin can cause a severe allergic reaction. Symptoms may include:

• trouble breathing
• swelling of your throat or tongue
• hives

Don’t take this drug again if you’ve ever had an allergic reaction to aspirin or other NSAIDs. Taking it again could be fatal.

Alcohol interaction

Combining this drug with alcohol may increase your risk for bleeding in your stomach or intestines. Talk to your doctor if you drink alcohol. You may need to limit how much alcohol you drink while taking this medication.

Warnings for people with certain health conditions

For people with heart conditions: Indomethacin may increase your risk for heart attack or stroke. It may also cause higher blood pressure levels.

For people with stomach problems: Indomethacin may increase your risk for swelling or bleeding in your stomach and intestines. It may also increase your risk for ulcers.

For people with kidney problems: Your kidneys may not work as well when taking indomethacin. It may damage your kidneys or lower the blood flow to your kidneys.

For people with asthma: Don’t use indomethacin if you have aspirin-sensitive asthma. It may cause a fatal allergic reaction.

Warnings for other groups

For pregnant women: Indomethacin is a category C pregnancy drug. That means two things:

1. Research in animals has shown adverse effects to the offspring when the mother takes the drug.
2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Indomethacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Do not use indomethacin if you have been pregnant for more than 29 weeks.

For women who are breastfeeding: Indomethacin may pass through breast milk and cause serious side effects in a breastfed child. You and your doctor may need to decide whether you’ll take indomethacin or breastfeed.

For older adults: If you’re age 65 years or older, you may have a higher risk for more side effects, such as bleeding in the stomach or intestines. Also, your kidney function may be decreased. Your kidneys may not remove the drug from your body as well as they should, putting you at risk for serious side effects.

Indomethacin can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with indomethacin. This list does not contain all drugs that may interact with indomethacin.

Before taking indomethacin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Blood pressure medications

• angiotensin-converting enzyme (ACE) inhibitors
• angiotensin II receptor blockers
• water pills (diuretics), such as hydrochlorothiazide

These drugs may not work as well to manage blood pressure when taken with indomethacin.

Aspirin

Combining these medications increases your risk for stomach problems, including ulcers and bleeding.

Bipolar disorder drug

• lithium

Combining these drugs may cause lithium to take longer to clear from your body. This increases the level of lithium in your body, which may cause nausea, tremors, and dizziness.

Disease-modifying anti-rheumatic drug

• methotrexate

Indomethacin may increase the amount of methotrexate in your body to toxic levels. This can raise your risk for infection, kidney damage, and low white blood cell counts.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Examples are:

• ibuprofen
• meloxicam
• naproxen

Taking other NSAIDs with indomethacin may increase the risk of stomach problems.

Oral anticoagulants, blood thinners

• warfarin
• clopidogrel
• ticlopidine
• rivaroxaban

Taking these drugs with indomethacin may increase your risk for bleeding in your stomach or intestines.

Keep these considerations in mind if your doctor prescribes indomethacin oral capsule for you.

General

Take with food to reduce risk of upset stomach. Don’t crush, chew, or cut extended-release capsules. They need to be released in your body slowly.

Storage

• Store at room temperature: 68°F to 77°F (20°C to 25°C). Don’t freeze indomethacin.
• Keep this drug away from light and high temperatures.
• Store these medications away from moisture and damp locations, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled.

When your your doctor gives you your prescription, they will write the number of refills you can have.

Travel

When traveling with your medication:

• Always carry your medication with you. Never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt this medication.
• You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled bottle with you when traveling.

Clinical monitoring

Your doctor will check you regularly for signs of stomach or intestinal bleeding. They’ll also order blood work to make sure that your liver and kidneys are working properly.

If you’re taking any drugs that may interact with indomethacin, your doctor may also order lab tests to monitor the levels of those drugs.

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

How to effectively get rid of weed on the site: folk methods and herbicides

Despite the value of goutweed as a food and medicinal plant, a rare summer resident will agree to start a plantation of white umbrellas on his site. But what about those who already have it? For them, we list the most effective ways to fight.

Important things to do this week

Southern Moscow region, 24 weeks

Cabbage

Treat cabbage from pests (slugs, caterpillars, cruciferous flea)

Onions

Fertilize onions with mineral or organic fertilizer

Tomatoes

Form tomatoes and pinch out stepchildren

Cucumbers

Feed cucumbers with organic or mineral fertilizer

Cucumbers

Weed and loosen cucumbers without damaging the roots and stems

Peppers

Form pepper bushes and pinch out the buds

Blueberries

Acidify the soil under the bushes with vinegar, citric acid or special compounds

Honeysuckle

Water the bushes if there is no rain, and then loosen the tree trunks

Strawberries

Remove the whiskers, leaving minimal stumps (no more than 1-2 cm long)

Hostas

Water the bushes in the morning or on cloudy days, without splashing on the leaves

Show more

Many summer residents have heard about the benefits of this tenacious herb. Biologists discovered in her the “talent” of a natural healer, able to heal many diseases – from lichen and psoriasis to gout. In recent years, the possibility of creating drugs for oncology based on sleepyness has been studied. What can I say, even the botanical name of the gout in Latin – Aegopodium podagraria – indicates its medicinal properties.

In addition, the vitamin greens of goutweed have long been used in cooking for soups, salads and pies. And the owners of auxiliary households appreciate this plant as the basis of the diet of domestic animals (rabbits, sheep, pigs, poultry).

If you are fond of traditional medicine or your grandmother-herbalist taught you how to make healing potions from goutweed, then probably planting this wonderful weed on the site, like an aspirin tablet in a first-aid kit, is a must.

Or maybe there are such shaded areas in your summer cottages where no other plant wants to take root, but sleep with pleasure. Then, of course, it is worth growing it as a ground cover (just choose a variegated form for this – it is less aggressive).

In all other cases, it is worth getting rid of the dwarf on the site, and as soon as possible – until it has captured all your beds and flower beds, turning the garden into a kingdom of white umbrellas. How to do it quickly and efficiently?

Hand weeder

If you have enough strength in your arms, and your back is still ready for feats, you can try to weed out the weed by hand. This is time-consuming and energy-intensive, but quite effective, especially if you take a pitchfork instead of a shovel and you can carefully remove the rhizomes from the ground without damaging them. It is important to remove all the remnants of the roots from the site, otherwise the young shoots of goutweed will grow from them – even more provocative and active than her “big sister”.

It makes sense to use such an old-fashioned way of fighting if you find the first “settlers” on the site – single gout bushes that “crawled” to you from a neighboring plot or got in some other way. Then there is still a chance to deal with the problem manually, because the roots hardly had time to grow to enormous sizes.

If goutweed thickets settled on the site before you, then weeding is unlikely to help – the rhizomes of this plant are huge and spread underground at an unthinkable speed. In addition, gout is actively propagated by seeds, and for many years it has seeded the soil so that it will last for a long time for renewal.

Agrotextile cover

This method helps to effectively control any weeds and is often used to prepare the land for future flower beds and beds. Places where objectionable plants grow, including gouts, should be covered with dense black agrotextile, film or any material that does not transmit light (fibreboard, boards, linoleum, roofing material).

Without access to the sun and water, plants die, their stems, roots and seeds rot in the soil and lose their ability to germinate. Gout – although resistant to adverse conditions, but still a plant, which means that without light it will not be able to develop.

Covering materials should lie on the site of weed thickets for at least a year – only in this case the method will be effective and you will be able to get rid of the annoying dream for sure.

Frequent mowing

There is an opinion that systematic mowing of its above-ground part will help lime gout. The statement is controversial, but you can try – in an unequal struggle, all means are good. The problem is that you have to mow often. But if you have where to apply the growing greens (for example, to prepare for animal feed), then you can catch two birds with one stone – over time, reduce the thickets of goutweed and provide the pets with vitamin greens.

However, the best option is not to let gouts grow and gain strength, but to remove young sprouts as soon as they appear. In this case, the plant will not be able to fully vegetate, its roots will be exhausted and die in two or three years. Ideally, if you cut down the growth with a chopper or flat cutter, capturing the growth point, which is located in the soil at a depth of 1-2 cm.

You may want to cook a salad from the harvested young greens or add them to a casserole – this useful ingredient will allow you to diversify your diet, enrich it with vegetable protein, vitamins, and iron.

If the idea of ​​using a weed does not inspire you, but there are chickens or other poultry on the farm, give them the opportunity to feast on juicy sprouts by simply releasing them into an overgrown area.

Another way to use cut goatweed is to make compost or herbal infusion to fertilize crops. The main condition: only the green part can be processed for processing, without inflorescences and pieces of rhizome. Otherwise, you will not only not get rid of the dream, but also settle it even more around the site. The gout bushes with flowers and roots can be folded into tight airtight bags, where the green mass will overheat and after a couple of years it will turn into valuable humus.

Herbicide treatment

The “natural” methods of struggle listed above are good, but they have a significant disadvantage – they require systematic repetition and frequent, or better, constant presence on the site. (Except for covering with a film, but this option for exterminating the gout is too long and not suitable for everyone.).

What to do if you are a “classic” summer resident who visits the site once a week? The only answer is to use herbicides. These specialized chemicals, after spraying on the leaves, penetrate into all tissues and organs of plants, disrupt metabolic processes, as a result of which weeds die.

Not all herbicides are suitable for gout control, but only those intended for the destruction of dicotyledonous perennial weeds. The most commonly used drugs based on glyphosate, approved for use in household plots: Glibest Grand, Chistogryad. The Deimos + Miura eradication complex has also proven itself well – a combination of drugs allows you to destroy not only goutweed, but also most annual and perennial weeds (sow thistle, dandelion, couch grass, euphorbia, ragweed, etc.).

These herbicides have a general exterminating effect, which means that they can only be used in areas where crop plants are not grown in the current year.