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Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals. Monitor renal function drug is renally excreted ; decreased renal function more likely in elderly. Use caution in patients with history of bronchospasm, cardiac disease, CHF, hypertension, hepatic or renal impairment. Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include elderly individuals, those with impaired renal function, hypovolemia, heart failure, liver dysfunction, or salt depletion, and those taking diuretics, angiotensin-converting enzyme ACE inhibitors, or angiotensin receptor blockers. Prolonged use may cause corneal deposits and retinal disturbances; discontinue if visual changes observed. Serious skin adverse events eg, exfoliative dermatitis, Stevens-Johnson Syndrome, and toxic epidermal necrolysis reported; discontinue is symptoms occur. Platelet adhesion and aggregation may decrease; may prolong bleeding time; monitor closely patients receiving anticoagulants; patients on long-term NSAID therapy should be monitored for anemia; agranulocytosis, aplastic anemia, thrombocytopenia reported rarely.

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The molecular weight is Indomethacin is a white to yellow crystalline powder. Indomethacin has a pKa of 4. The suspension has a pH of 4. After observing the response to initial therapy with indomethacin, the dose and frequency should be adjusted to suit an individual patient's needs. Adverse reactions generally appear to correlate with the dose of indomethacin. Therefore, every effort should be made to determine the lowest effective dosage for the individual patient.

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