Suppositories are one of the most common groups of medications for the treatment of gynecological diseases. This is primarily due to the fact that only through them, in case of a number of problems, can active substances be delivered directly to the end point, bypassing the digestive system. This makes medications safer and more effective.
Among such medications, gynecologists highlight Indomethacin suppositories. Where to insert, why they are needed and how they work are the main questions that concern women and require the most detailed answers.
Indomethacin suppositories: general information
This medication is a representative of the group of NSAIDs - non-steroidal anti-inflammatory drugs - and works due to the active substance of the same name. Indomethacin is a derivative of indolylacetic acid, which, by blocking the synthesis of prostaglandins, helps to relieve pain or reduce its severity, as well as eliminate fever and stop the inflammatory process, or alleviate its course. The main advantage of Indomethacin is the minimal number of side effects, especially when it comes to suppositories, i.e. about rectal use of the drug.
- The dosage of the active substance per 1 suppository is 50, 100 or 150 mg.
Among the main properties of indomethacin is the ability to relieve joint pain, however, in gynecology, Indomethacin suppositories are used for a different purpose. It could be:
- elimination of the inflammatory process in diseases of the genital organs;
- treatment of benign formations in the uterus/ovaries (mainly cysts and fibrolemia);
- reducing the intensity of pain due to uterine fibroids and endometriosis;
- relief of the menstrual cycle (for pain);
- exclusion of the appearance of adhesions after surgery;
- treatment of cystitis;
- reducing the likelihood of miscarriage (term from 16 to 32 weeks);
- relief from prostatitis (in men).
Despite the overall positive response to this drug, it can provoke the appearance of adverse reactions, among which nausea, vomiting and damage to the gastrointestinal mucosa are very rarely observed, and much more often - arrhythmia, shortness of breath, allergic skin reactions, headaches, depression, anxiety, swelling Quincke. Mostly all this is observed in patients who exceeded the prescribed dose of the drug.
Indomethacin
Nonsteroidal anti-inflammatory drugs (NSAIDs) today are more than drugs: they are a real phenomenon in medicine, salvation in many situations, an object of cult, a subject of heated debate and debate. The unique fusion of anti-inflammatory, antipyretic and analgesic effects has deprived them of competitors and has led to the fact that at the present time approximately 20% of the world's inhabitants are already on regular courses of NSAIDs. Whether this is good or bad is another question. But this is the reality. Indomethacin is a “pioneer” of the NSAID group: it burst into clinical practice in the early 60s of the last century and proved to be a powerful anti-inflammatory drug that can quickly achieve significant improvement in rheumatic diseases of an inflammatory nature. For example, in rheumatoid arthritis, indomethacin not only numbs the pain, but also helps overcome morning stiffness, making it easier for the joints to function. Clinical studies have proven its high effectiveness in ankylosing spondylitis, incl. compared to other NSAIDs. According to some expert estimates, indomethacin is an ideal treatment for seronegative spondylitis. And the effectiveness of indomethacin for relieving attacks of gouty arthritis is almost a reference (however, in fairness, it should be noted that in this case there is still no objective evidence of the leadership of indomethacin among other NSAIDs in terms of analgesic and anti-inflammatory effect). The mechanism of action of indomethacin is based on its ability to suppress the activity of the enzymes COX-1 and COX-2, as a result of which the synthesis of inflammatory mediators prostaglandins, “responsible” for pain, increased temperature and capillary permeability, is reduced.
The drug also has antithrombic properties.
Every barrel of honey has its own fly in the ointment. Such a benign picture of the effectiveness of indomethacin also has several black smears. Thus, this drug is prone to promote the development of a number of complications from the digestive tract, including persistent dyspepsia and gastrointestinal bleeding. Moreover, the risk of developing the latter exceeds that of other drugs in this group, which is confirmed by clinical trials. Therefore, without in any way detracting from the outstanding advantages of indomethacin in terms of pain relief and suppression of inflammation, we should not forget about its side effects. Thus, it seems inappropriate to talk about the advantages of this drug over other NSAIDs. Considering the above, we can characterize indomethacin as a good strong reserve drug in patients for whom taking other NSAIDs has proven to be ineffective. In this case, indomethacin can only be taken by persons who are not at risk of developing NSAID-potentiated gastropathy.
Indomethacin is available in several dosage forms: tablets, ointment, suppositories, gel. A wide range of release forms allows doctors to vary the route of administration, which can significantly optimize the therapeutic process. Considering the potential danger of indomethacin, its use must be agreed with a specialist.
Indomethacin suppositories in gynecology: instructions for use
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Before understanding the dosage for each specific case, you need to familiarize yourself with the list of contraindications to the use of these suppositories. Among them, in addition to increased sensitivity to active components, experts call:
- gastritis, colitis and ulcerative lesions of the gastrointestinal mucosa;
- kidney/liver dysfunction;
- bleeding in the rectum and inflammatory processes in it;
- bronchial asthma;
- epilepsy;
- hemophilia;
- breast-feeding;
- late pregnancy (from the 32nd week).
Indomethacin suppositories are used rectally in gynecology, i.e. inserted into the rectum. Before this, doctors recommend completely emptying the intestines, and to be safe, do an enema with 1-1.5 liters of water. Input is carried out up to 2 times a day, if therapy is carried out in a course - morning and evening, or with an interval of about 8-10 hours between them. This regimen allows you to keep the concentration of indomethacin in the blood at approximately the same level throughout the entire treatment period.
- Children's dosage of Indomethacin is 50 mg, adults - 100/150 mg. It is possible to reduce it through a spark plug break.
- Vaginal administration of Indomethacin is possible, before which the area must be thoroughly washed. The suppository is inserted as deeply as possible, in a lying position, to reduce the likelihood of it coming back out.
It should also be noted that these suppositories are not used simultaneously with medications based on acetylsalicylic acid and paracetamol. It is undesirable to combine them with diuretics, which will negate all therapy.
Properties and indications for use
Suppositories with indomethacin are used to ensure that the drug enters directly into the blood, bypassing the liver enzyme system. The active ingredient is indomethacin. Corn starch and solid fat are used as additional components. The amount of fillers varies depending on the dosage.
Initially, the drug was developed for the treatment of purulent-inflammatory diseases of the musculoskeletal system. Now it is used for prostatitis, pain during menstruation, and adnexitis. It does not cure, but only relieves symptoms.
After placing a suppository with Indomethacin, the concentration of the latter in the blood plasma increases and becomes maximum in 80–90 minutes. Once at the site of inflammation, the active substance binds to cyclooxygenase (an enzyme that leads to the release of pro-inflammatory agents) and lipoxygenase. After inhibition of proinflammatory enzymes, the concentration of leukotrienes and prostaglandins decreases.
As a result of suppression of the inflammatory reaction, the reactive tissues of the prostate gland cease to be swollen and painful. Due to blocking of prostaglandins, the volume of the gland decreases during benign hyperplasia or chronic inflammatory process.
For long-term treatment of chronic prostatitis, it is better to use Indomethacin, the price of which does not exceed 300 rubles per pack. The drug from this company is less toxic than others. The medicine can also be used for acute prostatitis to quickly eliminate dysuric and pain syndromes.
Side effects and contraindications
Indomethacin is a very powerful member of the NSAID group. Due to its high activity, the drug has a negative effect on the liver and kidneys. It should also be taken into account that when taking NSAIDs, the mucous membrane of the gastrointestinal tract suffers. Indomethacin suppositories are contraindicated for use if you have:
- allergic reactions to any of the components of the drug;
- history of bronchial and aspirin asthma;
- peptic ulcer of the stomach and duodenum;
- colitis and enterocolitis;
- immunosuppressive conditions;
- viral hepatitis or cirrhosis of the liver;
- hemophilia;
- use of other NSAIDs;
- acute glomerulonephritis or pyelonephritis;
- purulent diseases of the rectum and anatomical spaces near it.
NSAIDs rarely cause allergic reactions. Its main effect is aimed at blocking COX (cyclooxygenase), which is responsible for the synthesis of prostaglandins. The latter, in turn, are also responsible for the formation of the mucous membrane throughout the gastrointestinal tract. When the drug begins to act, regardless of the form of administration, the mucous membranes of the stomach and duodenum are damaged.
Indomethacin reduces the properties of platelet aggregation (sticking together). This can be dangerous for people who have wounds or open bleeding, such as from hemorrhoids. By blocking the metabolism of arachidonic acid, the drug leads to immunosuppression (decreased immune response). Based on this feature, it cannot be prescribed for immunodeficiencies and exhaustion.
The active substance is transformed in the liver and excreted by the kidneys, and the first side effects can occur in these organs. Its most common undesirable effects include:
- bitterness in the mouth;
- dyspeptic and dysuric phenomena;
- apathy;
- hematuria, proteinuria (release of red blood cells and protein through the kidneys);
- itching, hives, rashes (rare);
- headache;
- decrease in pressure;
- leukopenia and agranulocytosis.
Due to the effect on attention and reaction, the drug is not recommended to be taken while driving or in other similar situations. If after using the suppository a rash and itching appears on the skin, you should do a cleansing enema and replace the drug with another one. Dysuric phenomena may be associated with prostatitis, and not with taking the medication.
Indomethacin suppositories: reviews
To a large extent, comments about these suppositories are positive, although consumers note a very large list of contraindications and side effects that are very alarming. However, the effectiveness of the drug is highly rated.
- Irina : These suppositories were recommended to me by a gynecologist when I once again complained about too painful periods. The injection, of course, does not give a pleasant sensation, it burns quite strongly (like applying a warming ointment there), but it really relieves the pain syndrome. The main thing is to insert it deeper - it burns less there. Plus, for some reason I feel very sleepy after this, so they use Indomethacin at night.
- Alla : Indomethacin simply saved me when, out of stupidity, I developed inflammation of the appendages. The pain was such that I just wanted to cut everything out there - suddenly it would become easier. The product is inexpensive, I used it without consulting a doctor. The list of adverse reactions was frightening, but the condition was too severe to fear nausea or tachycardia. I lit candles before going to bed and did not feel any particular discomfort other than a slight burning sensation. The condition stabilized very quickly!
Indomethacin suppositories are used in gynecology primarily as an analgesic for pain associated with the menstrual cycle, endometriosis, uterine fibroids, and also as an anti-inflammatory agent for diseases of the genital organs. They manifest themselves extremely positively, however, due to the long list of side effects, it is recommended to consult a doctor before starting therapy.
Dosage and how to use
Suppositories are produced with a concentration of the active substance of 50 and 100 mg. It is recommended to use suppositories for men after physiological cleansing of the intestines. According to the instructions for use, the dose and frequency of administration depend on the type of inflammation of the prostate gland and its cause. Dosage for prostatitis:
- for acute bacterial prostatitis to relieve pain and swelling - 100 mg 2 times a day;
- for chronic prostatitis - 50 mg 2 times a day or 100 once;
- for prostate adenoma - 100 mg 2-3 times a day (depending on the size of the adenoma).
No overdose was observed with rectal use. Suppositories with NSAIDs cannot cure the disease, they only relieve symptoms. It is acceptable to use Indomethacin 3-4 times a week for a month. After the expiration date, the drug must be replaced.
What to replace
Anti-inflammatory suppositories are ordinary suppositories, the active ingredient of which is a representative of the NSAID group. For prostatitis, you can use any suppositories that relieve swelling and pain. Analogues of indomethacin suppositories:
- suppositories with Ibuprofen (good for pain relief, low toxicity);
- suppositories with Diclofenac sodium (excellent for pain relief).
If an allergy or burning sensation in the intestine occurs while taking indomethacin suppositories, the drug can be replaced with Analdim. Analdim is Analgin with Diphenhydramine. The drug eliminates signs of allergies and exhibits an analgesic effect. Can be used 2 times a day for no more than three days.
