Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Indomethacin
Drug ID BADD_D01156
Description Indometacin, or indomethacin, is a non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic, and antipyretic properties. NSAIDs consist of agents that are structurally unrelated; the NSAID chemical classification of indometacin is an indole-acetic acid derivative with the chemical name 1- (p-chlorobenzoyl)25-methoxy-2-methylindole-3-acetic acid.[A177871] The pharmacological effect of indometacin is not fully understood, however, it is thought to be mediated through potent and nonselective inhibition of the enzyme cyclooxygenase (COX), which is the main enzyme responsible for catalyzes the rate-limiting step in prostaglandin and thromboxane biosynthesis via the arachidonic acid (AA) pathway. Indometacin was first discovered in 1963 and it was first approved for use in the U.S. by the Food and Drug Administration in 1965, [A486] along with other acetic acid derivatives such as [diclofenac] and [sulindac] that were also developed during the 1960s.[A177871] Since then, indometacin has been extensively studied in clinical trials as one of the most potent NSAIDs in blocking prostaglandin synthesis and was among the first NSAIDs to be used in the symptomatic treatment of migraine and for headaches that eventually became known as “indomethacin-responsive” headache disorders.[A177871] Most commonly used in rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, acute shoulder pains, and acute gouty arthritis, indometacin is currently available as oral capsules as well as other methods of administration, including rectal and intravenous formulations. Intravenous indometacin is administered to close a hemodynamically significant patent ductus arteriosus, as indicated by clinical evidence, in premature infants.[L10553] Ophthalmic indometacin has been studied and used in the symptomatic treatment of postoperative ocular inflammation and pain and/or complications after cataract surgery. Although deemed effective in reducing ocular inflammation in clinical studies, topical NSAIDs were also associated with a potential reduction in corneal sensitivity accompanied by an increased risk of superficial punctate keratitis and subjective symptoms of discomfort, including pain, burning or pricking, or a tingling sensation after instillation into the cul‐de‐sac.[A177949]
Indications and Usage For moderate to severe rheumatoid arthritis including acute flares of chronic disease, ankylosing spondylitis, osteoarthritis, acute painful shoulder (bursitis and/or tendinitis) and acute gouty arthritis.
Marketing Status Prescription; Discontinued
ATC Code C01EB03; M01AB01; M02AA23; S01BC01
DrugBank ID DB00328
KEGG ID D00141
MeSH ID D007213
PubChem ID 3715
TTD Drug ID D0R1RS
NDC Product Code 33342-502; 63629-1913; 43063-773; 68462-302; 63629-1915; 69344-101; 71335-0756; 63323-659; 63629-8066; 55700-537; 71335-0992; 76420-029; 68071-3277; 48087-0069; 50090-0054; 50090-0053; 68788-6448; 48087-0070; 0713-0176; 71335-0107; 68788-6983; 63629-1914; 50090-0051; 68462-325; 71335-1568; 70518-1512; 71335-0747; 43063-368; 50090-0052; 50090-2987; 70518-3324; 70518-0254; 53002-3051; 67296-0886; 68462-406; 70518-0515; 73308-349; 70771-1004; 67296-0954; 66267-120; 55289-469; 71205-159; 68382-371; 68071-3060; 71205-215; 51552-0262; 43063-930; 35356-697; 63629-7679; 50268-431; 71335-0355; 53002-3050; 50268-430; 68071-5269; 65162-506; 61919-526; 43063-777; 70518-1458; 68788-8117; 11014-0418; 68084-411; 59746-347; 71052-550; 50090-0050; 43063-929; 60760-294; 61919-130; 63187-948; 31722-542; 67296-0723; 68071-4394; 63629-8993; 68788-8092; 72578-038; 50090-2803; 71335-1250; 49452-3670; 69344-102; 70934-395; 10702-016; 61919-129; 51655-329; 69597-350; 63629-3201; 72578-039; 50742-234; 50090-0055; 72865-149; 0409-1113; 70771-1203; 72865-148; 63187-282; 66267-119; 67296-1525; 59746-346; 61919-164; 31722-543; 63629-8994; 70771-1005; 11014-0419; 61919-985; 73308-350; 68382-470; 31722-565; 63187-852; 65977-0130; 53002-3500
Synonyms Indomethacin | Indometacin | Osmosin | Indocid | Metindol | Indomet 140 | Indomethacin Hydrochloride | Amuno | Indocin
Chemical Information
Molecular Formula C19H16ClNO4
CAS Registry Number 53-86-1
SMILES CC1=C(C2=C(N1C(=O)C3=CC=C(C=C3)Cl)C=CC(=C2)OC)CC(=O)O
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
ApoptosisCellular tumor antigen p53P10361Not Available10403534; 10027304; 10702201
DystoniaIntegrin alpha-MP11215T9561611401508; 15128285; 15138204
EnterocolitisB2 bradykinin receptorP30411T237149863482; 8613052; 9010912
EnterocolitisPlasma kallikreinP03952T827399863482; 8613052; 9010912
EnterocolitisHigh molecular weight kininogen IIQ6DMP4Not Available9863482; 8613052; 9010912
Gastric disorderNitric oxide synthase, inducibleP35228T0270315138204; 12678336; 11564662
Gastric disorderTumor necrosis factorP01375T2017815138204; 12678336; 11564662
Gastric disorderIntegrin beta-2P11835Not Available10486359; 9486176; 7694504
Gastric disorderTumor necrosis factor receptor superfamily member 1AP19438T8655215138204; 12678336; 11564662
Gastric disorderIntercellular adhesion molecule 1P05362T2620310486359; 9486176; 7694504
Gastric disorderP-selectinP16109T1096510486359; 9486176; 7694504
Granulocytes abnormalTumor necrosis factor receptor superfamily member 1AP19438T8655215138204; 12678336; 11564662
InjuryAcetylcholinesteraseP22303T300827638570; 9462208; 3968618; 14718104; 3317803; 15816997; 12379813
InjuryMyeloperoxidaseP11247Not Available15138204; 12678336; 11564662
Intestinal angioedemaB2 bradykinin receptorP30411T237149863482; 8613052; 9010912
Intestinal angioedemaPlasma kallikreinP03952T827399863482; 8613052; 9010912
Intestinal angioedemaHigh molecular weight kininogen IIQ6DMP4Not Available9863482; 8613052; 9010912
Metabolic disorderUDP-glucuronosyltransferase 2B2P08541Not Available3778523; 11875010; 3751624; 10096365
Metabolic disorderHeat shock 70 kDa protein 12AO43301Not Available10701834; 7638169; 14706622; 8631933
Metabolic disorderNADH-cytochrome b5 reductase 3P00387Not Available3778523; 11875010; 3751624; 10096365
Metabolic disorderEpoxide hydrolase 1P07099Not Available3778523; 11875010; 3751624; 10096365
Metabolic disorderUDP-glucuronosyltransferase 1A1Q64550Not Available3778523; 11875010; 3751624; 10096365
Metabolic disorderCytochrome b5P00167Not Available3778523; 11875010; 3751624; 10096365
Metabolic disorderNADPH--cytochrome P450 reductaseP00388Not Available3778523; 11875010; 3751624; 10096365
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal discomfort07.01.06.0010.000833%Not Available
Abdominal distension07.01.04.001--
Abdominal pain07.01.05.002--
Abdominal pain upper07.01.05.003--
Acidosis14.01.03.002--
Acute respiratory distress syndrome22.01.03.001--
Adrenal insufficiency14.11.01.004; 05.01.02.001--
Agranulocytosis01.02.03.001--Not Available
Alkalosis14.01.02.001--
Alopecia23.02.02.001--
Anaemia01.03.02.001--
Anaphylactic reaction24.06.03.006; 10.01.07.001--
Anaphylactic shock24.06.02.004; 10.01.07.002--Not Available
Angioedema23.04.01.001; 10.01.05.009--Not Available
Ankylosing spondylitis10.04.04.004; 15.01.09.001--Not Available
Anxiety19.06.02.002--
Apathy19.04.04.002--Not Available
Aplastic anaemia01.03.03.002--Not Available
Apnoea22.02.01.001--
Arrhythmia02.03.02.001--Not Available
Asthenia08.01.01.001--Not Available
Asthma10.01.03.010; 22.03.01.002--Not Available
Azotaemia20.01.01.001--Not Available
Blood potassium increased13.11.01.011--Not Available
Blood pressure decreased13.14.03.002--Not Available
Blood urea increased13.13.01.0060.000556%Not Available
Body temperature increased13.15.01.001--Not Available
Bradycardia02.03.02.002--Not Available
Breast enlargement21.05.04.001--Not Available
Breast tenderness21.05.05.004--Not Available
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