Last update: Sept. 10, 2015

Indomethacin

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

It is excreted into breast milk in non-significant clinically amounts.
There has not been side-effects described in children from treated mothers, except for a case reported in 1978 with convulsions in a newborn infant whose mother received a higher dose than recommended. However, a causal relationship was questioned by other author in the same publication.
Usually, breast milk and infant plasma levels have been found to be undetectable.

It has been successfully used with no side-effects on treated mothers who had high levels of Prostaglandin E (PGE) whose infants were suffering of “physiologic diarrhea)
This drug is used in neonates.
The American Academy of Pediatrics rates it as usually compatible with breastfeeding.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Indomethacin is also known as


Indomethacin in other languages or writings:

Tradenames

Main tradenames from several countries containing Indomethacin in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 90 %
Molecular weight 358 daltons
Protein Binding 99 %
VD 0,4 l/Kg
Tmax 1 - 2 hours
T1/2 4,5 hours
M/P ratio 0,4 -
Theoretical Dose 0,017 mg/Kg/d
Relative Dose 2,1 %
Relat.Ped.Dose 0,9 - 1,7 %

References

  1. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016 Abstract Full text (link to original source) Full text (in our servers)
  2. Risser A, Donovan D, Heintzman J, Page T. NSAID prescribing precautions. Am Fam Physician. 2009 Abstract Full text (link to original source) Full text (in our servers)
  3. Østensen M, Motta M. Therapy insight: the use of antirheumatic drugs during nursing. Nat Clin Pract Rheumatol. 2007 Abstract
  4. Leonhardt A, Seyberth HW. Do we need another NSAID instead of indomethacin for treatment of ductus arteriosus in preterm infants? Acta Paediatr. 2003 Abstract
  5. Bellander M, Ley D, Polberger S, Hellström-Westas L. Tolerance to early human milk feeding is not compromised by indomethacin in preterm infants with persistent ductus arteriosus. Acta Paediatr. 2003 Abstract
  6. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  7. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  8. Li SY, Geng ZC, Wang AZ, Gao YL, Li M, Wang HD, Wang WY. The relationship between PGE2 level in mothers' milk and physiological diarrhea of the baby and the treatment. Chin Med J (Engl). 1994 Abstract
  9. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  10. Beaulac-Baillargeon L, Allard G. Distribution of indomethacin in human milk and estimation of its milk to plasma ratio in vitro. Br J Clin Pharmacol. 1993 Abstract Full text (link to original source) Full text (in our servers)
  11. Lebedevs TH, Wojnar-Horton RE, Yapp P, Roberts MJ, Dusci LJ, Hackett LP, Ilett KF. Excretion of indomethacin in breast milk. Br J Clin Pharmacol. 1991 Abstract Full text (link to original source) Full text (in our servers)
  12. Helleberg L. Clinical Pharmacokinetics of indomethacin. Clin Pharmacokinet. 1981 Abstract
  13. Eeg-Olofsson O, Malmros I, Elwin CE, Steen B. Convulsions in a breast-fed infant after maternal indomethacin. Lancet. 1978 Abstract
  14. Fairhead FW. Convulsions in a breast-fed infant after maternal indomethacin. Lancet. 1978 Abstract

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