From the Guidelines
For recurrent pericarditis, indomethacin can be used long-term at a dose of 25-50 mg every 8 hours, with a typical maintenance dose starting at the lower end of the dosing range and titrating upward as needed to avoid headache and dizziness. According to the 2015 ESC guidelines for the diagnosis and management of pericardial diseases 1, the usual initial dose of indomethacin is 25-50 mg every 8 hours, and treatment duration can range from weeks to months.
Key Considerations
- The dose should be decreased by 25 mg every 1-2 weeks when tapering 1.
- It is essential to monitor for potential side effects, such as headache and dizziness, and adjust the dose accordingly.
- Indomethacin should be used with caution in patients with a history of gastrointestinal complications, and concurrent gastroprotection with a proton pump inhibitor may be necessary.
- Regular monitoring of renal function, blood pressure, and gastrointestinal side effects is necessary during long-term use.
- Lower doses should be considered in elderly patients or those with renal impairment.
Treatment Approach
- Treatment should be initiated at the lower end of the dosing range and titrated upward as needed to avoid side effects.
- Gradual tapering is essential when discontinuing therapy to prevent rebound symptoms.
- The duration of treatment typically ranges from several months to 1-2 years, depending on clinical response and recurrence patterns.
From the Research
Dose of Indomethacin for Recurrent Pericarditis
The provided studies do not specify a particular dose of indomethacin that can be taken long-term for recurrent pericarditis. However, some general information about the treatment of recurrent pericarditis can be gathered:
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin are commonly used to treat pericarditis 2, 3, 4.
- Colchicine is often used in addition to NSAIDs to reduce the risk of recurrences 2, 5, 3, 6.
- The treatment of pericarditis should be individualized, with the goal of achieving full daily control of symptoms and then tapering the medication 4.
Key Points
- Indomethacin is a type of NSAID that can be used to treat pericarditis.
- Colchicine is often used in addition to NSAIDs to reduce the risk of recurrences.
- The treatment of pericarditis should be individualized and tailored to the specific needs of the patient.
Treatment Options
- NSAIDs such as indomethacin, aspirin, or ibuprofen can be used to treat pericarditis.
- Colchicine can be used in addition to NSAIDs to reduce the risk of recurrences.
- Glucocorticoids can be used as a second-line treatment, but they are associated with a high rate of recurrent events 6.
- Interleukin-1 inhibitors such as anakinra and rilonacept can be used to reduce the risk of recurrences in patients with recurrent pericarditis 3, 6.