Comprehensive medication guide to Indomethacin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$10 copay for generic 25/50 mg capsules on most Tier 1 plans; some premium formularies may require step therapy through ibuprofen or naproxen first. Medicare Part D covers indomethacin with a $1–$5 copay on most plans.
Estimated Cash Pricing
$5–$30 retail for generic 25–50 mg capsules; as low as $5–$6 with GoodRx or SingleCare coupons for a 30-day supply. The 75 mg ER formulation retails up to $147 but costs ~$22 with GoodRx.
Medfinder Findability Score
65/100
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Indomethacin is a potent prescription nonsteroidal anti-inflammatory drug (NSAID) that has been used in medicine since 1963. Originally marketed as Indocin, it is now available only as a generic in the United States. It belongs to the indoleacetic acid class of NSAIDs and is one of the most powerful anti-inflammatory agents available by prescription.
The FDA has approved indomethacin to treat moderate to severe acute pain, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute gouty arthritis, bursitis, and tendinitis. An intravenous form is used in neonatal intensive care units to close a patent ductus arteriosus in premature infants. Indomethacin is also used off-label for pericarditis, certain headache syndromes, and reactive arthritis.
In 2023, it was the 287th most commonly prescribed medication in the United States, with more than 500,000 prescriptions. It is on the World Health Organization's List of Essential Medicines, reflecting its importance as a global therapeutic agent.
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Indomethacin works by inhibiting cyclooxygenase (COX) enzymes — specifically both COX-1 and COX-2. These enzymes are responsible for converting arachidonic acid into prostaglandins, which are chemical mediators that cause pain, inflammation, and fever. By blocking both enzyme types, indomethacin dramatically reduces prostaglandin production throughout the body.
Indomethacin is a nonselective COX inhibitor and is more potent at COX inhibition than most other common NSAIDs. It is highly lipid-soluble, allowing it to cross the blood-brain barrier readily — a property that makes it uniquely effective for certain central nervous system conditions like hemicrania continua, but also accounts for its higher rate of CNS side effects (headache, dizziness, confusion) compared to other NSAIDs.
The drug is rapidly absorbed after oral administration, with bioavailability close to 100%. Peak plasma concentrations are reached within 2 hours, and it achieves high concentrations in synovial fluid (joint fluid), explaining its effectiveness for gout and arthritis. Its elimination half-life is approximately 7 hours, though variable due to enterohepatic recirculation.
25 mg — capsule
Immediate-release oral capsule. Most commonly available formulation. Typical starting dose for arthritis and pain.
50 mg — capsule
Immediate-release oral capsule. Standard dose for acute gout (50 mg three times daily for 3-5 days) and moderate-to-severe arthritis.
75 mg — extended-release capsule
Extended-release capsule for once-daily dosing. Provides more sustained plasma levels than IR formulations. Not recommended for acute gout treatment.
20 mg / 40 mg — capsule (Tivorbex)
Tivorbex brand formulation for mild-to-moderate acute pain. Must be taken with food.
25 mg/5 mL — oral suspension
Liquid formulation for patients unable to swallow capsules. Very limited commercial availability; may require specialty pharmacy.
50 mg — rectal suppository
Rectal suppository for patients who cannot take oral medications. Near-absent commercial availability; compounding pharmacy may be required.
1 mg — intravenous injection
IV formulation for neonatal use only. Used in hospital settings to close patent ductus arteriosus in premature infants.
Standard indomethacin 25 mg and 50 mg immediate-release capsules are generally available at most pharmacies in 2026 — they receive a findability score of 65 out of 100, reflecting that while generally findable, the supply landscape has some meaningful vulnerabilities. The 75 mg extended-release capsule is more prone to stock-outs, having been recalled by two manufacturers (Glenmark in July 2024 and KVK-Tech in May 2025). Specialty forms like the oral suspension and rectal suppository have near-absent commercial availability.
The underlying issue is that several major generic manufacturers — including Heritage Pharmaceuticals, Mylan, Sandoz, and Teva — have discontinued specific indomethacin formulations over the years. With fewer manufacturers, any quality recall at one company creates a ripple effect across the market. The original brand-name Indocin is no longer commercially available in the U.S., leaving the market entirely dependent on remaining generic producers.
If you're having trouble finding indomethacin at your pharmacy, medfinder can call pharmacies near you to check which ones have your specific formulation in stock, saving you from making multiple phone calls while you're dealing with pain or inflammation.
Indomethacin is not a controlled substance, so any licensed healthcare provider with prescribing authority can write a prescription without DEA registration or special certification. This makes it broadly accessible through primary care, urgent care, specialist, and telehealth settings.
Rheumatologists — for rheumatoid arthritis, ankylosing spondylitis, gout management
Primary care physicians (PCPs) — for acute gout, osteoarthritis, bursitis, tendinitis, general pain
Orthopedic surgeons — for joint pain, musculoskeletal injuries, bursitis
Emergency physicians — for acute gout attacks and acute pain in ER/urgent care settings
Neurologists — for indomethacin-responsive headache syndromes (hemicrania continua, paroxysmal hemicrania)
Nurse practitioners (NPs) and physician assistants (PAs) — can prescribe in all 50 states
Indomethacin is available via telehealth in most states. Platforms like Teladoc, MDLive, PlushCare, and Sesame can prescribe indomethacin after a video or asynchronous consultation. This is especially convenient for patients experiencing an acute gout attack or for refills of ongoing therapy.
No. Indomethacin is not a controlled substance and is not scheduled by the Drug Enforcement Administration (DEA). It can be prescribed by any licensed healthcare provider — physicians, nurse practitioners, physician assistants — without DEA registration or special prescribing authority.
There are no federal limits on the number of refills or quantity per prescription for indomethacin. Prescribers can write for multiple refills and 90-day supplies as clinically appropriate. Prescriptions can also be called or faxed to pharmacies, and electronic prescribing is standard. Indomethacin can also be prescribed via telehealth in most states without any additional restrictions.
Indomethacin carries FDA Boxed Warnings for increased risk of cardiovascular thrombotic events (heart attack and stroke) and serious GI adverse events (bleeding, ulceration, perforation). Taking indomethacin with food or milk reduces GI irritation for most patients.
Nausea, upset stomach, heartburn, abdominal pain
Headache and dizziness
Drowsiness — avoid driving if affected
Tinnitus (ringing in ears) — discontinue if this occurs
Constipation or diarrhea
GI bleeding: black or tarry stools, vomiting blood or coffee-ground material, severe abdominal pain
Heart attack: chest pain, pressure, shortness of breath, pain radiating to arm or jaw
Stroke: sudden confusion, weakness on one side of body or face, slurred speech
Serious skin reactions: rash, blistering, peeling (Stevens-Johnson Syndrome, TEN, DRESS)
Anaphylaxis: hives, difficulty breathing, throat swelling
CNS effects (especially elderly): confusion, disorientation, psychosis
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Naproxen (Aleve, Naprosyn)
Nonselective NSAID available OTC and by prescription. First-line alternative for acute gout (500 mg BID). Twice-daily dosing. Similar efficacy to indomethacin for most indications with a somewhat better tolerability profile.
Ibuprofen (Advil, Motrin)
Nonselective NSAID available OTC and by prescription. Most widely available NSAID globally. Requires more frequent dosing (3-4x daily for prescription doses). Good for acute pain, gout, and arthritis.
Celecoxib (Celebrex)
Selective COX-2 inhibitor. Significantly lower GI bleeding risk than indomethacin. Once or twice daily dosing. Requires prescription. Good for patients with GI risk factors or history of ulcers.
Meloxicam (Mobic)
Preferential COX-2 inhibitor. Once-daily dosing. Widely available as an affordable generic (~$4-10/month). Good option for osteoarthritis and rheumatoid arthritis with a better safety profile for chronic use.
Colchicine (for gout)
Non-NSAID alternative specifically for acute gout. Works through a different mechanism. First-line per ACR guidelines when given within 12-24 hours of gout attack onset. Good alternative when NSAIDs are contraindicated.
Prefer Indomethacin? We can find it.
Ketorolac (Toradol)
majorContraindicated. Additive toxicity — increased GI bleeding risk and renal toxicity.
High-dose Methotrexate
majorIndomethacin reduces methotrexate renal clearance, potentially causing fatal hematologic and GI toxicity.
Warfarin (Coumadin)
majorSynergistic increase in GI bleeding risk. Monitor INR closely; consider PPI co-therapy.
Lithium
majorIndomethacin increases lithium levels by reducing renal excretion. Can cause lithium toxicity.
ACE Inhibitors (lisinopril, enalapril, captopril)
moderateReduced antihypertensive effect. Risk of significant renal impairment, especially in elderly or dehydrated patients.
Furosemide / Thiazide Diuretics
moderateIndomethacin reduces diuretic efficacy by inhibiting renal prostaglandins. May cause fluid retention.
Corticosteroids (prednisone)
moderateAdditive GI ulceration and bleeding risk. Consider PPI co-therapy if combination is required.
SSRIs/SNRIs (sertraline, fluoxetine, venlafaxine)
moderateAdditive antiplatelet effect increases GI bleeding risk. Particularly relevant with long-term concurrent use.
Probenecid
minorMay increase indomethacin plasma levels by inhibiting tubular secretion and biliary excretion.
Other NSAIDs (ibuprofen, naproxen, aspirin)
majorAvoid combination. Increased GI bleeding, kidney damage, and cardiovascular risk without additional benefit.
Indomethacin remains one of the most effective anti-inflammatory medications available despite being over 60 years old. Its potency makes it a first-choice treatment for acute gout, ankylosing spondylitis, and certain rare headache syndromes. However, its side effect profile — particularly GI and CNS effects — means it requires careful patient selection and monitoring, especially in elderly patients for whom it is flagged on the Beers Criteria.
For most patients taking standard oral capsules (25 mg or 50 mg), indomethacin is affordable — as little as $5-$6 per month with a GoodRx or SingleCare coupon. The extended-release 75 mg formulation costs more and has experienced supply disruptions from recent recalls, but remains available with some effort. Specialty forms (oral suspension, suppository) require compounding pharmacy access.
If you're having trouble finding indomethacin at your local pharmacy, medfinder can search pharmacies near you on your behalf and text you the results — saving you hours of calling around while you're dealing with pain.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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Medfinder is actively checking pharmacy inventory for Indomethacin. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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