Indomethacin safe? or take ibuprofen?.

[John Gee]

Is indomethecin safe for people over 65?

I have been taking indomethacin for many years for gout pain. I am now 65 with Unitedhealthcare Medicare Advantage plan. I had a recent gout attack and requested to renew my indomethacin prescription. I was surprised that Medicare initially declined my prescription because they deemed it to be harmful.

They recommended that I ask my doctor for an alternative drug, in which my doctor recommended a strong 800 mg of ibuprofen 3 times daily. However, I am currently taking my remaining indomethacin pills because I feared that the ibuprofen would not work.

I can still get indomethacin but it is a slow process for my doctor to prepare paperwork to allow the indomethecin prescription.

Any thoughts on safety of indomethecin for older people?

[Keith Taylor]

Hi again, jgee

I should point out that I have no medical qualifications. I can advise on gout from experience, but my only advice on strictly medical matters is “you need to discuss this with your doctor”

That said, I’m happy to share my limited knowledge of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).

Both indomethacin and ibuprofen are NSAIDs, as are naproxen and diclofenac. There are also many less well-known NSAIDs. They all work in similar ways to reduce inflammation, and all NSAIDs carry the same health warnings about heart risks. Apparently risks increase the longer you take NSAIDs, especially at the max strength required to appease the gout gods. My understanding is that slight variances between different NSAIDs mean that individuals might find one better than the other.

Personally, ibuprofen always worked for me, but other people have said the same for naproxen. What really matters for gout is that NSAIDs are used in the right way.

First, they are not a long-term solution for gout. They are useful for new gout sufferers who might not qualify for uric acid treatment. Once gout has worsened to more than one flare per year, uric acid treatment should commence. If this is managed correctly, NSAIDs will not be required after a few months.

Secondly, NSAIDs should be just one part of your pain control plan. You can reduce dependence on NSAIDs by incorporating colchicine and/or a compatible pain blocker (often Tylenol, subject to doctor or pharmacist safety check).

I’ve never seen anything to suggest that age should be a factor. Having said that, I’ve never investigated it. I leave that sort of thing to the doctors, while I focus on optimum uric acid treatment that removes the need for pain relief as soon as possible.

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