Indocin (Indomethacin)

Dose, efficacy and tolerability of long-term indomethacin treatment of chronic paroxysmal hemicrania and hemicrania continua

JA Pareja1, AB Caminero2, E Franco3, JL Casado3, J Pascual 4 and M Sánchez del R ´o1
1 Department of Neurology, Fundación Hospital Alcorcón, Juan Carlos I University, Madrid,
2 Department of Neurology, Hospital NaSa de Sonsoles, Avila,
3 Department of Neurology, Hospital Cl ´nico Juan Ramón Jimenez, Huelva
4 Department of Neurology, University Hospital Marqués de Valdecilla, Santander, Spain

Indomethacin has consistently been proven to provide complete and sustained relief of symptoms in hemicrania continua (HC) and chronic paroxysmal hemicrania (CPH), but is not devoid of side-effects. The goal of this retrospective study is to assess the dose and side-effects of prolonged indomethacin treatment of HC and CPH. Twenty-six patients with either HC or CPH were followed during an average of 3.8 years after onset of treatment with indomethacin. Relief of symptoms occurred within 3 days of treatment, with 84 ± 32 mg/day of indomethacin. With time, 42% of patients experienced a decrease of up to 60% in the dose of indomethacin required to maintain a pain-free state. Six (23%) patients showed adverse events, mostly gastrointestinal and relieved with ranitidine. No major side-effects were observed. These results indicate that prolonged indomethacin treatment of HC or CPH has a good safety and tolerability profile with a reduction of up to 60% in the initial dose.

Chronic paroxysmal hemicrania, hemicrania continua, indomethacin


Juan A. Pareja, Department of Neurology, Fundación Hospital Alcorcón, C/Budapest 1, 28922 Madrid, Spain. Tel. +91 621 94 00 ext-12052, e-mail JAPareja@fhalcorcon.es