What are the side effects of Indomethacin, which should concern my unborn baby as well as me?

Alexander Kofinas M.D.

Use of Indomethacin does not result in any serious side effects for the mother. The most common effects are mild gastrointestinal symptoms and fluid retention. Occasionally, patients complain of headaches. It is important to note however, that most of these symptoms subside within 2-3 days. In rare cases we have been forced to reduce the dosage in order to get rid of some symptoms, but more often than not the symptoms subside on their own. Indomethacin has been found to cause temporary constriction of the ductus arteriosus if used after 34 weeks and for more than 48 hours. At KOFINAS PERINATAL we never use Indomethacin after 32 weeks and we have never seen any signs of constriction in fetuses prior to 32 weeks when the medication is in use according to our protocol. We rarely use Indomethacin for more than seven days, and we always monitor the condition of the ductus arteriosus with color and pulsed wave Doppler before and after the treatment. Another fetal side effect is oligohydramnios (reduction in volume of the amniotic fluid). We have seen a few cases where amniotic fluid volumes dropped slightly, but as soon as we stopped the medication, the fluid rebounded to normal levels. Overall, the benefits of Indomethacin far outweigh any theoretical risks.