Indocin vs. Prednisone for Rheumatoid Arthritis and Osteoarthritis: Important Differences and Potential Risks.

Key takeaways

Indocin (indomethacin) and prednisone are both prescription medications used to treat inflammation, but they belong to different drug classes and work in different ways. Indocin is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce inflammation and pain by blocking proteins called cyclooxygenase (COX). It's available as a tablet, liquid, and rectal suppository, which can be a good option if you have trouble swallowing pills. Prednisone, on the other hand, is a corticosteroid that mimics a natural hormone in your body to calm down your immune response. It's taken orally and is available in various forms, including tablets and liquid. While Indocin is typically used for arthritis and shoulder pain, prednisone treats a wider range of conditions, including allergies, skin conditions, and certain cancers. Both medications have serious side effects, but prednisone can also cause long-term issues like weakened bones and a higher risk of infections if used for a long time. Indocin is not recommended during pregnancy, especially after 20 weeks, while prednisone requires careful monitoring if you're pregnant or planning to become pregnant.

Indomethacin

(Indocin)

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Prednisone

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Summary for Indocin

Prescription only

Indomethacin (Indocin) suppository is an NSAID that's used to treat different types of arthritis and conditions that cause pain in the shoulder. It helps lower inflammation and relieve pain. As a suppository, it's inserted into the rectum, typically 2 to 4 times a day depending on what condition the medication is being used to treat. Side effects might include headache and stomach upset. Unlike other NSAIDs, indomethacin (Indocin) suppository isn't available over-the-counter and requires a prescription from your healthcare provider.

Indications for Indocin

Moderate-to-severe rheumatoid arthritis, including flare-ups
Moderate-to-severe ankylosing spondylitis
Moderate-to-severe osteoarthritis
Shoulder pain caused by bursitis or tendonitis
Gouty arthritis

Pros and Cons for Indocin

Pros

Good option for people who have trouble swallowing pills
Can treat many different types of arthritis
Available as a lower-cost generic

Cons

Only available in one strength (50 mg), so you might need to use several suppositories if you're taking a high dose
Might need to take multiple times per day
Not available over-the-counter

Common Side Effects for Indocin

Note: The side effects listed here are for indomethacin capsules. Side effects for the suppositories might differ.

Headache
Dizziness
Nausea
Stomach upset

Warnings for Indocin

Stomach bleeding and ulcers
Heart attack and stroke
High blood pressure and heart failure
Liver problems
Kidney damage and high potassium levels
Severe allergic reactions
Severe asthma attack
Worsening of nervous system and mental health problems
Harm to unborn babies

Summary for Prednisone

Prescription only

Prednisone is an oral corticosteroid. It's taken by mouth by adults and children to treat health conditions related to an overactive immune system or inflammation, such as allergies and certain skin conditions. Your healthcare team will determine your dose based on what medical condition you have. Some of the common short-term side effects of prednisone include stomach irritation and mood changes. And if you take this medication for a month or longer, you're more likely to experience long-term side effects, like weight gain and weakened immune system.

Indications for Prednisone

This medication is used for many different conditions. Generally, it's used for autoimmune problems, conditions related to swelling, or cancer. Some examples include:

Allergies or allergic reactions
Skin conditions
Conditions affecting certain hormones (e.g., low adrenal hormones)
Eye conditions
Lung conditions
Gut conditions (e.g., ulcerative colitis)
Conditions related to blood cells
Certain cancers (e.g., leukemia
Nervous system conditions (e.g., multiple sclerosis)
Joint conditions (e.g., rheumatoid arthritis)
Lupus

Pros and Cons for Prednisone

Pros

Works well to treat many different conditions involving the immune system
Available as a liquid, which is a good option for people who have difficulty swallowing pills
Available as a lower-cost generic
Dose can be adjusted based on your response to the medication

Cons

Can cause side effects like upset stomach, mood changes, and sleep problems
Need to taper your dose before stopping (if you took it for more than a couple of weeks)
Might raise your risk for infections, bone weakening, and skin problems if used long term
Can slow growth in children if they take it for a long period of time