INDOMETHACIN

What is indomethacin (Indocin)?

Indomethacin belongs to the class of medications called non-steroidal anti-inflammatory drugs (NSAIDs). Other drugs found within this class are diclofenac (Voltaren), meloxicam (Mobic), ibuprofen (Advil), and naproxen (Naprosyn). Indomethacin and other NSAIDs work by inhibiting the compounds responsible for inducing inflammation [1].

What is the link between indomethacin and long-COVID?

Many patients diagnosed with long-COVID are plagued by moderate to severe, frequent headaches. The cause is thought to be massive inflammation accompanied by a cytokine storm (overexaggeration of the immune system) [2]. These headaches can worsen a preexisting primary headache or, more specifically, present as a new (intermittent or daily) headache starting during the acute infection or after a delay [2].

To treat these headaches, providers have begun using indomethacin. A study was conducted in 37 patients, and 36 of those patients’ use of indomethacin reduced headaches by more than 50% on day 3 with complete resolution on day 5 [3]. In another study comparing paracetamol (acetaminophen/Tylenol) to indomethacin, the indomethacin group experienced quicker symptom relief and complained only of tiredness as a side effect [4].

Although indomethacin will not cure long-COVID, it may offer symptom management in headache sufferers. Indomethacin is relatively safe and has shown effectiveness in patients where other therapies have failed, making it an attractive option for those dealing with headaches from long-COVID.

References:

¹https://my.clevelandclinic.org/health/articles/24411-prostaglandins#:~:text=Prostaglandins%20are%20hormone%2Dlike%20because,bloodstream%20like%20they%20do%20hormones

²https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01450-8

³https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453033/

⁴https://www.nature.com/articles/s41598-022-10370-1