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Old 06-01-2010, 07:00 AM #1
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Help tooth extraction - can i use indomethacin?

i am having a tooth extracted today. presumably i will be told to take some sort of prophylactic treatment for pain.

in the past i have always used ibuprofen for tooth-related pain.

thing is i have a migraine ongoing. i use indomethacin for migraines. i took some this morning - i timed it so next dose should be about the time of the extraction, so that i can switch med if need be.

i am wondering if if indomethacin will appropriate for the extraction also. i mean, i would think so - it is still an NSAID.

if anyone here knows, please advise.

because, i would prefer to take the indomethacin than the (high) dose of ibuprofen i would need to control the migraine. but if i am not sure, and the dentist doesn't know, i guess i will have to go with the ibuprofen.

thank you

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Last edited by waves; 06-01-2010 at 07:26 AM.
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Old 06-01-2010, 07:08 AM #2
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Dear Waves,
I just got on here.
Give me about 15 minutes and I will see what I can find.

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Old 06-01-2010, 07:27 AM #3
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thought it was cox-2 specific but double checked and it is not. i can't find anything regarding teeth. i will tell him i took it as there may be more bleeding.
now i am wondering if i should call and see if he even wants to take me. geez if not i hope they don't make me pay for the appointment.

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Old 06-01-2010, 07:39 AM #4
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Default i called and left a message

i called and the dentist is busy but the receptionist wrote it down i gave her the time and dose i took and told her i would have to keep taking it because of the migraine as well, so ideally if he is going to do this i would need stitches too (here not everyone gives stitches) - she is going to call me as soon as she can find out.

i hope the dentist gets free before i have to get on the bus or it will be expensive even if they don't charge me.



stupid stupid me i should have thought to call as soon as i took the med. idiot idiot.



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Old 06-01-2010, 07:41 AM #5
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Sometimes the pharmacist know more about medications than a doctor does. Can you check with one in your neck of the woods?

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Old 06-01-2010, 07:41 AM #6
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Default sorry about your headache

Dear Waves,

I found almost nothing on it.
http://en.wikipedia.org/wiki/Indometacin
-- wikipedia says should always be taken with food
--wikipedia says psychosis has been reported with long term use
-apparently it interferes with lithium

I don't much of anything about this re bipolar, mania, mood disorders, or depression.

I found a study about prolonged use:
http://www.springerlink.com/content/25qfqpvf8ghct602/
Non-steroidal Anti-inflammatory Drugs with Adverse Psychiatric Reactions: Five Case Reports
Quote:
We describe here five psychiatric outpatients, two with major depressive disorders, one bipolar disorder, one schizophrenic disorder and one anxiety disorder, who were treated with NSAIDs for pain due to rheumatoid arthritis, osteoarthritis or other painful neuromuscular conditions. All five patients developed a moderate to severe depressive state, three patients became obviously paranoid, and four had either thoughts of suicide or an attempt while undergoing co-administration of NSAIDs. The psychiatric symptoms remitted when the NSAIDs were stopped.

Here is an article about two days of use:
Mania and Indomethacin

Quote:
In the course of her outpatient evaluation, the patient sought care from an orthopedic surgeon for arthritic lower back pain. She was started on indomethacin 50 mg twice daily. After 2 days of indomethacin, she presented with hypersensitivity and a complaint of racing thoughts.

Here is my two cents.
The decision to take the medicine might depend on how complicated the tooth extraction is expected to be. Also it depends on the severity of the headache.

I think if you need one or two doses of the pill you could be ok. You can watch yourself and take a benzo as soon as you feel the med giving you too much energy.

You and I have gone through this will my wisdom teeth extractions. My dentist at the time had me ice that part of the mount (from the out side of course) for part of the day after the extraction and he asked me to eat ice cream (no pieces in it like fruit or nuts) for about 24 hours. That much milk protein upsets my stomach so I really did eat ice cream and froz yogurt for about 36 hours. In other words, stay away from hot foods.

This is taking longer than I thought it would.

Good luck.

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Old 06-01-2010, 07:43 AM #7
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Waves,
What is your concern?
Is it mood?
Headache and toothache?
Bleeding?

Sorry. I think I am trying to read your posts too quickly.
Also I am very unfamiliar with the meds you are talking about.

That is good that you called the dentist.

M.
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Old 06-01-2010, 08:31 PM #8
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Wink Dear Mari

i want to thank you again for taking the time to look into this with me today. and also, this is very interesting! now i have more time and not specific concern with the procedure/bleeding whatnot, i am looking over your posts again in more depth.

Quote:
Originally Posted by Mari View Post
Non-steroidal Anti-inflammatory Drugs with Adverse Psychiatric Reactions: Five Case Reports
....
Here is an article about two days of use:
Mania and Indomethacin
psychosis??? i've heard nasty things about it but psychosis???

and mania after only TWO DAYS of BID dosing - yikes!

and you know, these things are NOT on the insert. here everything comes in boxes - pharmacy cannot dispense things in the brown plastic containers with stick-on labels like in the US. everything comes boxed from the manufacturer, complete with the full drug insert.

maybe these are very very very rare reactions? i should ask my pdoc. i think i am safe because i haven't had any sort of activation (the opposite, if anything) at all, but still! this should be on the insert!

in case you are curious... the only bit in the insert that touches on psychiatric stuff is (translated):

There are rare reports of the following reactions: confusion, syncope, somnolence, seizures, coma, depression and other psychic disturbances such as derealization. These effects are often transitory and usually remit as therapy continues or following a dosage reduction. However, on occasion, these reactions may be pronounced enough to require suspension of treatment.

Quote:
My dentist at the time had me ice that part of the mount (from the out side of course) for part of the day after the extraction and he asked me to eat ice cream (no pieces in it like fruit or nuts) for about 24 hours.
you know, my dad had some extractions at a different center - and they told him to avoid milk products for the first day or so afterwards!!! where i went i was not given food restrictions other than nothing hot for the first 24 hours, and warned that spicy food might be irritating. yah, i might hold off on the indian pickle for a while! .

Quote:
That much milk protein upsets my stomach so I really did eat ice cream and froz yogurt for about 36 hours.
are you sure it is not lactose intolerance? have you ever seen that A+ milk with Lactobacillus acidophilus in it?
http://en.wikipedia.org/wiki/Lactobacillus_acidophilus
Quote:
At adequate daily feeding levels, L. acidophilus may facilitate lactose digestion in lactose-intolerant subjects.[
L. acidophilus is also present in yogurt. i wonder if that could be why you find yogurt more digestible than milk or cream?

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Old 06-01-2010, 10:32 PM #9
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just wanted to say
hi
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Old 06-01-2010, 07:45 AM #10
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Quote:
Originally Posted by waves View Post
i

i am wondering if if indomethacin will appropriate for the extraction also. i mean, i would think so - it is still an NSAID.
Waves,
I missed the part that you already took it.

I think you will be fine.

I will look some more.

M.
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