Pharmacokinetics of indomethacin in pregnancy

Erik Rytting, Tatiana Nanovskaya, Xiao-Ming Wang, Daria I. Vernikovskaya, Shannon Clark, Marlo Cochran, Susan M. Abdel-Rahman, Raman Venkataramanan, Steve N. Caritis, Gary Hankins, Mahmoud Ahmed

Research output: Contribution to journalArticle

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Abstract

Background and objectives: Although indomethacin has been widely used for the treatment of preterm labor over the past 40 years, there are few reports regarding its pharmacokinetics in pregnant women. Methods: This opportunistic study assessed the steady-state pharmacokinetics of indomethacin in pregnant subjects to whom an oral dose of 25 mg every 6 h was prescribed. Indomethacin concentrations in plasma and urine were analyzed by a validated high-performance liquid chromatography method with mass spectrometric detection. Results: The mean area under the plasma concentration versus time curve at steady state (AUCss) was 1.91 ± 0.53 μg·h/mL, mean peak plasma concentration (C max) was 1.02 ± 0.49 μg/mL, and mean time to reach C max (t max) was 1.3 ± 0.7 h. The mean apparent clearance at steady state was 14.5 ± 5.5 L/h, which is higher than the apparent clearance reported in the literature for non-pregnant subjects. Indomethacin crosses the placenta; the mean fetal/maternal ratio from five sets of cord blood samples collected at delivery was 4.0 ± 1.1. Conclusions: Further studies are needed to determine whether any dose adjustments are necessary as a result of the increased clearance of indomethacin during pregnancy.

Original languageEnglish (US)
Pages (from-to)545-551
Number of pages7
JournalClinical Pharmacokinetics
Volume53
Issue number6
DOIs
StatePublished - 2014

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Indomethacin
Pharmacokinetics
Pregnancy
Premature Obstetric Labor
Fetal Blood
Placenta
Pregnant Women
High Pressure Liquid Chromatography
Mothers
Urine
Therapeutics

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Medicine(all)

Cite this

Pharmacokinetics of indomethacin in pregnancy. / Rytting, Erik; Nanovskaya, Tatiana; Wang, Xiao-Ming; Vernikovskaya, Daria I.; Clark, Shannon; Cochran, Marlo; Abdel-Rahman, Susan M.; Venkataramanan, Raman; Caritis, Steve N.; Hankins, Gary; Ahmed, Mahmoud.

In: Clinical Pharmacokinetics, Vol. 53, No. 6, 2014, p. 545-551.

Research output: Contribution to journalArticle

Rytting, E, Nanovskaya, T, Wang, X-M, Vernikovskaya, DI, Clark, S, Cochran, M, Abdel-Rahman, SM, Venkataramanan, R, Caritis, SN, Hankins, G & Ahmed, M 2014, 'Pharmacokinetics of indomethacin in pregnancy', Clinical Pharmacokinetics, vol. 53, no. 6, pp. 545-551. https://doi.org/10.1007/s40262-014-0133-6
Rytting, Erik ; Nanovskaya, Tatiana ; Wang, Xiao-Ming ; Vernikovskaya, Daria I. ; Clark, Shannon ; Cochran, Marlo ; Abdel-Rahman, Susan M. ; Venkataramanan, Raman ; Caritis, Steve N. ; Hankins, Gary ; Ahmed, Mahmoud. / Pharmacokinetics of indomethacin in pregnancy. In: Clinical Pharmacokinetics. 2014 ; Vol. 53, No. 6. pp. 545-551.
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