Epacil 25 mg Capsule

NSAID for pain and inflammation:

• Acute gout attacks
• Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis
• Acute musculoskeletal disorders, bursitis, tendinitis
• Period pain
• Suppositories: night pain and morning stiffness
• Eye drops: inflammation and pain after eye surgery; prevention of macular oedema

Adults (capsules): 25 mg two to three times daily, increased to 50 mg three times daily if needed (maximum 150–200 mg/day).

• Acute gout: 50 mg three times daily until pain eases (usually 3–5 days), then reduce.

Modified release: 75 mg once or twice daily.

Suppository: 100 mg at night, repeated in the morning if needed (maximum 200 mg/day total including oral).

Eye drops 0.1%: as directed by the eye surgeon.

• Take with food, milk or an antacid.
• Not usually recommended for children.

• Allergy to indomethacin, aspirin or other NSAIDs
• Active or past recurrent peptic ulcer/bleeding; inflammatory bowel disease
• Severe heart, kidney or liver failure
• Last 3 months of pregnancy
• Suppositories: proctitis or recent rectal bleeding

Common: headache (frequent — often frontal), dizziness, light-headedness, indigestion, nausea, abdominal pain, diarrhoea.

Less common: drowsiness, depression, confusion (especially elderly), fluid retention, raised blood pressure, rash, tinnitus.

Rare but serious: stomach bleeding/ulcer, kidney injury, heart attack/stroke, severe allergy, blood disorders, blurred vision (corneal deposits) with long-term use.

• More central nervous system side effects than other NSAIDs — elderly people should usually avoid it.
• Do not drive if dizzy.
• Epilepsy, Parkinson's disease, psychiatric illness: may worsen.
• Long-term use: regular eye checks.
• Heart disease, high blood pressure, kidney disease: caution.

Avoid in the first 6 months unless advised; contraindicated in the last 3 months (affects the baby's heart and kidneys). Avoid while breastfeeding.

• Other NSAIDs, aspirin, steroids (stomach bleeding)
• Warfarin, antiplatelets, SSRIs (bleeding)
• ACE inhibitors, ARBs, diuretics (kidney injury, less effect); triamterene (kidney failure)
• Lithium, methotrexate, digoxin (toxicity)
• Probenecid (raises levels)

Nausea, vomiting, severe headache, dizziness, confusion, drowsiness, seizures. Seek medical care.

Store below 30°C, protected from light.