Night-time indomethacin in rheumatoid arthritis

Indomethacin is commonly prescribed at night to relieve morning stiffness in patients with rheumatoid arthritis. Pharmacokinetic and pharmacodynamic interactions are frequently described with non-steroidal anti-inflammatory drugs, and the rationale of using more than one of these agents at the same time is questionable. A randomized crossover trial was carried out in 14 patients to compare the effects of 100 mg indomethacin at night with those of placebo when added to a baseline regimen of stabilized salicylate therapy with a slow-release preparation. Each treatment was given for 2 weeks. The results suggest that the addition of indomethacin produced no significant benefit in terms of reduction in the duration of morning stiffness or on the overall daily pain score.