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indometacin (IV) (Indocin IV)

✓ Approved

Merck & Co. · PTGS1 · Small Molecule

What is indometacin (IV)?

indometacin (IV) is a small molecule developed by Merck & Co.. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesIndocin IV
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetPTGS1, PTGS2
RouteInjectable (Others), Intravenous (IV)
StatusApproved

Mechanism of Action

Molecular Targets

indometacin (IV) acts on 2 molecular targets:

PTGS1prostaglandin-endoperoxide synthase 1 (COX3, PCOX1)
PTGS2prostaglandin-endoperoxide synthase 2 (GRIPGHS, hCox-2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

indometacin (IV) is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Congenital, familial and genetic disordersPatent ductus arteriosus✓ Approved

Related Research Articles

PubMedArchiv der Pharmazie2026-10-15

Synthesis of Some New Xanthine Derivatives and Evaluation of DPP IV Inhibitory Activities.

Akgün Erol E, Yurttaş Leyla L, Kaleli Sevde Nur Biltekin SNB, Osmaniye Derya D et al.

Dipeptidyl peptidase IV (DPP IV) inhibition prolongs incretin activity and represents an established therapeutic strategy for the management of type 2 diabetes mellitus. To investigate the underexplored combination of benzyl groups at the N7 position and a piperazine-linked arylthiazole moiety at the C8 position of the xanthine scaffold, 15 novel compounds (6a-6o) were synthesised. The synthetic route involved bromination at the C8 position of theophylline, introduction of benzyl groups at the N7 position, replacement of the bromine atom at the C8 position with piperazine, and subsequent cyclocondensation with phenacyl thiocyanate derivatives. All final compounds were characterised by 1H and 13C NMR spectroscopy, high-resolution accurate-mass mass spectrometry, and analytical HPLC. All derivatives inhibited DPP IV in the low-nanomolar range, with compounds 6c and 6b showing the highest activities, with IC50 values of 3.95 ± 0.53 and 4.04 ± 0.65 nM, respectively. NIH3T3 cytotoxicity IC50 values ranged from 28.52 to 397.63 µM, indicating substantial preliminary concentration margins relative to DPP IV inhibition. Molecular docking, 100 ns molecular dynamics simulations, interaction-fingerprint analyses and trajectory-based MM/PBSA calculations supported persistent interactions with key DPP IV active-site residues. These results identify the synthesised derivatives, particularly 6b and 6c, as promising lead structures for further optimisation.

PubMedAcute and critical care2026-10-15

The effects of intravenous glutamine supplementation in critically ill patients: a systematic review and meta-analysis.

Lee Jae Gil JG, Kwon In Gyu IG, Baik Seung Min SM

Studies evaluating intravenous (IV) glutamine supplementation in critically ill patients have shown inconsistent results. This study aimed to evaluate the effects of IV glutamine on mortality, infectious complications, length of stay, and duration of mechanical ventilation. A systematic search of Ovid Medline, Embase, the Cochrane Central Register of Controlled Trials, and KoreaMed was conducted from inception through October 2023 and updated in April 2025. Randomized controlled trials comparing IV glutamine supplementation with standard care in critically ill adults were included. Pooled estimates were calculated using random-effects models. A total of 10 randomized trials involving 1,593 critically ill patients were included in the analysis. IV glutamine supplementation was not associated with reduced overall mortality (risk ratio [RR], 0.93; 95% CI, 0.77-1.13) or overall infection rates (RR, 0.86; 95% CI, 0.63-1.18). No mortality benefit was observed in either non-surgical or surgical/trauma subgroups. Glutamine supplementation was associated with reduced pneumonia incidence (RR, 0.65; 95% CI, 0.49-0.87) and shorter mechanical ventilation duration (mean difference, -0.97 days; 95% CI, -1.62 to -0.32); however, these findings were based on a limited number of small studies. Intensive care unit and hospital length of stay were longer in the glutamine group. IV glutamine supplementation was not associated with improved survival or overall infection rates in critically ill adults. Current evidence does not support routine IV glutamine supplementation in unselected critically ill patients.

PubMedNPJ digital medicine2026-10-15

Current status and future outlook of artificial intelligence and automation in intravenous infusion systems.

Ibrahim Islam M IM, Elkomy Rahma A RA, Mohamed Merna A MA, Farok Fatemah A FA et al.

The combination of the Internet of Things (IoT), artificial intelligence (AI), and wearable biosensors is transforming healthcare by allowing continuous, real-time monitoring and more intelligent clinical decision-making. This review explores AI-driven monitoring, smart intravenous (IV) infusion automation, and wearable biosensors, and proposes Intelligent IV Automation and Smart Patient Synchronization (INFUSYNC), a conceptual framework synchronizing monitoring, automated fluid delivery, and predictive analytics. The literature shows meaningful progress: wearables increasingly support non-contact monitoring with near clinical-grade accuracy for select parameters, while infusion pumps with dose-error-reduction and AI-assisted decision support are reported to improve delivery precision and safety. Predictive models further support early detection of physiological decline. Progress remains uneven, however: most AI-enabled infusion systems are prototype-stage, closed-loop control remains rare, and interoperability, data security, and privacy remain underdeveloped. Future systems will need compatible, security-by-design, clinically validated, feedback-controlled architectures. Overall, this review outlines a clear but early-stage trajectory toward integrated smart-health environments for IV therapy.

PubMedFrontiers in cardiovascular medicine2026-10-15

Prognostic discrimination of SOFA-2 vs. SOFA-1 and incremental information from cardiovascular scoring and vasoactive support intensity in patients with sepsis receiving early vasoactive therapy.

Huang Tianci T, Pan Mingyuan M, Pan Lifan L, Liang Peng P et al.

Patients with sepsis who require vasoactive support during the first 24 h of intensive care represent a heterogeneous population. It is uncertain whether the Sequential Organ Failure Assessment (SOFA)-2 score improves mortality discrimination compared with the SOFA-1 score and whether observed circulatory support intensity provides complementary prognostic information. This multicohort observational study used Medical Information Mart for Intensive Care IV (MIMIC-IV) for a 24-h conditional landmark analysis. Patients alive and still in the ICU beyond 24 h were followed from ICU admission +24 h through ICU day 28 for reconstructed all-cause mortality. We compared SOFA-1 and SOFA-2, evaluated SOFA-2 total and cardiovascular scores, analyzed first-24-h five-agent norepinephrine-equivalent peak burden (norepinephrine, epinephrine, dopamine, phenylephrine, and vasopressin), and internally evaluated an exploratory drug-composition model. Fixed strata were assessed directionally in eICU Collaborative Research Database and an independent-center high-risk stress test cohort with cohort-specific endpoints. The MIMIC-IV 24-h landmark cohort included 11,892 patients and 2,687 post-landmark deaths. SOFA-2 showed no observed discrimination advantage over SOFA-1 (area under the receiver operating characteristic curve, AUROC, 0.731 vs. 0.732; difference, -0.0005; 95% confidence interval, -0.0086 to 0.0076; P = 0.908). The SOFA-2 cardiovascular score had lower discrimination than the SOFA-1 cardiovascular score (0.663 vs. 0.676; P = 0.006). Mortality was 51.94% for the exploratory SOFA-2 ≥12 group and 17.09% below 12, and increased from 11.30% to 47.45% across four study-defined peak burden categories. The SOFA-2-plus-drug-composition model had an apparent AUROC of 0.768 and a bootstrap-corrected AUROC of 0.767, but it was not externally validated. Fixed strata preserved the direction of risk ranking in both external cohorts, whereas absolute risk and calibration differed. SOFA-2 did not show an observed overall mortality discrimination advantage over SOFA-1 in this population. SOFA-2 total and cardiovascular scores, together with observed vasoactive support intensity, provided complementary prognostic description at 24 h. The ≥12 rule is exploratory, and drug-related associations do not establish causal treatment effects or clinical decision utility.

PubMedFrontiers in neurology2026-10-15

Prognostic value of platelet-to-white blood cell ratio in critically ill patients with non-traumatic subarachnoid hemorrhage: a machine learning-driven study of the public database and the hospital information system.

Liu Liang L, Huang Zhilei Z, Gui Binbin B, Xu Lin L et al.

Assessment of prognosis is crucial for managing non-traumatic subarachnoid hemorrhage (NSAH) patients. The study aimed to explore the association between platelet-to-white blood cell ratio (PWR) and all-cause mortality in this high-risk population and to develop machine learning models to improve prognostic accuracy. Using data from the Medical Information Mart for Intensive Care (MIMIC-IV). The observational endpoints were 30-day and 365-day mortality. Patients were categorized into four groups based on the quartiles of PWR. Kaplan-Meier curves, multivariate Cox regression analyses, restricted cubic splines (RCS), and subgroup analyses were applied. We also developed machine learning models that include PWR and clinical features selected with the Boruta and LASSO algorithms to predict 30-day mortality. Model performance was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Shapley Additive exPlanations (SHAP) method was utilized to provide model interpretability. External validations in the eICU-Collaborative Research Database (eICU-CRD) and the Hospital Information System (HIS) of the First Affiliated Hospital of Harbin Medical University were used to assess generalizability. A total of 1,176 patients with critically ill NSAH were enrolled from MIMIC-IV, predominantly male (58.8%), with a median age of 62 years. In multivariable Cox models, higher PWR quartiles were independently associated with lower risk of 30-day (HR = 0.55, 95% CI 0.35, 0.86, p = 0.009) and 365-day (HR = 0.53, 95% CI 0.37, 0.77, p = 0.001) mortality after fully adjusting. RCS suggested a linear association. No significant interaction was observed by subgroup analysis across all subgroups. The top-performing machine learning model attained an AUC of 0.868 during internal validation (MIMIC-IV). External validations yielded AUC values of 0.874 (eICU-CRD) and 0.763 (HIS). SHAP analysis revealed a correlation between decreased PWR and an elevated predicted risk of mortality. PWR is an independent predictor of short- and long-term mortality in ICU patients with NSAH. Machine learning models incorporating PWR significantly improve risk stratification, thereby providing precious support for the early identification and personalized management of patients in the ICU.

PubMedJournal of materials chemistry. B2026-10-15

Mitochondria-targeted ROS-scavenging nanoreactor with dual-drug-loaded carbon dots for osteoarthritis therapy.

Li Weikun W, Luo Jinyuan J, Liang Shuiqi S, Zhong Qian Q et al.

Osteoarthritis (OA) pathology entails complex interactions among oxidative stress, chronic inflammation, cartilage degradation, and dysregulation of subchondral bone remodeling. Current therapeutic agents suffer from limited efficacy due to poor joint targeting and low bioavailability, highlighting the critical need for advanced drug delivery systems. In this study, a mitochondria-targeting reactive oxygen species (ROS)-scavenging nanoreactor (A@HP@SH/T) was developed for multi-mechanism OA repair. The nanoreactor is constructed using hollow mesoporous prussian blue (HMPB) as the carrier, loaded with carbon dots (AA CDs) co-assembled from astragaloside IV (AS-IV) and alendronate sodium (ALN), coated with diselenide-modified hyaluronic acid (Se-Se HA), and further conjugated with the mitochondrial-targeting ligand TPP. Through a temporal cascade of TPP-mediated mitochondrial anchoring, Se-Se HA ROS-responsive cleavage, and HMPB-mediated in situ protection and sustained release, AA CDs are precisely delivered to the lesion site, where they efficiently scavenge ROS and modulate mitochondrial homeostasis, thereby fundamentally breaking the vicious cycle of oxidative stress, chronic inflammation, and cartilage degradation within the joint. Additionally, the ALN component in AA CDs targets subchondral bone and modulates bone metabolism to reshape the local microstructure, offering both mechanical support and a beneficial nutritional microenvironment for cartilage regeneration. Both in vitro and in vivo studies confirmed that this system effectively restores mitochondrial homeostasis, alleviates inflammation, promotes cartilage differentiation, and regulates bone metabolism, thereby promoting OA repair. Collectively, this nanoreactor represents a highly promising strategy for the treatment of osteoarthritis.

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