What is the dosage schedule for Indocin when used as a tocolytic for pregnancies less than 32 weeks gestation?

The correct dosage schedule for Indocin, when used as a tocolytic for pregnancies less than 32 weeks gestation, involves a loading dose followed by a maintenance dose. Administering a loading dose of 100 mg orally allows for rapid achievement of therapeutic drug levels, which is crucial in tocolysis to inhibit labor. Following this, a maintenance dose of 50 mg every 8 hours is appropriate to sustain effective levels of the medication in the body.

Indomethacin acts as a non-steroidal anti-inflammatory drug (NSAID) and works by inhibiting prostaglandin production, which is known to play a role in initiating uterine contractions. The schedule of using a loading dose followed by a smaller, regular maintenance dose is standard practice to balance efficacy with the need to minimize potential side effects associated with longer-term NSAID use.

The other dosing regimens do not align with the established guidelines for tocolytic therapy. For instance, taking a dose every 6 hours or every 12 hours does not provide the sustained plasma levels needed to effectively manage preterm labor in this patient population. Likewise, a once-daily dosing schedule would not maintain adequate therapeutic concentrations to be effective in delaying delivery. Therefore, the recommended regimen