Liometacen interferes with the synthesis of prostaglandins and their important intermediates, which play an important role in physiological functions. The drug does therefore require particular care or it should not be used when the patient presents the following conditions:
- renal hypoperfusion
- renal diseases
- cardiac insufficiency
- cirrhosis of the liver or severe hepatitis
- old age
Administration of the drug shortly before delivery can delay birth; moreover, if administered during this period, the drug can cause haemodynamic alterations of the pulmonary circulation of the neonate, with serious consequences for respiration. As a result of interaction with the metabolism of arachidonic acid, in asthmatic and other sensitive subjects, the drug may cause bronchospasm attacks and even shock as well as other allergic phenomena. Since the product is characterised by a high activity, and due to the variability of its tendency to cause side effects, the lowest active dose should be used for each patient since an increase in dosage tends to raise the incidence of side effects. Particular care must be given to detecting as early as possible any gastrointestinal, ocular and nervous adverse reactions to the drug so that a prompt decision can be made as to whether it is advisable to interrupt treatment or, if necessary, continue with a lower dose. However, in the event of haemorrhage, treatment must be interrupted. As ocular reactions can be asymptomatic, subjects receiving long-term treatment should undergo regular ophthalmic examinations. Indomethacin can mask infections already present and unrecognised at the start of treatment or which occur during the course of treatment.
