Q: What is the role of Indomethacin in acute liver failure?


Answer:  It has been reported that increased Intra-Cranial Pressure (ICP) in fulminant  hepatic failure which stays refractory to all treatments may respond to a single intravenous dose of 25 mg  Indomethacin given over one minute. Proposed mechanism of action is cerebral vasoconstriction.


References: 

 1. Clemmesen JO, Hansen BA, Larsen FS. Indomethacin normalizes intracranial pressure in acute liver failure: a twenty-three-year-old woman treated with indomethacin. Hepatology 1997; 26:1423.

2. Tofteng F, Larsen FS. The effect of indomethacin on intracranial pressure, cerebral perfusion and extracellular lactate and glutamate concentrations in patients with fulminant hepatic failure. J Cereb Blood Flow Metab 2004; 24:798.