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Drug

Indomethacin

Common brand names:

Indocid

Pronounced

"in-doh-METH-uh-sin"

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), cidofovir, corticosteroids (such as prednisone), lithium, methotrexate, "water pills" (diuretics such as furosemide).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, diflunisal, ibuprofen, or ketorolac). These drugs are similar to indomethacin and may increase your risk of side effects if taken together. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.

This medication may interfere with certain lab tests, possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Negative Interactions
4
- Indomethacin
  Iron
  Potential Negative Interaction
  Iron supplements can cause stomach irritation. Use of iron supplements with indomethacin increases the risk of stomach irritation and bleeding. However, stomach bleeding causes iron loss. If both iron and indomethacin are prescribed, they should be taken with food to reduce stomach irritation and bleeding risk.
  Iron
  Indomethacin
  ×
  1. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 139-40.
- Indomethacin
  Potassium
  Potential Negative Interaction
  Indomethacin may cause elevated blood potassium levels in people with normal and abnormal kidney function. Until more is known, people taking indomethacin should not supplement potassium without medical supervision.
  Potassium
  Indomethacin
  ×
  1. Tan SY, Shapiro R, Franco R, et al. Indomethacin-induced prostaglandin inhibition with hyper kalemia. Ann Intern Med 1979;90:783-5.
  2. Goldszer RC, Coodley EL, Rosner MJ, et al. Hyperkalemia associated with indomethacin. Arch Intern Med 1981;141:802-4.
  3. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 252-a.
  4. Perazella MA. Drug-induced hyperkalemia: Old culprits and new offenders. Am J Med 2000;109:307-14 [review].
- Indomethacin
  Sodium
  Potential Negative Interaction
  Indomethacin may cause sodium and water retention. It is healthful to reduce dietary salt intake by decreasing the use of table salt and avoiding heavily salted foods.
  Sodium
  Indomethacin
  ×
  1. Somova L, Zaharieva S, Ivanova M. Humoral factors involved in the regulation of sodium-fluid balance in normal man. II. Effects of indomethacin on sodium concentration, renal prostaglandins, vasopressin and renin-angiotensin-aldosterone system. Acta Physiol Pharmacol Bulg 1984;10:29-33.
- Indomethacin
  White Willow
  Potential Negative Interaction
  White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs. Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.
  White Willow
  Indomethacin
  ×
  1. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172-90.
Supportive Interactions
5
- Indomethacin
  Calcium
  Replenish Depleted Nutrients
  Indomethacin has been reported to decrease absorption of folic acid and vitamin C. Under certain circumstances, indomethacin may interfere with the actions of vitamin C. Calcium and phosphate levels may also be reduced with indomethacin therapy. It remains unclear whether people taking this drug need to supplement any of these nutrients.
  Calcium
  Indomethacin
  ×
  1. Hodges R. Nutrition in Medical Practice. Philadelphia: W. B. Saunders, 1980, 323-31 [review].
  2. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138,140.
- Indomethacin
  Iron
  Replenish Depleted Nutrients
  This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
  NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.
  Iron
  Indomethacin
  ×
  1. Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
  2. Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.
- Indomethacin
  Vitamin C
  Replenish Depleted Nutrients
  Indomethacin has been reported to decrease absorption of folic acid and vitamin C. Under certain circumstances, indomethacin may interfere with the actions of vitamin C.Calcium and phosphate levels may also be reduced with indomethacin therapy. It remains unclear whether people taking this drug need to supplement any of these nutrients.
  Vitamin C
  Indomethacin
  ×
  1. Hodges R. Nutrition in Medical Practice. Philadelphia: W. B. Saunders, 1980, 323-31 [review].
  2. Ogilvy CS, DuBois AB, Douglas JS. Effects of ascorbic acid and indomethacin on the airways of healthy male subjects with and without induced bronchoconstriction. J Allergy Clin Immunol 1981;67:363-9.
  3. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138,140.
- Indomethacin
  Stinging Nettle
  Support Medicine
  This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
  In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
  Stinging Nettle
  Indomethacin
  ×
  1. Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.
- Indomethacin
  Licorice
  Reduce Side Effects
  This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
  The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.
  Licorice
  Indomethacin
  ×
  1. Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
  2. Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.
Explanation Required
1
- Indomethacin
  Food
  Needs Explanation
  Indomethacin should be taken with food to prevent stomach irritation. However, applesauce, high-protein foods, and high-fat foods have been reported to interfere with indomethacin absorption and/or activity.
  Food
  Indomethacin
  ×
  1. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 252-a.
  2. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138-9.