Drug interactions
Acetylsalicylic acid + Indomethacin
Severity: Major
Acetylsalicylic acid and Indomethacin: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining aspirin with indomethacin increases the risk of gastrointestinal ulceration and bleeding without added benefit. Indomethacin may also reduce the antiplatelet effect of low-dose aspirin.
What this interaction means in plain words
Acetylsalicylic acid and Indomethacin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Acetylsalicylic acid belongs to Musculoskeletal; Indomethacin belongs to Musculoskeletal.
Why it happens
Additive inhibition of platelet function and gastric prostaglandin synthesis, with possible competition at platelet COX-1.
What to do
Avoid the combination where possible. If both are needed, add a proton pump inhibitor and monitor for bleeding and renal function.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Acetylsalicylic acid and Indomethacin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Alteplase + Indomethacin Major
- Amiloride + Indomethacin Major
Frequently asked questions
Can I take Acetylsalicylic acid with Indomethacin?
MediHelp rates the interaction as major. Acetylsalicylic acid and Indomethacin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining aspirin with indomethacin increases the risk of gastrointestinal ulceration and bleeding without added benefit. Indomethacin may also reduce the antiplatelet effect of low-dose aspirin.
How serious is the interaction between Acetylsalicylic acid and Indomethacin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible. If both are needed, add a proton pump inhibitor and monitor for bleeding and renal function.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
