Drug interactions
Clopidogrel + Indomethacin
Severity: Major
Clopidogrel 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
Both drugs impair platelet function, and indomethacin also damages the gastroduodenal mucosa. Together they substantially increase the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Clopidogrel 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.
Clopidogrel belongs to Cardiovascular; Indomethacin belongs to Musculoskeletal.
Why it happens
Additive antiplatelet effects (P2Y12 blockade plus reversible COX-1 inhibition) with NSAID-induced mucosal injury.
What to do
Avoid concurrent use when possible; if an NSAID is needed, use the shortest course and add a proton pump inhibitor that does not interfere with clopidogrel, such as pantoprazole, while monitoring for bleeding.
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?
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References
Other interactions of Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Acetylsalicylic acid + Indomethacin Major
- Alteplase + Indomethacin Major
Other interactions of Clopidogrel
Frequently asked questions
Can I take Clopidogrel with Indomethacin?
MediHelp rates the interaction as major. Clopidogrel 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. Both drugs impair platelet function, and indomethacin also damages the gastroduodenal mucosa. Together they substantially increase the risk of gastrointestinal and other bleeding.
How serious is the interaction between Clopidogrel 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 concurrent use when possible; if an NSAID is needed, use the shortest course and add a proton pump inhibitor that does not interfere with clopidogrel, such as pantoprazole, while monitoring for bleeding.
What other medicines interact with Indomethacin?
MediHelp also lists interactions of Indomethacin with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Indomethacin page.
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