Drug interactions
Dabigatran + Indomethacin
Severity: Major
Dabigatran and Indomethacin: major interaction.
Last updated
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
Indomethacin increases the risk of bleeding with dabigatran through its antiplatelet action and gastrointestinal mucosal injury. Bleeding can be serious, particularly in older patients or those with renal impairment.
What this interaction means in plain words
Dabigatran 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.
Why it happens
Additive pharmacodynamic effect of direct thrombin inhibition and NSAID-induced platelet dysfunction and mucosal damage.
What to do
Avoid NSAIDs where possible and use paracetamol instead. If necessary, use the shortest course with gastroprotection 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?
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Other interactions of Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Acetylsalicylic acid + Indomethacin Major
- Alteplase + Indomethacin Major
Frequently asked questions
Can I take Dabigatran with Indomethacin?
MediHelp rates the interaction as major. Dabigatran 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. Indomethacin increases the risk of bleeding with dabigatran through its antiplatelet action and gastrointestinal mucosal injury. Bleeding can be serious, particularly in older patients or those with renal impairment.
How serious is the interaction between Dabigatran 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 NSAIDs where possible and use paracetamol instead. If necessary, use the shortest course with gastroprotection and monitor for bleeding and renal function.
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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