Drug interactions
Diclofenac + Indomethacin
Severity: Major
Diclofenac 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
Taking two NSAIDs together provides no added analgesic benefit and increases the risk of GI bleeding, renal injury, hyperkalemia and cardiovascular events.
What this interaction means in plain words
Diclofenac 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.
Diclofenac belongs to Musculoskeletal; Indomethacin belongs to Musculoskeletal.
Why it happens
Duplicate COX inhibition produces additive effects on gastric mucosa, platelets and renal prostaglandins.
What to do
Avoid concurrent use of two systemic NSAIDs and choose a single agent at the lowest effective dose. If a switch is made, stop the first drug before starting the second.
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 Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac Major
Frequently asked questions
Can I take Diclofenac with Indomethacin?
MediHelp rates the interaction as major. Diclofenac 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. Taking two NSAIDs together provides no added analgesic benefit and increases the risk of GI bleeding, renal injury, hyperkalemia and cardiovascular events.
How serious is the interaction between Diclofenac 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 of two systemic NSAIDs and choose a single agent at the lowest effective dose. If a switch is made, stop the first drug before starting the second.
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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