Drug interactions
Diclofenac + Reteplase
Severity: Major
Diclofenac and Reteplase: 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
Diclofenac inhibits platelet function and can injure the gastric mucosa, while reteplase dissolves fibrin clots. Taken together they raise the risk of serious bleeding, particularly gastrointestinal and intracranial hemorrhage.
What this interaction means in plain words
Diclofenac and Reteplase 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: NSAID-induced platelet inhibition and mucosal injury combined with thrombolytic fibrinolysis.
What to do
Review the need for NSAID therapy before and after thrombolysis and avoid it where possible, using paracetamol if analgesia is needed. Monitor closely for bleeding if the combination cannot be avoided.
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 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 Reteplase?
MediHelp rates the interaction as major. Diclofenac and Reteplase 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 inhibits platelet function and can injure the gastric mucosa, while reteplase dissolves fibrin clots. Taken together they raise the risk of serious bleeding, particularly gastrointestinal and intracranial hemorrhage.
How serious is the interaction between Diclofenac and Reteplase?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Review the need for NSAID therapy before and after thrombolysis and avoid it where possible, using paracetamol if analgesia is needed. Monitor closely for bleeding if the combination cannot be avoided.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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