Drug interactions
Enoxaparin + Indomethacin
Severity: Major
Enoxaparin 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
Indomethacin impairs platelet function and can injure the gastric mucosa, increasing the bleeding risk in patients on enoxaparin. Gastrointestinal and spinal or epidural hematoma risks are of particular concern.
What this interaction means in plain words
Enoxaparin 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.
Enoxaparin belongs to Cardiovascular; Indomethacin belongs to Musculoskeletal.
Why it happens
Additive hemostatic impairment: antiplatelet action of NSAID plus anti-factor Xa and antithrombin-mediated effects of enoxaparin.
What to do
Avoid concomitant NSAIDs where possible; if used, monitor for bleeding, hemoglobin 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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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 Enoxaparin
- Defibrotide + Enoxaparin Contraindicated
- Enoxaparin + Ketorolac Contraindicated
- Enoxaparin + Mifepristone Contraindicated
- Abciximab + Enoxaparin Major
- Aceclofenac + Enoxaparin Major
- Acetylsalicylic acid + Enoxaparin Major
Frequently asked questions
Can I take Enoxaparin with Indomethacin?
MediHelp rates the interaction as major. Enoxaparin 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 impairs platelet function and can injure the gastric mucosa, increasing the bleeding risk in patients on enoxaparin. Gastrointestinal and spinal or epidural hematoma risks are of particular concern.
How serious is the interaction between Enoxaparin 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 concomitant NSAIDs where possible; if used, monitor for bleeding, hemoglobin 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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