Drug interactions
Eplerenone + Indomethacin
Severity: Moderate
Eplerenone and Indomethacin: moderate 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
NSAIDs such as indomethacin can blunt the blood pressure lowering and natriuretic effects of eplerenone. Together they also raise the risk of hyperkalemia and acute kidney injury, particularly in older, dehydrated or renally impaired patients.
What this interaction means in plain words
Eplerenone and Indomethacin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Eplerenone belongs to Cardiovascular; Indomethacin belongs to Musculoskeletal.
Why it happens
Inhibition of renal prostaglandin synthesis causes sodium retention, reduced renal perfusion and reduced potassium excretion, opposing eplerenone.
What to do
Monitor blood pressure, serum potassium and creatinine within the first weeks of combined use and periodically thereafter; use the lowest NSAID dose for the shortest time or choose an alternative analgesic.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Eplerenone with Indomethacin?
MediHelp rates the interaction as moderate. Eplerenone and Indomethacin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. NSAIDs such as indomethacin can blunt the blood pressure lowering and natriuretic effects of eplerenone. Together they also raise the risk of hyperkalemia and acute kidney injury, particularly in older, dehydrated or renally impaired patients.
How serious is the interaction between Eplerenone and Indomethacin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, serum potassium and creatinine within the first weeks of combined use and periodically thereafter; use the lowest NSAID dose for the shortest time or choose an alternative analgesic.
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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