Drug interactions
Heparin + Indomethacin
Severity: Major
Heparin 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 inhibits platelet function and can cause gastric erosions, which increases the risk of bleeding during heparin therapy. Serious hemorrhage may occur.
What this interaction means in plain words
Heparin 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.
Heparin belongs to Cardiovascular; Indomethacin belongs to Musculoskeletal.
Why it happens
Additive hemostatic impairment: NSAID antiplatelet effect and mucosal damage plus heparin-enhanced antithrombin activity.
What to do
Avoid NSAIDs in patients on therapeutic heparin where possible; if needed, monitor aPTT or anti-Xa, hemoglobin and signs of bleeding.
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
Other interactions of Heparin
- Defibrotide + Heparin Contraindicated
- Heparin + Ketorolac Contraindicated
- Heparin + Oritavancin Contraindicated
- Acemetacin + Heparin Major
- Acetylsalicylic acid + Heparin Major
- Alteplase + Heparin Major
Frequently asked questions
Can I take Heparin with Indomethacin?
MediHelp rates the interaction as major. Heparin 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 inhibits platelet function and can cause gastric erosions, which increases the risk of bleeding during heparin therapy. Serious hemorrhage may occur.
How serious is the interaction between Heparin 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 in patients on therapeutic heparin where possible; if needed, monitor aPTT or anti-Xa, hemoglobin and signs of bleeding.
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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