Drug interactions
Ibrutinib + Indomethacin
Severity: Major
Ibrutinib 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
Ibrutinib impairs platelet function and carries a bleeding risk, which is increased when combined with an NSAID such as indomethacin that also inhibits platelets and irritates the gastric mucosa. Serious gastrointestinal or other hemorrhage is possible.
What this interaction means in plain words
Ibrutinib 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.
Ibrutinib belongs to Oncology; Indomethacin belongs to Musculoskeletal.
Why it happens
Additive impairment of platelet function (BTK inhibition plus COX-1 inhibition), with NSAID-related mucosal injury.
What to do
Avoid the combination where possible and use an alternative analgesic such as paracetamol. If it is necessary, monitor for bleeding signs and consider gastroprotection.
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 Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Ibrutinib with Indomethacin?
MediHelp rates the interaction as major. Ibrutinib 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. Ibrutinib impairs platelet function and carries a bleeding risk, which is increased when combined with an NSAID such as indomethacin that also inhibits platelets and irritates the gastric mucosa. Serious gastrointestinal or other hemorrhage is possible.
How serious is the interaction between Ibrutinib 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 the combination where possible and use an alternative analgesic such as paracetamol. If it is necessary, monitor for bleeding signs and consider gastroprotection.
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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