Drug interactions
Indomethacin + Levomilnacipran
Severity: Moderate
Indomethacin and Levomilnacipran: 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
Serotonin-norepinephrine reuptake inhibitors reduce platelet serotonin uptake and impair aggregation, and NSAIDs add antiplatelet and gastric mucosal effects. The combination raises the risk of GI and other bleeding.
What this interaction means in plain words
Indomethacin and Levomilnacipran 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.
Indomethacin belongs to Musculoskeletal; Levomilnacipran belongs to Central Nervous System.
Why it happens
Additive impairment of platelet function: depletion of platelet serotonin plus cyclooxygenase-1 inhibition, with NSAID-related mucosal injury.
What to do
Monitor for bleeding signs and consider a proton pump inhibitor in patients at GI risk. Use the lowest effective NSAID dose for the shortest duration 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 Levomilnacipran
- Isocarboxazid + Levomilnacipran Contraindicated
- Levomilnacipran + Linezolid Contraindicated
- Levomilnacipran + Methylthioninium chloride Contraindicated
- Levomilnacipran + Phenelzine Contraindicated
- Levomilnacipran + Procarbazine Contraindicated
- Levomilnacipran + Rasagiline Contraindicated
Frequently asked questions
Can I take Indomethacin with Levomilnacipran?
MediHelp rates the interaction as moderate. Indomethacin and Levomilnacipran 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. Serotonin-norepinephrine reuptake inhibitors reduce platelet serotonin uptake and impair aggregation, and NSAIDs add antiplatelet and gastric mucosal effects. The combination raises the risk of GI and other bleeding.
How serious is the interaction between Indomethacin and Levomilnacipran?
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 for bleeding signs and consider a proton pump inhibitor in patients at GI risk. Use the lowest effective NSAID dose for the shortest duration 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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