Drug interactions
Indomethacin + Lithium
Severity: Major
Indomethacin and Lithium: 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 can raise serum lithium concentrations and may cause lithium toxicity, with tremor, confusion, ataxia, vomiting, and in severe cases seizures or arrhythmias. Risk is greater with dehydration or renal impairment.
What this interaction means in plain words
Indomethacin and Lithium 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 belongs to Musculoskeletal; Lithium belongs to Central Nervous System.
Why it happens
NSAIDs reduce renal prostaglandin-dependent blood flow, decreasing renal lithium clearance and increasing proximal reabsorption.
What to do
Avoid the combination if possible. If used, measure lithium levels at baseline and within about a week of starting, and reduce the lithium dose as needed.
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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Indomethacin with Lithium?
MediHelp rates the interaction as major. Indomethacin and Lithium 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 can raise serum lithium concentrations and may cause lithium toxicity, with tremor, confusion, ataxia, vomiting, and in severe cases seizures or arrhythmias. Risk is greater with dehydration or renal impairment.
How serious is the interaction between Indomethacin and Lithium?
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 if possible. If used, measure lithium levels at baseline and within about a week of starting, and reduce the lithium dose as needed.
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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