Drug interactions
Indomethacin + Milnacipran
Severity: Moderate
Indomethacin and Milnacipran: 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
Milnacipran inhibits serotonin reuptake in platelets and, with indomethacin, increases the risk of bleeding, particularly from the upper gastrointestinal tract.
What this interaction means in plain words
Indomethacin and Milnacipran 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; Milnacipran belongs to Central Nervous System.
Why it happens
Additive platelet dysfunction from reduced platelet serotonin and COX-1 inhibition, plus NSAID mucosal injury.
What to do
Monitor for signs of gastrointestinal bleeding and consider gastroprotection with a proton pump inhibitor in high-risk patients. Avoid long-term combined use where possible.
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 Milnacipran
- Isocarboxazid + Milnacipran Contraindicated
- Methylene blue + Milnacipran Contraindicated
- Milnacipran + Phenelzine Contraindicated
- Milnacipran + Procarbazine Contraindicated
- Milnacipran + Rasagiline Contraindicated
- Milnacipran + Safinamide Contraindicated
Frequently asked questions
Can I take Indomethacin with Milnacipran?
MediHelp rates the interaction as moderate. Indomethacin and Milnacipran 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. Milnacipran inhibits serotonin reuptake in platelets and, with indomethacin, increases the risk of bleeding, particularly from the upper gastrointestinal tract.
How serious is the interaction between Indomethacin and Milnacipran?
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 signs of gastrointestinal bleeding and consider gastroprotection with a proton pump inhibitor in high-risk patients. Avoid long-term combined use where possible.
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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