Drug interactions
Indomethacin + Rivaroxaban
Severity: Major
Indomethacin and Rivaroxaban: 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 increases the risk of bleeding in patients taking rivaroxaban, including gastrointestinal hemorrhage. The risk is higher in older patients and those with renal impairment.
What this interaction means in plain words
Indomethacin and Rivaroxaban 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; Rivaroxaban belongs to Cardiovascular.
Why it happens
Additive hemostatic impairment from NSAID platelet inhibition and mucosal injury plus factor Xa inhibition.
What to do
Avoid the combination where possible and use paracetamol instead. If an NSAID is essential, use the shortest course, add gastroprotection and monitor for bleeding and hemoglobin.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Frequently asked questions
Can I take Indomethacin with Rivaroxaban?
MediHelp rates the interaction as major. Indomethacin and Rivaroxaban 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 increases the risk of bleeding in patients taking rivaroxaban, including gastrointestinal hemorrhage. The risk is higher in older patients and those with renal impairment.
How serious is the interaction between Indomethacin and Rivaroxaban?
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 paracetamol instead. If an NSAID is essential, use the shortest course, add gastroprotection and monitor for bleeding and hemoglobin.
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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