Drug interactions
Indomethacin + Spironolactone
Severity: Major
Indomethacin and Spironolactone: 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 cause hyperkalemia and acute kidney injury while also reducing the natriuretic and antihypertensive effects of spironolactone. The combination increases the risk of dangerous hyperkalemia, especially in heart failure, diabetes, or renal impairment.
What this interaction means in plain words
Indomethacin and Spironolactone 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; Spironolactone belongs to Cardiovascular.
Why it happens
Additive potassium retention from aldosterone antagonism and NSAID inhibition of renal prostaglandins and renin release.
What to do
Avoid the combination where possible; if used, monitor serum potassium, creatinine and blood pressure closely, especially at the start.
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 Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Indomethacin with Spironolactone?
MediHelp rates the interaction as major. Indomethacin and Spironolactone 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 cause hyperkalemia and acute kidney injury while also reducing the natriuretic and antihypertensive effects of spironolactone. The combination increases the risk of dangerous hyperkalemia, especially in heart failure, diabetes, or renal impairment.
How serious is the interaction between Indomethacin and Spironolactone?
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; if used, monitor serum potassium, creatinine and blood pressure closely, especially at the start.
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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