Drug interactions
Indomethacin + Ticagrelor
Severity: Major
Indomethacin and Ticagrelor: major interaction.
Last updated Sources: US FDA label
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, particularly gastrointestinal, in patients taking ticagrelor. The risk is higher with chronic NSAID use.
What this interaction means in plain words
Indomethacin and Ticagrelor 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; Ticagrelor belongs to Cardiovascular.
Why it happens
Additive platelet inhibition from ticagrelor P2Y12 blockade and NSAID COX-1 inhibition, plus NSAID gastric mucosal injury.
What to do
Avoid regular NSAID use with ticagrelor and use paracetamol for analgesia. If unavoidable, give gastroprotection and monitor for bleeding.
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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References
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 Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
Frequently asked questions
Can I take Indomethacin with Ticagrelor?
MediHelp rates the interaction as major. Indomethacin and Ticagrelor 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, particularly gastrointestinal, in patients taking ticagrelor. The risk is higher with chronic NSAID use.
How serious is the interaction between Indomethacin and Ticagrelor?
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 regular NSAID use with ticagrelor and use paracetamol for analgesia. If unavoidable, give gastroprotection and monitor for bleeding.
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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