Drug interactions
Indomethacin + Tolfenamic acid
Severity: Major
Indomethacin and Tolfenamic acid: 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
Using two NSAIDs together increases the risk of GI ulceration, bleeding and renal injury without added efficacy.
What this interaction means in plain words
Indomethacin and Tolfenamic acid 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; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Both inhibit cyclooxygenase, giving additive loss of protective prostaglandins and platelet inhibition.
What to do
Avoid concurrent use and keep to a single NSAID at the lowest effective dose.
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 Tolfenamic acid
Frequently asked questions
Can I take Indomethacin with Tolfenamic acid?
MediHelp rates the interaction as major. Indomethacin and Tolfenamic acid 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. Using two NSAIDs together increases the risk of GI ulceration, bleeding and renal injury without added efficacy.
How serious is the interaction between Indomethacin and Tolfenamic acid?
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 concurrent use and keep to a single NSAID at the lowest effective dose.
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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