Drug interactions
Indomethacin + Vorapaxar
Severity: Major
Indomethacin and Vorapaxar: 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
Vorapaxar is an antiplatelet agent and indomethacin impairs platelet function and irritates the gastric mucosa. Together they increase the risk of bleeding.
What this interaction means in plain words
Indomethacin and Vorapaxar 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.
Why it happens
Additive antiplatelet effects from PAR-1 antagonism by vorapaxar and COX-1 inhibition by indomethacin, plus NSAID mucosal injury.
What to do
Avoid chronic NSAID use where possible and use paracetamol instead; if combined, consider 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
Frequently asked questions
Can I take Indomethacin with Vorapaxar?
MediHelp rates the interaction as major. Indomethacin and Vorapaxar 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. Vorapaxar is an antiplatelet agent and indomethacin impairs platelet function and irritates the gastric mucosa. Together they increase the risk of bleeding.
How serious is the interaction between Indomethacin and Vorapaxar?
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 chronic NSAID use where possible and use paracetamol instead; if combined, consider 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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