It helps treat swelling, stiffness, and pain caused by conditions like osteoarthritis and rheumatoid arthritis. It’s part of the class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). While it’s an effective treatment option for many types of painful conditions, it may interact with certain medications, causing potentially harmful reactions.
NSAIDs
Because indomethacin is an NSAID itself, taking it with other NSAIDs, such as over-the-counter (OTC) Advil, can increase your risk of side effects. Don’t take indomethacin with the following NSAIDs unless expressly directed to by your healthcare provider:
Advil, Motrin (ibuprofen) Aleve (naproxen) Aspirin Celebrex (celecoxib) Mobic (meloxicam) Voltaren, Zorvolex, Zipsor (diclofenac) Ketorolac
Antidepressants
Tell your healthcare provider if you’re taking an antidepressant. Some antidepressants may interact with indomethacin and increase your risk of bleeding.
SSRIs
The following selective serotonin reuptake inhibitors (SSRIs) may interact with indomethacin:
Celexa (citalopram) Luvox (fluvoxamine) Paxil (paroxetine) Prozac (fluoxetine) Zoloft (sertraline)
SNRIs
The following selective serotonin and norepinephrine reuptake inhibitors (SNRIs) may interact with indomethacin:
Cymbalta (duloxetine) Effexor XR (venlafaxine) Pristiq (desvenlafaxine)
Heart Medicines
Some heart medicines may interact with indomethacin. Combining indomethacin with ACE inhibitors, AR blockers, or beta blockers can diminish their effectiveness. In older adults, combining indomethacin with heart medicines can cause kidney problems and, in some cases, kidney failure.
Indomethacin comes with a black box warning that cautions people to avoid the medication if they have a history of heart disease. Taking it for long periods can increase your risk of heart attack, stroke, and blood clots.
ACE Inhibitors
Your healthcare provider may need to monitor you and adjust the dosage of indomethacin if you take any of the following angiotensin-converting enzyme (ACE) inhibitor drugs:
Accupril (quinapril)Altace (ramipril)CaptoprilFosinoprilLisinopril Lotensin (benazepril)Mavik (trandolapril)Univasc (moexipril)Vasotec (enalapril)
ARBs
Several angiotensin II receptor blockers (ARBs) may interact with indomethacin, including:
Atacand (candesartan)Avapro (irbesartan)Benicar (olmesartan)Cozaar (losartan)Tenormin (telmisartan)Teveten (eprosartan)
Beta Blockers
Beta blockers that may interact with indomethacin include:
Corgard (nadolol)InnoPran XL (propranolol)Lopressor (metoprolol)Tenormin (atenolol)Trandate (labetalol)
Others
Other medications that may interact with indomethacin include:
Cyclosporine, an immunosuppressant used to prevent organ rejection Blood thinners Digoxin, a drug that treats irregular heartbeat and heart failure Diuretics Lithium Methotrexate, a disease-modifying anti-rheumatic drug (DMARD) Phenytoin, an anti-seizure drug
Because blood thinners affect the body’s clotting ability, taking them with indomethacin (which may increase your risk of internal bleeding) can be dangerous.
Combining lithium with indomethacin increases the blood concentration of lithium. It can cause lithium to take longer to clear the body. This can also happen when taking indomethacin with digoxin, methotrexate, and cyclosporine, increasing the risk of kidney problems.
Supplements
You should always tell your healthcare provider about any OTC vitamins, supplements, or herbal products you’re taking because they may interact with certain medications.
Iron and potassium supplements can interact with indomethacin. Because iron can irritate the stomach, taking it with indomethacin can increase your risk of gastrointestinal side effects, including bleeding and ulcers.
Mixing potassium supplements with indomethacin can cause adverse kidney reactions whether or not you have existing kidney problems.
Alcohol
People who drink a lot of alcohol while taking indomethacin may be more likely to experience certain side effects, such as:
UlcersInternal bleedingPerforations in the gastrointestinal tractLiver disease
Older adults are more likely to experience dangerous side effects from mixing alcohol with medications like indomethacin.
Most NSAIDs don’t mix well with alcohol. If you want to keep enjoying alcohol while taking indomethacin, talk to your healthcare provider to determine whether it’s safe to do so. Until you talk to a healthcare provider, avoid drinking alcohol.
NauseaVomiting (vomit may look like it contains coffee grounds)Weight loss that can’t be explainedBlood in the stools
If you have any of the above symptoms while taking indomethacin, talk to your healthcare provider. If you’re vomiting blood, go to the emergency room.
