Indomethacin

Concurrent therapy with indomethacin is not recommended as it blunts bumetanide-induced increases in urine volume, sodium excretion, and plasma renin activity.

Combined use has been associated with fatal gastrointestinal hemorrhage. Diflunisal decreases renal clearance and significantly increases plasma levels of indomethacin.

Concomitant use associated with significantly increased incidence of GI adverse reactions and increased risk of bleeding.

Increased risk of bleeding; monitor patients for signs of bleeding during concomitant use.

Indomethacin significantly elevates both peak and trough levels of amikacin in premature infants, potentially increasing aminoglycoside toxicity risk.

May result in deterioration of renal function including possible acute renal failure, especially in elderly, volume-depleted, or renally impaired patients. May diminish antihypertensive effect.

Increased nephrotoxicity; acute water intoxication has been reported with concomitant use of indomethacin and cyclophosphamide.

Acute water intoxication reported with concomitant use; indomethacin potentiates cyclophosphamide nephrotoxicity.

Concomitant administration of indomethacin with cyclosporine has been associated with increased cyclosporine-induced toxicity and requires careful renal function monitoring.

In patients taking indomethacin, dasiglucagon may lose its ability to raise blood glucose or may even produce hypoglycemia.

Indomethacin may prolong digoxin half-life, increasing risk of digoxin toxicity. Close monitoring with frequent ECGs and serum digoxin levels required in neonates.

NSAID that may result in deterioration of renal function, including acute renal failure, especially in elderly, volume-depleted, or renally compromised patients.

NSAID that may result in deterioration of renal function and diminish antihypertensive effect of enalapril, especially in elderly, volume-depleted, or renally compromised patients.

May result in deterioration of renal function, including acute renal failure, especially in elderly, volume-depleted, or renally compromised patients.

Indomethacin significantly elevates both peak and trough levels of gentamicin in premature infants, potentially increasing aminoglycoside toxicity risk.

Glucagon may lose its ability to raise blood glucose or may produce hypoglycemia in patients taking indomethacin. Monitor blood glucose levels during glucagon treatment.

In patients taking indomethacin, glucagon may lose its ability to raise blood glucose or may produce hypoglycemia. Monitor blood glucose levels during glucagon treatment.

Significantly increases steady-state plasma lithium concentrations, with risk of lithium toxicity.

May result in deterioration of renal function including possible acute renal failure, especially in elderly, volume-depleted, or renally impaired patients. May diminish antihypertensive effect.

Concomitant use with indomethacin has been associated with bleeding in post-marketing experience. Monitor prothrombin time closely.

Risk of hyperkalemia due to drug's potential to increase serum potassium. May also increase risk of renal impairment.

Concomitant use with SSRIs and NSAIDs potentiates the risk of bleeding more than NSAID alone.

Combination with potassium-sparing diuretics has been associated with severe hyperkalemia and reduced diuretic effects.

Combination with potassium-sparing diuretics has been associated with severe hyperkalemia; may reduce diuretic effects.

Increased sulfamethoxazole blood levels may occur in patients receiving indomethacin.

Acute renal failure has been reported in subjects when indomethacin was given with triamterene. Caution is advised.

Acute renal failure reported in patients receiving indomethacin with triamterene and hydrochlorothiazide formulations.

Acute renal failure has been reported when indomethacin was given with triamterene. Caution is advised.

Synergistic effect on bleeding with increased risk of serious bleeding compared to either drug alone.

May reduce diuretic, natriuretic, and antihypertensive effects of amiloride HCl. Both agents may increase serum potassium levels; potential effects on potassium kinetics and renal function should be considered.

Both indomethacin and potassium-sparing diuretics may increase serum potassium levels. Consider effects on potassium kinetics and renal function when administered concurrently.

In such high risk patients, monitor for signs of worsening renal function ( 7 ) Diuretics: NSAIDs can reduce natriuretic effect of furosemide andthiazide diuretics.

May decrease the hypotensive effects of beta-blockers.

Prostaglandin synthase inhibitor may decrease hypotensive effects of beta-blockers.

VYLEESI may slow gastric emptying and reduce absorption of indomethacin; patients should consider discontinuing VYLEESI if delayed drug effect occurs when quick onset is desired.

Indomethacin can reduce the antihypertensive effects of captopril. May result in further deterioration of renal function in patients with compromised renal function.

False-negative results in dexamethasone suppression test have been reported in patients treated with indomethacin.

False-negative results in dexamethasone suppression test have been reported in patients treated with indomethacin.

Indomethacin has been reported to cause false-negative dexamethasone suppression test results; DST results should be interpreted with caution.

May result in deterioration of renal function including acute renal failure in elderly, volume-depleted, or renally compromised patients. NSAIDs may diminish antihypertensive effect.

NSAIDs may diminish the antihypertensive effect of enalaprilat. In patients with compromised renal function, may result in further deterioration of renal function.

Diuretics Clinical Impact: Clinical studies, as well as post-marketing observations, showed that NSAIDs reduced the natriuretic effect of loop diuretics (e.g., furosemide) and thiazide diuretics in some patients. Effects on Laboratory Tests INDOCIN reduces basal plasma renin activity (PRA), as well as those elevations of PRA induced by furosemide administration, or salt or volume depletion. In such high risk patients, monitor for signs of worsening renal function ( 7 ) Diuretics : NSAIDs can reduce natriuretic effect of furosemide and thiazide diuretics.

Interferes with platelet aggregation and may induce bleeding. Use with caution; dose reduction of antiplatelet agent or heparin recommended.

Indomethacin can reduce the antihypertensive effects of losartan. May result in further deterioration of renal function in patients with compromised renal function.

Cyclooxygenase inhibitor may impact accuracy of MACRILEN diagnostic test by directly affecting pituitary growth hormone secretion. Avoid concomitant use.

NSAIDs may diminish antihypertensive effect; monitor blood pressure during concomitant use.

Competes with penicillin G for renal tubular secretion, prolonging serum half-life.

Competes with penicillin G for renal tubular secretion, prolonging serum half-life of penicillin.

Competes with penicillin G for renal tubular secretion, prolonging serum half-life of penicillin.

NSAIDs inhibit folate-dependent enzymes in laboratory experiments.

OAT3 substrate. Pretomanid inhibits OAT3 transporter, potentially increasing indomethacin concentrations and adverse reactions. Monitor and consider dose reduction.

Probenecid increases plasma elimination half-life and concentrations of indomethacin; lower dosage may be required.

Probenecid increases mean plasma elimination half-life and plasma concentrations of indomethacin; use lower dosages cautiously.

NSAIDs may diminish the antihypertensive effect of beta-blockers; monitor blood pressure during concomitant use.

Indomethacin may displace sulfonamides from plasma albumin and increase concentrations of free drug in plasma.

Probenecid inhibits OAT1/3, increasing indomethacin plasma concentrations and risk of adverse reactions. May require dosage adjustment.

Partial inhibition of natriuretic effect of torsemide demonstrated under dietary sodium restriction conditions.

May prolong the effect of vasopressin on cardiac index and systemic vascular resistance. Hemodynamic monitoring recommended.

May prolong vasopressin effects on cardiac index and systemic vascular resistance. Hemodynamic monitoring recommended; adjust vasopressin dose as needed.

In vitro data indicate doxazosin has no effect on protein binding of indomethacin.

Prazosin has been administered without adverse drug interaction with indomethacin in limited clinical experience.

Administered without adverse drug interaction in limited clinical experience.

Terazosin has been used concomitantly with indomethacin in at least 50 patients with no interactions observed.

Used concomitantly with terazosin in at least 50 patients with no interactions observed.

No clinically significant pharmacokinetic interactions were observed when coadministered with valsartan.