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Indomethacin

Drug Information

Indomethacin is a member of the non-steroidal anti-inflammatory drug (NSAIDs) family of drugs. NSAIDs reduce inflammation (swelling), pain, and temperature. Indomethacin is used to reduce pain/swelling involved in osteoarthritis, rheumatoid arthritis, bursitis, tendinitis, gout, ankylosing spondylitis, and headaches.

Common brand names:

Indocin, Indocin SR

Summary of Interactions with Vitamins, Herbs, & Foods

What Are Nutrient Interactions
Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Folic Acid

    Indomethacin has been reported to decrease absorption of folic acid and vitamin C.1 Under certain circumstances, indomethacin may interfere with the actions of vitamin C.2 Calcium and phosphate levels may also be reduced with indomethacin therapy.3 It remains unclear whether people taking this drug need to supplement any of these nutrients.

  • Vitamin C

    Indomethacin has been reported to decrease absorption of folic acid and vitamin C.4 Under certain circumstances, indomethacin may interfere with the actions of vitamin C.5 Calcium and phosphate levels may also be reduced with indomethacin therapy.6 It remains unclear whether people taking this drug need to supplement any of these nutrients.

  • Calcium

    Indomethacin has been reported to decrease absorption of folic acid and vitamin C.7 Under certain circumstances, indomethacin may interfere with the actions of vitamin C.8 Calcium and phosphate levels may also be reduced with indomethacin therapy.9 It remains unclear whether people taking this drug need to supplement any of these nutrients.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • none

Support Medicine

  • none

Reduces Effectiveness

  • none

Potential Negative Interaction

  • Potassium

    Indomethacin may cause elevated blood potassium levels in people with normal and abnormal kidney function.10 , 11 , 12 , 13 Until more is known, people taking indomethacin should not supplement potassium without medical supervision.

  • Sodium

    Indomethacin may cause sodium and water retention.14 It is healthful to reduce dietary salt intake by decreasing the use of table salt and avoiding heavily salted foods.

  • White Willow

    White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs.15 Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Explanation Required 

  • Iron

    Iron supplements can cause stomach irritation. Use of iron supplements with indomethacin increases the risk of stomach irritation and bleeding.16 However, stomach bleeding causes iron loss. If both iron and indomethacin are prescribed, they should be taken with food to reduce stomach irritation and bleeding risk.

  • Food

    Indomethacin should be taken with food to prevent stomach irritation.17 However, applesauce, high-protein foods, and high-fat foods have been reported to interfere with indomethacin absorption and/or activity.18

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Hodges R. Nutrition in Medical Practice. Philadelphia: W. B. Saunders, 1980, 323–31 [review].

2. Ogilvy CS, DuBois AB, Douglas JS. Effects of ascorbic acid and indomethacin on the airways of healthy male subjects with and without induced bronchoconstriction. J Allergy Clin Immunol 1981;67:363–9.

3. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138,140.

4. Hodges R. Nutrition in Medical Practice. Philadelphia: W. B. Saunders, 1980, 323–31 [review].

5. Ogilvy CS, DuBois AB, Douglas JS. Effects of ascorbic acid and indomethacin on the airways of healthy male subjects with and without induced bronchoconstriction. J Allergy Clin Immunol 1981;67:363–9.

6. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138,140.

7. Hodges R. Nutrition in Medical Practice. Philadelphia: W. B. Saunders, 1980, 323–31 [review].

8. Ogilvy CS, DuBois AB, Douglas JS. Effects of ascorbic acid and indomethacin on the airways of healthy male subjects with and without induced bronchoconstriction. J Allergy Clin Immunol 1981;67:363–9.

9. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138,140.

10. Tan SY, Shapiro R, Franco R, et al. Indomethacin-induced prostaglandin inhibition with hyper kalemia. Ann Intern Med 1979;90:783–5.

11. Goldszer RC, Coodley EL, Rosner MJ, et al. Hyperkalemia associated with indomethacin. Arch Intern Med 1981;141:802–4.

12. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 252–a.

13. Perazella MA. Drug-induced hyperkalemia: Old culprits and new offenders. Am J Med 2000;109:307–14 [review].

14. Somova L, Zaharieva S, Ivanova M. Humoral factors involved in the regulation of sodium-fluid balance in normal man. II. Effects of indomethacin on sodium concentration, renal prostaglandins, vasopressin and renin-angiotensin-aldosterone system. Acta Physiol Pharmacol Bulg 1984;10:29–33.

15. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.

16. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 139–40.

17. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 252–a.

18. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138–9.

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