Indomethacin and Amikacin Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Indomethacin
Amikacin Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Amikacin toxicity (renal dysfunction, ototoxicity)
Interaction Deep Dive
Preterm infants who were given indomethacin IV concurrently with gentamicin or amikacin, had increased trough (48% gentamicin, 28% amikacin) and peak (32% gentamicin, 17% amikacin) concentrations. In patients with renal dysfunction, indomethacin has been shown to decrease GFR12.
Why it happens (mechanism)
Decreased amikacin clearance
Literature reports
1 report — tap to read
a) Twenty preterm infants (29.4 +/- 2.9 wk, 1.2 +/- 0.4 kg) with patent ductus and receiving gentamicin or amikacin were evaluated prior to and during indomethacin therapy. Trough levels for both aminoglycosides were higher during indomethacin treatment. However baseline troughs (gentamicin 3.1 +/- 1.2 vs 4.6 +/- 2.0, amikacin 10.1 +/- 2.5 vs 13 +/- 4) were above recommended levels. This is an expected reaction (ie, prostaglandin inhibitors have been reported to decrease renal flow) that has not previously been documented in infants. However, considering the overlap in trough level measurements, with either aminoglycoside this interaction may or may not be significant 1.
Common questions
Can I take Indomethacin and Amikacin Injection together?
Amikacin toxicity (renal dysfunction, ototoxicity) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Indomethacin and Amikacin Injection interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Indomethacin or Amikacin Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
Keep reading about Indomethacin
Keep reading about Amikacin Injection
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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