Indomethacin and Furosemide Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Furosemide Injection
Indomethacin
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
Increased risk of acute renal failure and decreased antihypertensive and diuretic efficacy
Interaction Deep Dive
Acute renal failure has been reported with the concomitant use of NSAIDs and torsemide, and coadministration may reduce the antihypertensive and diuretic effects of torsemide. The natriuretic effect of torsemide was partially inhibited in concomitant use with indomethacin in sodium-restricted patients (50 mEq/day), but not in those with a normal sodium intake (150 mEq/day)1. During concomitant use of indomethacin and loop diuretics, monitor for signs of worsening renal function and assure diuretic efficacy, including appropriate effects on blood pressure 2.
Why it happens (mechanism)
Unknown
Literature reports
2 reports — tap to read
a) The effect of indomethacin on the pharmacokinetics of furosemide was studied in 8 healthy subjects to determine if a pharmacokinetic drug interaction could explain the attenuated response to furosemide in patients on indomethacin. Each subject participated in 2 studies with IV furosemide (20 mg and 40 mg) alone, 2 studies with the same furosemide doses after pretreatment with indomethacin (100 mg), and 2 control studies with no drug or indomethacin alone. Indomethacin significantly decreased the renal clearance of furosemide and also inhibited nonrenal elimination (not significantly), but this did not account for the effect of indomethacin attenuating the response to furosemide 3.
b) In part A of a study designed to investigate the influence of diuretics on renal prostaglandins, 24 healthy subjects on a constant sodium intake received furosemide (80 mg daily), hydrochlorothiazide (100 mg), triamterene (200 mg), or spironolactone (300 mg). In part B of the study, the same subjects were pretreated for 3 days with indomethacin (150 mg daily). This was continued during the 3-day administration of the diuretics. In study A, triamterene administration led to a rise in urinary prostaglandins E2 and F2 alpha, but this was not observed with the other diuretics. In study B, the natriuretic effect of spironolactone and furosemide was reduced and was unaffected by hydrochlorothiazide and triamterene. Prostaglandins were significantly inhibited in all subjects. The results suggest that prostaglandins contribute to the interaction between NSAIDs and the natriuretic effects of furosemide and spironolactone, but not to the natriuretic effects of hydrochlorothiazide and triamterene 4.
Common questions
Can I take Indomethacin and Furosemide Injection together?
Increased risk of acute renal failure and decreased antihypertensive and diuretic efficacy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Indomethacin and Furosemide Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
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 Furosemide 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 a safer alternative to one of these medications for me?
References (4)
- Product Information: DEMADEX(R) oral tablets, torsemide oral tablets. Meda Pharmaceuticals Inc (per FDA), Somerset, NJ, 2017. DailyMed
- Product Information: TIVORBEX(R) oral capsules, indomethacin oral capsules. Iroko Pharmaceuticals LLC (per FDA), Philadelphia, PA, 2016. DailyMed
- Chennavasin P, Seiwell R, & Brater DC: Pharmacokinetic-dynamic analysis of the indomethacin-furosemide interaction in man. J Pharmacol Exp Ther 1980; 215:77-81. DOI
- Favre L, Glasson P, Riondel A, et al: Interaction of diuretics and non-steroidal anti-inflammatory drugs in man. Clin Sci (Lond) 1983; 64(4):407-415. PubMed
Keep reading about Furosemide Injection
Keep reading about Indomethacin
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