Indometacin Antacids

Antacids Indometacin ( other NSAIDs) Variable effects of different formulations aluminium-containing antacids reduce the rate and extent of absorption of indometacin sodium bicarbonate increases the rate and extent of absorption of indometacin No action required, unless a marked reduction in absorption results in a poor response to the NSAID, in which case dosages may need to be increased or the antacid withdrawn... 

Although a variety of different antacids have slightly altered the absorption of indometacin the changes are probably not clinically important. Aluminium/magnesium hydroxide had no effect on sulindac absorption. 

Not known. Aluminium compounds might form insoluble salts with indometacin. Food might reduce this effect, see NSAIDs Diflunisal + Antacids , p.l40. 

Adequately but not extensively documented. Some small reduction in plasma indometacin levels is possible with some aluminium containing antacids. Despite this the manufacturers of indometacin recommend that it be taken with food, milk or an antacid to minimise gastrointestinal disturbances. Sulindac absorption is not affected. 

Although information is limited, no particular precautions would seem to be needed if aluminium or aluminium/magnesium antacids are given with any of these antacids. Note that antacids have been frequently given with NSAIDs to reduce their gastric irritant effects. Consider also coxibs , (p.l39), diclofenac , (p.l40), diflunisal ,(p.l40), ibuprofenand related drugs , (p.l40), indometacin , (p.l41), fenamates , (p.l40), and oxi-cams , (below) for information about the interaction of other NSAIDs with antacids. 

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