Indomethacin Interactions with Dietary Supplements

Iron
Iron supplements can cause stomach irritation. Use of iron supplements with indomethacin increases the risk of stomach irritation and bleeding.¹ 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.

Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion of lithium from the body, resulting in higher blood levels of the mineral, though sulindac may have an opposite effect.² Since major changes in lithium blood levels can produce unwanted side effects or interfere with its efficacy, NSAIDs should be used with caution, and only under medical supervision, in people taking lithium supplements.

Potassium
may cause elevated blood potassium levels in people with normal and abnormal kidney function.^{3 4 5 6} Until more is known, people taking indomethacin should not supplement potassium without medical supervision.

Vitamins and minerals
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.

Sodium
may cause sodium and water retention.¹⁰ It is healthful to reduce dietary salt intake by decreasing the use of table salt and avoiding heavily salted foods.