Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: sulindac
BRAND NAME: Clinoril
DRUG CLASS AND MECHANISM: Sulindac is a
nonsteroidal antiinflammatory drug
(NSAID). Other NSAIDs include ibuprofen (Motrin), indomethacin (Indocin),
nabumetone (Relafen) and several others. These drugs are used for the management
of mild to moderate pain, fever, and inflammation. They work by reducing the
levels of prostaglandins, chemicals that are responsible for pain, fever, and
inflammation. Sulindac blocks the enzyme that makes prostaglandins
(cyclooxygenase), resulting in lower concentrations of prostaglandins. As a
consequence, inflammation, pain and fever are reduced. Sulindac was approved by
the FDA in September 1978.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: tablets: 150, 200 mg
STORAGE: Sulndac should be stored in a sealed container and protected from
moisture at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: Sulindac is used for the short and long term treatment of
pain and fever. It also is used to treat the pain, fever, and swelling and
tenderness of joints caused by the inflammation of rheumatoid arthritis,
ankylosing spondylitis,
gouty arthritis, and osteoarthritis. It also is used for
inflammation of soft tissues such as
tendinitis and bursitis.
DOSING: The usual adult dose is 150 or 200 mg given twice daily with meals.
The maximum dose is 400 mg daily.
DRUG INTERACTIONS: Sulindac may increase the blood levels of lithium
(Eskalith) by reducing the excretion of lithium by the kidneys. Increased levels
of lithium may lead to lithium toxicity.
Sulindac may reduce the blood pressure lowering effects of blood pressure
medications. This may occur because prostaglandins play a role in the regulation
(reduction) of blood pressure.
When sulindac is used in combination with methotrexate or aminoglycoside
antibiotics (for example, gentamicin) the blood levels of methotrexate or
aminoglycoside may increase, presumably because the elimination of methotrexate
or aminoglycosides from the body is reduced. This may lead to more methotrexate-
or aminoglycoside-related side effects.
Individuals taking oral blood thinners or anticoagulants, for example,
warfarin, (Coumadin), should avoid sulindac because sulindac also thins the
blood, and excessive blood thinning may lead to bleeding.
Persons who consume more than three alcoholic beverages per day are at
increased risk of developing stomach ulcers when taking sulindac or other
NSAIDs.
PREGNANCY: There are no adequate studies of sulindac in
pregnant women.
Therefore, sulindac is not recommended during pregnancy.
NURSING MOTHERS: It is not known whether sulindac is excreted in
breast milk.
SIDE EFFECTS: Most patients benefit from sulindac and other NSAIDs with few
side effects. However, serious side effects can occur and generally tend to be
dose related, that is occur more frequently with higher doses. Therefore, it is
advisable to use the lowest effective dose to minimize side effects. The most
common side effects of sulindac involve the gastrointestinal system. It can
cause ulcerations of the stomach and small intestine, abdominal pain, cramping,
nausea, gastritis, and even serious gastrointestinal bleeding and liver
toxicity. Sometimes, ulceration of the stomach and bleeding can occur without
any abdominal pain, and black tarry stools, weakness, and dizziness upon
standing may be the only signs of internal
bleeding. Rash, kidney impairment,
ringing in the ears, and lightheadedness also can occur.
Sulindac should be avoided by patients with a history of exacerbation of
asthma, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but
severe allergic reactions have been reported in such individuals. It also should
be avoided by patients with peptic ulcer disease or poor kidney function, since
this medication can aggravate both conditions. Fluid retention, blood clots,
heart attacks, hypertension, and heart failure have also been associated with
the use of NSAIDs.
Last Editorial Review: 3/27/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Nonsteroidal Antiinflammatory Drugs (NSAIDs) - Describes Nonsteroidal Antiinflammatory Drugs (NSAIDs), which are medications used primarily to treat inflammation, mild to moderate pain, and fever.
- Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
- ibuprofen, Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc. - Explains the medication ibuprofen (Advil, Motrin, Nuprin, Medipren) a drug used for the management of mild to moderate pain, fever, and inflammation. Article includes descriptions, uses, drug interactions, and side effects.
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