Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: sulindac
BRAND NAME: Clinoril
DRUG CLASS AND MECHANISM: Sulindac is a nonsteroidal anti-inflammatory drug (NSAID) that is used for treating pain, fever, and inflammation. Other NSAIDs include ibuprofen (Motrin), indomethacin (Indocin), nabumetone (Relafen) as well as others. They work by reducing the levels of prostaglandins, chemicals that are produced by the body and 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.
GENERIC AVAILABLE: Yes
PREPARATIONS: tablets: 150 and 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, osteoarthritis, and acute painful shoulder. 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, Lithobid) by reducing the elimination 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 have a role in the regulation (reduction) of blood pressure. Combining NSAIDs such as sulindac with angiotensin receptor blockers (for example, valsartan [Diovan], losartan [Cozaar], irbesartan [Avapro]) or angiotensin converting enzyme (ACE) inhibitors (for example, enalapril [Vasotec], captopril [Capoten]) in patients who are elderly, fluid-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.
When sulindac is used in combination with methotrexate (Rheumatrex, Trexall) 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.
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