GENERIC NAME: Sulindac

COMMON BRAND: Clinoril

Sulindac is an oral prescription drug belongs to a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). It is used for the treatment of rheumatoid arthritis and osteoarthritis and also used in ankylosing spondylitis, acute painful shoulder and acute gouty arthritis. It works by inhibiting cyclooxygenase (both COX-1 and COX-2), leading to the inhibition of prostaglandin synthesis. As prostaglandins sensitise pain receptors, inhibition of their synthesis may be associated with the analgesic and antipyretic effects sulindac.

It is available in both brand-name version and generic-name version. The oral tablet is sold under the common brand “Clinoril”. The generic drugs usually cost less than the brand name version.

What is Sulindac used for?

Sulindac is commonly used to reduce pain, swelling, and joint stiffness from arthritis. This drug is also used to treat acute shoulder pain, minor aches and swellings, arthritis of the spine and gouty arthritis.

How to use Sulindac?

Read the medication guide carefully given by your pharmacist before you start taking this medicine and whenever you get a refill. If you have any problem or you do not understand any part, discuss with your doctor or pharmacist.

Sulindac comes as an oral tablet. Take this medication orally, usually once in a day with a full glass of water or as advised by your doctor. Do not lie down wait for at least 10 minutes after taking this drug. To avoid gastrointestinal problems (like stomach upset) take this drug with food.

Do not change your dose or take it more frequently than directed by your doctor. Pain medication works best if they are used with the first signs of pain. If you wait until your pain worsens, the medicine may not work well.

The dose depends on the medical condition and treatment response.

It may take up to 1-3 weeks to get the full benefit for conditions like arthritis. Use this medication regularly to get the full benefit from it. To avoid missing of dose take this drug at the same time each day.

What are the side effects of Sulindac?

The common side effects observed with the use of this drug are abdominal pain, diarrhoea, stomach upset, nausea, vomiting, dizziness, headache, itching or rash. If any of these effects remain or get worse, notify your doctor immediately.

This drug rarely causes severe, possibly fatal liver damage and can even lead to liver failure. The symptoms of liver damage are persistent nausea, vomiting, weakness, swelling in the legs and ankles, severe abdominal pain, dark urine, yellow discoloration in the sclera of the eyes or skin. If you notice any of these effects, stop taking sulindac and consult your doctor or pharmacist right away.

Get emergency medical assistance if you notice symptoms of GIT bleeding or ulcers such as stomach pain or abdominal pain, black/sticky stools and bloody vomit.

Seek medical assistance promptly, if you notice any severe side effects, like easy bruising/bleeding, hearing problems (like ringing in the ears), signs of kidney problems (like change in the amount of urine), stiff neck, vision changes, symptoms of heart failure (like swelling of ankles/feet).

This document does not include all possible side effects. If you see other side effects not listed above, reach out to your doctor or pharmacist.

What are the precautions while using Sulindac?

Inform your doctor/pharmacist before taking sulindac, if you are allergic to it; or if you have other allergies (including aspirin and other NSAIDs like ketoprofen, ibuprofen, indomethacin, etc.). This drug may also contain some inactive ingredients that can cause allergic reactions or other problems. Talk to your doctor/pharmacist for further information.

Inform your doctor about all the products you are using including prescription, non-prescription, vitamins, nutritional supplements, and herbal products.

Before taking sulindac, discuss with your doctor or pharmacist about your medical history especially of asthma, severe kidney disease, recent heart bypass surgery (CABG), active bleeding/sores in stomach/intestines (ulcer, gastrointestinal bleeding), blood disorders (like anemia), high blood pressure, diabetes, liver disease, growths in the nose (nasal polyps), obesity, tobacco use, stroke, swelling of the ankles/feet/hands.

Sulindac may cause stomach or intestinal bleeding, which can be fatal, older adults are more susceptible to this condition. Regular use of this drug with alcohol and tobacco may increase your chances for stomach bleeding. Restrict the use of alcohol and stop smoking. Consult your doctor/pharmacist for further information.

NSAIDs like sulindac sometimes can cause kidney problem which is more likely to occur if you have kidney disease or have heart failure, in severe dehydration, or an older adult. To avoid kidney problems take plenty of water. Notify your doctor instantly if you have a change in the amount of urine.

If you are using this medication, you may be more sensitive to sun exposure. Limit your time under sun exposure. Avoid tanning booths and sunlamps. Use sun protection (such as sunscreen) and wear protective clothing when you are going outdoors. Inform your doctor as soon as possible if you get sunburns or if you have blisters or redness on your skin.

Older adults are susceptible to the side effects of this drug especially to stomach bleeding and kidney problems. Therefore, caution is required while using this drug in older adults.

During pregnancy, use this medication only when benefits outweigh the risk and only if prescribed by your doctor. This drug is not recommended during pregnancy as it may harm to the fetus and interference with normal delivery/labour.

This drug may cross into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breastfeeding.

Also, see warnings.

What are the drug interactions of Sulindac?

Sulindac may interact with other medications, herbs, or vitamins you may be using. A drug interaction is when a substance changes the way a drug works which can be harmful or block the drug from working well.

Do not start, stop, or alter the dose of the drug without consulting your doctor because your doctor may be monitoring you for all possible drug interactions.

Some products that may interact with sulindac are aliskiren, ACE inhibitors (like captopril, lisinopril), angiotensin II receptor blockers (like losartan, candesartan), other medications that may affect the kidneys (like cidofovir), corticosteroids (like prednisone), or diuretics (like furosemide), sulindac.

Sulindac may increase the levels of certain mental health drug like lithium in your body. Symptoms of lithium toxicity include slurred speech and tremors.

Taking “blood thinners” such as dabigatran/enoxaparin/warfarin and anti-platelet drugs such as clopidogrel with sulindac increases the risk of severe stomach bleeding.

Take advice from your doctor/pharmacist before using any over-the-counter medicine for cold, allergy, or pain. Many over-the-counter medications contain aspirin or other NSAIDs similar to sulindac (such as ibuprofen, naproxen, diclofenac, etc.), taking them together with sulindac can increase the amount of sulindac in your body which may result in severe side effects. However, you should continue using aspirin if you are already using it for the prevention of heart attack or stroke but only on doctor’s advice.

Sulindac like some other NSAIDs may interfere with specific laboratory tests, giving a false test result. Make sure that laboratory personnel and all your doctors know you use this drug.

WARNINGS:

Heart risk:

NSAID’s like sulindac may increase the risk of heart problems, such as blood clot, stroke, heart attack or heart failure which can be fatal. The risk may increase if you already have heart disease or have taken sulindac for an extended period or at high doses.

Coronary artery bypass graft (CABG) warning:

This drug is contraindicated for the treatment of pain before coronary artery bypass graft (CABG) surgery (heart surgery is done to increase blood flow to the heart). Taking this drug before surgery may increase the risk of heart attack and stroke.

Gastrointestinal:

This drug may increase your risk of stomach problems, like bleeding, or peptic ulcers which can be fatal. These conditions can occur at any time and without any warning signs. If you are above 65 years, you may have a higher chance of developing severe stomach issues.

What are the forms and strengths of Sulindac?

Generic: Sulindac
Form: Oral tablet
Strengths: 150 mg, 200 mg

What is the dosage of Sulindac?

For Osteoarthritis:

Adults (18–64 years):

Typical dosage: 150mg twice a day (for a total of 300mg per day).

Children (0–17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established.

Senior dosage (65 years and above):

Older adults may process drugs slowly, and this results in slow metabolism of the drug. As a result, more of a drug accumulates in your body. This increases the chances for side effects.

Your doctor may star lower dosage initially to help maintain normal levels of this drug in your body.

For Rheumatoid Arthritis:

Adults (18–64 years):

Typical dosage: 150mg twice a day (for a total of 300mg per day).

Children (0–17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established.

Senior dosage (65 years and above)

Older adults may process drugs slowly, and this results in slow metabolism of the drug. As a result, more of a drug accumulates in your body. This increases the chances for side effects.

Your doctor may star lower dosage initially to help maintain normal levels of this drug in your body.

For Ankylosing Spondylitis:

Adults (18–64 years)

Typical dosage: 150mg twice a day in evenly spaced doses (for a total of 300mg per day).

Children (0–17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established.

Senior dosage (65 years and older):

Older adults may process drugs slowly, and this results in slow metabolism of the drug. As a result, more of a drug accumulates in your body. This increases the chances for side effects.

Your doctor may star lower dosage initially to help maintain normal levels of this drug in your body.

For Acute Shoulder Pain:

Adults (18–64 years):

Typical dosage: 200mg twice a day in evenly spaced doses (for a total of 400mg per day). Therapy usually lasts 7 to14 days.

Children (0–17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established.

Senior dosage (65 years and above):

Older adults may process drugs slowly, and this results in slow metabolism of the drug. As a result, more of a drug accumulates in your body. This increases the chances for side effects.

Your doctor may star lower dosage initially to help maintain normal levels of this drug in your body.

For Acute Gouty Arthritis:

Adults (18–64 years):

Typical dosage: 200mg twice a day in evenly spaced doses (for a total of 400mg per day). Therapy usually lasts seven days.

Children (0–17 years):

Avoid use of this drug in children below 18 years of age, as the studies have not been established.

Senior dosage (65 years and above):

Older adults may process drugs slowly, and this results in slow metabolism of the drug. As a result, more of a drug accumulates in your body. This increases the chances for side effects.

Your doctor may star lower dosage initially to help maintain normal levels of this drug in your body.

Special Considerations:

Liver impairment: People with liver disease may have reduced the ability to clear this drug from the body, which results in more side effects. If you have mild to moderate liver disease, your daily dose of sulindac may be reduced by half. If you have severe liver disease, avoid taking this medication.

Kidney disease: Kidney disease may make it difficult to eliminate this drug from your body. If you have any kidney problem, your doctor may lower your dosage.

Most common questions asked about Sulindac / Q&A’s:

What are the symptoms of Sulindac overdose?

Sulindac overdose symptoms may include loss of consciousness, fainting, dizziness, blurred vision, upset stomach, decreased urination. Seek a medical emergency as soon as possible if you experience any of these symptoms.

Disclaimer

TheMedPharma has made every effort to make sure that all the information is factually correct, comprehensive, and up-to-date. However, this website should not be considered as a substitute for the advice, knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or licensed health care professional before taking any medication. The drug information contained herein is subjected to changes if required. The lack of warnings or other information for a given drug does not mean that the drug or its combination is safe, effective or appropriate for use in all patients.