Sulindac

By Medically reviewed by hellodoktor

Generic Name: Sulindac Brand Name(s): Sulindac.

Uses

What is Sulindac used for?

Sulindac is used to reduce pain, swelling, and joint stiffness from arthritis. It is also used to treat arthritis of the spine, gouty arthritis, and shoulder bursitis/tendonitis. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID).

How should I take Sulindac?

Take this medication by mouth as directed by your doctor, usually twice daily. Take this medication with a full glass of water (8 ounces or 240 milliliters), unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this drug. Take this medication either with food, right after meals, or with antacids to prevent stomach upset.

Dosage is based on your medical condition and response to treatment. To lessen side effect risks (such as stomach bleeding), use this medication at the lowest effective dose for the shortest possible length of time. Do not increase your dose or take it more often than prescribed. For chronic conditions such as arthritis, continue taking it as directed by your doctor. Discuss the risks and benefits with your doctor or pharmacist. Also, the manufacturer recommends that you do not take more than 400 milligrams per day because this may increase your risk of liver problems.

In certain conditions (such as arthritis), it may take 1-2 weeks before the full benefits take effect when this drug is taken regularly.

If you are taking this drug on an “as needed” basis (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has significantly worsened, the medicine may not work as well.

Tell your doctor if your condition worsens.

How do I store Sulindac?

Sulindac is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Sulindac in the bathroom or the freezer. There may be different brands of Sulindac that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Sulindac down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Sulindac?

Take this medication by mouth as directed by your doctor, usually twice daily. Take this medication with a full glass of water (8 ounces or 240 milliliters), unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this drug. Take this medication either with food, right after meals, or with antacids to prevent stomach upset.

Dosage is based on your medical condition and response to treatment. To lessen side effect risks (such as stomach bleeding), use this medication at the lowest effective dose for the shortest possible length of time. Do not increase your dose or take it more often than prescribed. For chronic conditions such as arthritis, continue taking it as directed by your doctor. Discuss the risks and benefits with your doctor or pharmacist. Also, the manufacturer recommends that you do not take more than 400 milligrams per day because this may increase your risk of liver problems.

In certain conditions (such as arthritis), it may take 1-2 weeks before the full benefits take effect when this drug is taken regularly.

If you are taking this drug on an “as needed” basis (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has significantly worsened, the medicine may not work as well.

Tell your doctor if your condition worsens.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Sulindac during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Sulindac. Sulindac is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Sulindac?

Upset stomach, nausea, vomiting, gas, diarrhea, constipation, dizziness, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if any of these unlikely but serious side effects occur: hearing changes (such as ringing in the ears), mental/mood changes, difficult/painful swallowing, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).

Get medical help right away if any of these rare but very serious side effects occur: signs of kidney problems (such as change in the amount of urine), unexplained stiff neck.

This drug may rarely cause serious (possibly fatal) liver disease. If you notice any of the following highly unlikely but very serious side effects, stop taking sulindac and consult your doctor or pharmacist right away: dark urine, persistent nausea/vomiting, severe stomach/abdominal pain, yellowing eyes or skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Sulindac?

Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), cidofovir, dimethyl sulfoxide (DMSO), lithium, methotrexate, corticosteroids (such as prednisone), “water pills” (diuretics such as furosemide).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to sulindac and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Sulindac may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Sulindac?

Sulindac may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Sulindac?

Sulindac may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Sulindac.

What is the dose of Sulindac for an adult?

Usual Adult Dose for Acute Gout

Initial dose: 200 mg orally twice a day

Maximum dose: 400 mg orally per day

Duration of therapy: 7 days is usually adequate

Comment:

-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient’s treatment goals.

Use: Use: For the relief of signs and symptoms of acute gouty arthritis

Usual Adult Dose for Ankylosing Spondylitis

Initial dose: 150 mg orally twice a day

Maximum dose: 400 mg orally per day

Comment:

-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient’s treatment goals.

Use: For the relief of signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis

Usual Adult Dose for Osteoarthritis

Initial dose: 150 mg orally twice a day

Maximum dose: 400 mg orally per day

Comment:

-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient’s treatment goals.

Use: For the relief of signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis

Usual Adult Dose for Rheumatoid Arthritis

Initial dose: 150 mg orally twice a day

Maximum dose: 400 mg orally per day

Comment:

-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient’s treatment goals.

Use: For the relief of signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis

Usual Adult Dose for Bursitis

Initial dose: 200 mg orally twice a day

Maximum dose: 400 mg orally per day

Duration of therapy: 7 to 14 days is usually adequate

Comment:

-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient’s treatment goals.

Use: For the relief of signs and symptoms of acute painful shoulder, including acute subacromial bursitis and supraspinatus tendinitis.

Usual Adult Dose for Tendonitis

Initial dose: 200 mg orally twice a day

Maximum dose: 400 mg orally per day

Duration of therapy: 7 to 14 days is usually adequate

Comment:

-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient’s treatment goals.

Use: For the relief of signs and symptoms of acute painful shoulder, including acute subacromial bursitis and supraspinatus tendinitis.

Renal Dose Adjustments

-Advanced Renal Disease: Not recommended; if treatment is necessary, close monitoring of renal function and a lower daily dose is advised.

Liver Dose Adjustments

-Use caution; lower daily doses may be required in patients with acute or chronic hepatic disease.

-Patients who have an abnormal liver test or who develop signs or symptoms of liver dysfunction should be evaluated for hepatic dysfunction; if liver disease develops or if systemic manifestations such as eosinophilia or rash occur, this drug should be discontinued.

Dialysis

No adjustment recommended.

Other Comments

Administration advice:

-Take twice a day with food.

General:

-Response to therapy can usually be seen within 1 week of beginning treatment in half of patients with osteoarthritis, ankylosing spondylitis, and rheumatoid arthritis; others may take longer to respond.

-Once response to therapy is determined, dose and frequency should be adjusted to the lowest effective dose for the shortest duration possible to suit the individual patient’s treatment goals.

-There is an increased risk of heart attack, heart failure, and stroke when taking nonsteroidal anti-inflammatory drugs (NSAIDs); these events may occur at any time during treatment and risk increases with long term use, a history of cardiovascular (CV) disease or risk factors for CV disease, and higher doses.

Monitoring:

-Cardiovascular: Monitor blood pressure closely during initiation and throughout course of therapy.

-Gastrointestinal: Monitor for signs/symptoms of gastrointestinal bleeding.

-Renal function: Monitor renal status, especially in patients with conditions where renal prostaglandins have a supportive role in the maintenance of renal perfusion.

-Monitor blood counts, renal, and hepatic function periodically for patients receiving long-term therapy.

Patient advice:

-Patients should seek medical advice for signs and symptoms of cardiovascular events, gastrointestinal events, adverse skin reactions, allergic reactions, hepatotoxicity, or unexplained weight gain or edema.

-Patients should seek medical attention immediately if signs/symptoms of cardiovascular events occur, including, shortness of breath, slurred speech, chest pain, or weakness on one side of the body.

-Patients should talk to their health care provider if they are pregnant, planning to become pregnant, or breastfeeding; this drug should not be used during pregnancy at 30 weeks gestation or later.

-Patients should be aware that there are a number of potential drug interactions with this drug and they should speak with a healthcare professional before starting any new medications including over the counter medications.

What is the dose of Sulindac for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Sulindac available?

Sulindac is available in the following dosage forms and strengths:

  • Oral tablet,
  • Compounding powder.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Sulindac, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: June 1, 2018 | Last Modified: September 12, 2019

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