Sulindac

What is Sulindac

Sulindac is a nonsteroidal anti-inflammatory drug (NSAID) of the indole and indene acetic acid chemical class.

Sulindac possesses analgesic and antipyretic properties. Because the sulfone metabolite is inactive and is largly renally excreted, nephrotoxicity relative to other NSAIDs is hypothesized to be less. However, recent data do not support this hypothesis. More data are needed.

Sulindac and celecoxib are the only NSAIDs that appear to be effective for the regression of colorectal polyps in patients with familial adenomatous polyposis (FAP).

According to guidelines from The American Society of Colon and Rectal Surgeons, sulindac should not be used for the prevention or primary treatment of FAP with the exception of patients with pouch polyposis or selected patients with rectal polyposis after ileorectal anastomosis in whom surgery is undesirable.

Brand Name

Clinoril

Indications

  1. ankylosing spondylitis
  2. arthralgia
  3. bone pain
  4. bursitis
  5. desmoid tumor
  6. familial adenomatous polyposis
  7. gouty arthritis
  8. headache
  9. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
  10. migraine
  11. moderate pain
  12. myalgia
  13. osteoarthritis
  14. rheumatoid arthritis
  15. tendinitis

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anaphylactic shock
  5. anaphylactoid reactions
  6. anemia
  7. angioedema
  8. anorexia
  9. anxiety
  10. aplastic anemia
  11. aseptic meningitis
  12. blurred vision
  13. bronchospasm
  14. cholestasis
  15. colitis
  16. confusion
  17. constipation
  18. crystalluria
  19. depression
  20. diarrhea
  21. dizziness
  22. drowsiness
  23. dysgeusia
  24. dyspepsia
  25. dysphagia
  26. dyspnea
  27. dysuria
  28. ecchymosis
  29. edema
  30. elevated hepatic enzymes
  31. eosinophilia
  32. epistaxis
  33. erythema multiforme
  34. esophageal stricture
  35. esophageal ulceration
  36. esophagitis
  37. exfoliative dermatitis
  38. fever
  39. flatulence
  40. gastritis
  41. GI bleeding
  42. GI perforation
  43. glossitis
  44. gynecomastia
  45. headache
  46. hearing loss
  47. heart failure
  48. hematuria
  49. hemolytic anemia
  50. hepatic failure
  51. hepatitis
  52. hyperglycemia
  53. hyperkalemia
  54. hypertension
  55. hyponatremia
  56. insomnia
  57. interstitial nephritis
  58. jaundice
  59. leukopenia
  60. malaise
  61. metallic taste
  62. myasthenia
  63. myocardial infarction
  64. nausea
  65. necrotizing fasciitis
  66. nephrolithiasis
  67. nephrotic syndrome
  68. neuritis
  69. neutropenia
  70. odynophagia
  71. palpitations
  72. pancreatitis
  73. paresthesias
  74. peptic ulcer
  75. peripheral edema
  76. photophobia
  77. photosensitivity
  78. platelet dysfunction
  79. proteinuria
  80. pruritus
  81. psychosis
  82. purpura
  83. pyrosis (heartburn)
  84. rash
  85. renal failure (unspecified)
  86. renal papillary necrosis
  87. seizures
  88. Stevens-Johnson syndrome
  89. stomatitis
  90. stroke
  91. syncope
  92. thrombocytopenia
  93. thromboembolism
  94. tinnitus
  95. toxic epidermal necrolysis
  96. urine discoloration
  97. urticaria
  98. vaginal bleeding
  99. vasculitis
  100. vertigo
  101. visual impairment
  102. vomiting
  103. weight gain
  104. xerostomia

Monitoring Parameters

  • CBC
  • LFTs
  • serum creatinine/BUN
  • stool guaiac

Contraindications

  • acute bronchospasm
  • acute myocardial infarction
  • alcoholism
  • anemia
  • angina
  • anticoagulant therapy
  • asthma
  • bone marrow suppression
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • cerebrovascular disease
  • chemotherapy
  • children
  • coagulopathy
  • coronary artery bypass graft surgery (CABG)
  • coronary artery disease
  • corticosteroid therapy
  • dehydration
  • dental disease
  • dental work
  • diabetes mellitus
  • dysphagia
  • edema
  • esophageal stricture
  • esophagitis
  • geriatric
  • GI bleeding
  • GI disease
  • GI perforation
  • heart failure
  • hematological disease
  • hemophilia
  • hepatic disease
  • hypertension
  • hypovolemia
  • immunosuppression
  • intramuscular injections
  • jaundice
  • labor
  • myocardial infarction
  • nasal polyps
  • neutropenia
  • NSAID hypersensitivity
  • obstetric delivery
  • peptic ulcer disease
  • peripheral vascular disease
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • rheumatoid arthritis
  • salicylate hypersensitivity
  • stroke
  • surgery
  • systemic lupus erythematosus (SLE)
  • tachycardia
  • thrombocytopenia
  • thromboembolism
  • tobacco smoking
  • ulcerative colitis
  • urticaria

Interactions

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