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

• Abciximab
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• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
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