Sulindac interactions
Full monograph for SulindacCheck it against another medicine
Medicines
405 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Acalabrutinib | Major | Synergy | Coadministration of acalabrutinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. | 3 sources — open the full entry |
| Adefovir Dipivoxil | Major | Excretion | Coadministration of adefovir dipivoxil with other nephrotoxic agents may increase the risk and severity of renal impairment due to additive effects on the… | 1 sources — open the full entry |
| Apixaban | Major | Synergy | Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation… | 39 sources — open the full entry |
| Betrixaban | Major | Synergy | Concomitant use of betrixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation… | 39 sources — open the full entry |
| Cabozantinib | Major | Synergy | Coadministration of cabozantinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment… | 39 sources — open the full entry |
| Dabigatran Etexilate Mesylate | Major | Synergy | Coadministration of thrombin inhibitors with drugs that affect platelet function may potentiate the risk of bleeding due to additive or synergistic effects on… | 2 sources — open the full entry |
| Dalteparin Sodium | Major | Synergy | In patients receiving neuraxial anesthesia or spinal puncture, the risk of developing an epidural or spinal hematoma during low molecular weight heparin (LMWH)… | 12 sources — open the full entry |
| Dasatinib | Major | Synergy | Coadministration of dasatinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment with… | 5 sources — open the full entry |
| Deferasirox | Major | Synergy | Coadministration with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of gastrointestinal bleeding associated with the use of deferasirox… | 3 sources — open the full entry |
| Enoxaparin Sodium | Major | Synergy | In patients receiving neuraxial anesthesia or spinal puncture, the risk of developing an epidural or spinal hematoma during low molecular weight heparin (LMWH)… | 12 sources — open the full entry |
| Everolimus | Major | Synergy | Coadministration of macrolide immunosuppressants with other nephrotoxic agents may increase the risk and/or severity of renal impairment due to additive… | 4 sources — open the full entry |
| Fondaparinux Sodium | Major | Synergy | In patients receiving neuraxial anesthesia or spinal puncture, the risk of developing an epidural or spinal hematoma during LMWH, heparinoid, or fondaparinux… | 1 sources — open the full entry |
| Human Anti-D Immunoglobulins | Major | Synergy | Coadministration of intravenous immune globulin preparations with nephrotoxic agents may potentiate the risk of renal impairment. Many commercially available… | 11 sources — open the full entry |
| Ibrutinib | Major | Synergy | Coadministration of ibrutinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. | 6 sources — open the full entry |
| Iodixanol | Major | Synergy | Concomitant use of intravascular radiocontrast media with other nephrotoxic agents may potentiate the risk of contrast-induced nephropathy and renal… | 7 sources — open the full entry |
| Iohexol | Major | Synergy | Concomitant use of intravascular radiocontrast media with other nephrotoxic agents may potentiate the risk of contrast-induced nephropathy and renal… | 7 sources — open the full entry |
| Iopamidol | Major | Synergy | Concomitant use of intravascular radiocontrast media with other nephrotoxic agents may potentiate the risk of contrast-induced nephropathy and renal… | 7 sources — open the full entry |
| Ketorolac Tromethamine | Major | Synergy | The use of ketorolac in combination with other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of serious adverse effects such as renal… | 1 sources — open the full entry |
| Leflunomide | Major | Synergy | The recent, concomitant, or subsequent use (without the recommended leflunomide washout period or procedure) of other agents known to induce hepatotoxicity… | 3 sources — open the full entry |
| Methotrexate | Major | Excretion | Coadministration with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the plasma concentrations and toxicities of methotrexate. The proposed… | 30 sources — open the full entry |
| Monobasic Sodium Phosphate + Dibasic Sodium Phosphate | Major | Others | The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing… | 3 sources — open the full entry |
| Ponatinib Hydrochloride | Major | Synergy | Coadministration of ponatinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment with… | 3 sources — open the full entry |
| Prasugrel Hydrochloride | Major | Synergy | Concomitant use of prasugrel with other agents that affect hemostasis such as anticoagulants, platelet inhibitors, thrombin inhibitors, thrombolytic agents… | 2 sources — open the full entry |
| Ramucirumab | Major | Synergy | Theoretical concerns exist that nonsteroid anti-inflammatory drugs (NSAIDs) and salicylates may potentiate the risk of bleeding and gastrointestinal… | 1 sources — open the full entry |
| Regorafenib Monohydrate | Major | Synergy | Coadministration of regorafenib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment… | 5 sources — open the full entry |
| Rivaroxaban | Major | Synergy | Concomitant use of rivaroxaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation… | 1 sources — open the full entry |
| Tacrolimus MonohydrateOralTopical | Major | Synergy | Coadministration of macrolide immunosuppressants with other nephrotoxic agents may increase the risk and/or severity of renal impairment due to additive… | 4 sources — open the full entry |
| Tenofovir Alafenamide | Major | Excretion | Coadministration of tenofovir with other nephrotoxic agents may increase the risk of renal impairment due to additive effects on the kidney. Additionally… | 8 sources — open the full entry |
| Tenofovir Disoproxil | Major | Excretion | Coadministration of tenofovir with other nephrotoxic agents may increase the risk of renal impairment due to additive effects on the kidney. Additionally… | 8 sources — open the full entry |
| Warfarin Sodium | Major | Synergy | Nonsteroidal anti-inflammatory drugs (NSAIDs) may potentiate the hypoprothrombinemic effect and bleeding risk associated with oral anticoagulants. | 72 sources — open the full entry |
| Acyclovir + Hydrocortisone | Moderate | Synergy · Unknown | The combined use of corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the potential for serious gastrointestinal (GI) toxicity…2 documented mechanisms | 11 sources — open the full entry |
| Alendronic acid | Moderate | Synergy | Theoretical concerns exist regarding the potential for increased risk and severity of gastrointestinal toxicity during coadministration of oral bisphosphonates… | 12 sources — open the full entry |
| Alendronic Acid + Vitamin D3 | Moderate | Synergy | Theoretical concerns exist regarding the potential for increased risk and severity of gastrointestinal toxicity during coadministration of oral bisphosphonates… | 12 sources — open the full entry |
| Allium cepa + Heparin + Allantoin | Moderate | Synergy | Theoretically, the coadministration of nonsteroidal anti-inflammatory drugs (NSAIDs) and heparin or low molecular weight heparin (LMWH) may potentiate the risk… | 6 sources — open the full entry |
| Alteplase | Moderate | Synergy | Systemically and topically administered nonsteroidal anti-inflammatory drugs (NSAIDs) may potentiate the risk of bleeding in patients treated with… | 3 sources — open the full entry |
| Amikacin | Moderate | Synergy | The nephrotoxic effect of aminoglycosides may be potentiated by nonsteroidal anti-inflammatory drugs (NSAIDs), particularly if the latter had been given in… | 6 sources — open the full entry |
| Amlodipine Besilate | Moderate | Antagonism | Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to… | 41 sources — open the full entry |
| Amlodipine Besilate + Atenolol | Moderate | Antagonism | Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to…2 documented mechanisms | 51 sources — open the full entry |
| Amlodipine Besilate + Atorvastatin | Moderate | Antagonism · Unknown | Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to…2 documented mechanisms | 41 sources — open the full entry |
| Amlodipine Besilate + Benazepril Hydrochloride | Moderate | Antagonism | Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to…2 documented mechanisms | 57 sources — open the full entry |
| Amlodipine Besilate + Olmesartan Medoxomil | Moderate | Antagonism | Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to…2 documented mechanisms | 47 sources — open the full entry |
| Amlodipine Besilate + Telmisartan | Moderate | Antagonism | Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to…2 documented mechanisms | 47 sources — open the full entry |
| Amlodipine Besilate + Valsartan | Moderate | Antagonism | Limited data indicate that some cyclooxygenase inhibitors may attenuate the antihypertensive effects of some calcium channel blockers. The mechanism appears to…2 documented mechanisms | 47 sources — open the full entry |
| Aspirin | Moderate | Synergy | The combined use of low-dose or high-dose aspirin with other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the potential for serious… | 26 sources — open the full entry |
| Aspirin + Dipyridamole | Moderate | Synergy | The combined use of low-dose or high-dose aspirin with other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the potential for serious…2 documented mechanisms | 29 sources — open the full entry |
| Atenolol | Moderate | Antagonism | Nonsteroidal anti-inflammatory drugs (NSAIDs) may attenuate the antihypertensive effect of beta-blockers. The proposed mechanism is NSAID-induced inhibition of… | 10 sources — open the full entry |
| Atenolol + Chlorthalidone | Moderate | Antagonism | Nonsteroidal anti-inflammatory drugs (NSAIDs) may attenuate the antihypertensive effect of beta-blockers. The proposed mechanism is NSAID-induced inhibition of…2 documented mechanisms | 36 sources — open the full entry |
| Azilsartan Medoxomil | Moderate | Antagonism | Nonsteroidal anti-inflammatory drugs (NSAIDs) may attenuate the antihypertensive effects of angiotensin II receptor antagonists. The proposed mechanism is…2 documented mechanisms | 10 sources — open the full entry |
| Azilsartan Medoxomil + Chlorthalidone | Moderate | Antagonism | Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and diuretics may adversely affect renal function due to NSAID inhibition of the renal…3 documented mechanisms | 36 sources — open the full entry |
| Baricitinib | Moderate | Synergy | Baricitinib and tofacitinib, both Janus kinase (JAK) inhibitors, have been associated with an increased risk of diverticulitis (DV) and gastrointestinal (GI)… | 2 sources — open the full entry |
Food & lifestyle
alcohol
ModerateSynergy
The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
What to do: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
1 source
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
Conditions
Conditions in which Sulindac needs care, as documented in this source.
Asthma
MajorNonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in patients with history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs; severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients. A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polyps, severe potentially fatal bronchospasm, and/or intolerance to aspirin and other NSAIDs. Since cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients, therapy with any NSAID should be avoided in patients with this form of aspirin sensitivity. NSAIDs should be used with caution in patients with preexisting asthma (without known aspirin sensitivity), and these patients should be monitored for changes in the signs and symptoms of asthma.
15 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
Show all 15 sourcesShow fewer sources
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
Exanthema
MajorNonsteroidal anti-inflammatory drugs (NSAIDs) can cause serious skin adverse reactions (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis, and exfoliative dermatitis), which can be fatal. These serious events may occur without warning. Patients should be advised to discontinue the NSAID and seek medical attention promptly at the first sign of skin rash or any other sign of hypersensitivity. NSAIDs are contraindicated in patients with previous serious skin reactions to these drugs.
16 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
Show all 16 sourcesShow fewer sources
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
- "Product Information. Meclofenamate Sodium (meclofenamate)." Mylan Pharmaceuticals Inc (2012):
Kidney Diseases
MajorLong-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) has resulted in renal papillary necrosis and other renal injury. Renal toxicity has been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion: in such patients, NSAIDs may cause a dose-dependent reduction in prostaglandin synthesis and, secondarily, in renal blood flow, which may precipitate overt renal decompensation. Patients at greatest risk for this reaction include the elderly, those with impaired renal function, dehydration, hypovolemia, heart failure, or liver dysfunction, and those taking diuretics, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers; discontinuation of NSAID therapy will usually lead to recovery to the pretreatment state. No information is available regarding use NSAIDs in patients with advanced renal disease; the renal effects of NSAIDs may hasten the progression of renal dysfunction in patients with preexisting renal disease. Volume status should be corrected in dehydrated or hypovolemic patients prior to initiating treatment. Renal function should be monitored during therapy in patients with renal or liver dysfunction, heart failure, dehydration, or hypovolemia. NSAIDs should be avoided in patients with advanced renal disease unless the benefits are expected to outweigh the risk of worsening renal function; if an NSAID is used in such patients, they should be monitored for signs of worsening renal function.
16 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
Show all 16 sourcesShow fewer sources
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Dolobid (diflunisal)." Merck & Co., Inc (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
Peptic Ulcer
MajorNonsteroidal anti-inflammatory drugs (NSAIDs) can cause serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal. These serious adverse events can develop at any time, with or without warning symptoms. Only 1 in 5 patients who develop a serious upper GI side effect on NSAIDs is symptomatic. NSAIDs should be used with caution in patients with history of peptic ulcer disease and/or GI bleeding, as these patients had a greater than 10-fold increased risk for developing a GI bleed compared to patients without these risk factors. Caution is also advised if NSAIDs are prescribed to patients with other factors that increase risk of GI bleeding, such as: prolonged NSAID therapy; concomitant use of oral corticosteroids, antiplatelet agents (e.g., aspirin), anticoagulants, selective serotonin reuptake inhibitors; alcohol use; smoking; history of gastrointestinal surgery or anastomosis, older age; poor general health status; and advanced liver disease and/or coagulopathy. Particular vigilance is necessary when treating elderly or debilitated patients since most postmarketing reports of fatal GI events occurred in these patients.
16 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
Show all 16 sourcesShow fewer sources
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Dolobid (diflunisal)." Merck & Co., Inc (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
Thrombosis
MajorNonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Clinical trials of several cyclooxygenase-2 (COX-2) selective and nonselective NSAIDs of up to 3 years duration have supported this increased risk. It is unclear from available data if the risk for cardiovascular thrombotic events is similar for all NSAIDs. Therapy with NSAIDs should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease. Patients should be treated with the lowest effective dosage for the shortest duration necessary. Appropriate antiplatelet therapy should be administered to patients requiring cardioprotection; however, there is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious cardiovascular thrombotic events associated with NSAID use, while the risk of serious gastrointestinal events is increased. Physicians and patients should remain alert for the development of adverse cardiovascular events throughout the entire duration of therapy, even without prior cardiovascular symptoms. Patients should be advised to promptly seek medical attention if they experience symptoms of cardiovascular thrombotic events (including chest pain, shortness of breath, weakness, or slurring of speech).NSAIDs are contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Two large clinical trials of a COX-2 selective NSAID for the treatment of pain in the first 10 to 14 days following CABG surgery found an increased incidence of myocardial infarction and stroke.The use of NSAIDs should be avoided in patients with a recent myocardial infarction unless the benefits are expected to outweigh the risk of recurrent cardiovascular thrombotic events. If an NSAID is used in patients with a recent myocardial infarction, they should be monitored for signs of cardiac ischemia.
8 sources
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Ponstel (mefenamic acid)." Pfizer U.S. Pharmaceuticals Group (2006):
- "Product Information. Meclofenamate Sodium (meclofenamate)." Mylan Pharmaceuticals Inc (2012):
Water-Electrolyte Imbalance
MajorFluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure. Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.
14 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Anaprox (naproxen)." Roche Laboratories (2006):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
Show all 14 sourcesShow fewer sources
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
Anemia
ModerateAnemia has been reported in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs). This may be due to fluid retention, occult/gross blood loss, or an incompletely described effect on erythropoiesis. Hemoglobin or hematocrit should be monitored in patients with any signs/symptoms of anemia or blood loss, especially during long-term therapy. NSAIDs may increase risk of bleeding events; comorbid conditions (e.g., coagulation disorders; concomitant use of warfarin/other anticoagulants, antiplatelet agents, serotonin/serotonin norepinephrine reuptake inhibitors) may increase this risk, and patients with these conditions should be monitored for signs of bleeding. Therapy with NSAIDs should be administered cautiously in patients with or predisposed to anemia. Clinical monitoring of hematopoietic function may be appropriate, particularly during chronic therapy.
17 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Toradol (ketorolac)." Roche Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
Show all 17 sourcesShow fewer sources
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Dolobid (diflunisal)." Merck & Co., Inc (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
Blood Platelet Disorders
ModerateNonsteroidal anti-inflammatory drugs (NSAIDs) reversibly inhibit platelet adhesion and aggregation and may prolong bleeding time in some patients. With the exception of aspirin, the platelet effects seen with most NSAIDs at usual recommended dosages are generally slight and of relatively short duration but may be more pronounced in patients with underlying hemostatic abnormalities. Thrombocytopenia has also been reported rarely during NSAID use. Therapy with NSAIDs should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. NSAIDs that selectively inhibit cyclooxygenase-2 (i.e., COX-2 inhibitors) do not appear to affect platelet function or bleeding time at indicated dosages and may be preferable if risk of bleeding is a concern.
16 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
Show all 16 sourcesShow fewer sources
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Dolobid (diflunisal)." Merck & Co., Inc (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
- "Product Information. Flector Patch (diclofenac topical)." Actavis U.S. (Alpharma USPD) (2016):
Heart Failure
ModerateFluid retention and edema have been observed in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs), including some topical formulations. These drugs should be avoided in patients with severe heart failure unless the benefits are expected to outweigh the risk of worsening heart failure. If an NSAID is used in patients with severe heart failure, they should be monitored for signs of worsening heart failure.
12 sources
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Dolobid (diflunisal)." Merck & Co., Inc (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
Show all 12 sourcesShow fewer sources
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Meclofenamate Sodium (meclofenamate)." Mylan Pharmaceuticals Inc (2012):
- "Product Information. Flector Patch (diclofenac topical)." Actavis U.S. (Alpharma USPD) (2016):
Hyperkalemia
ModerateIncreases in serum potassium concentration (including hyperkalemia) have been reported with use of nonsteroidal anti-inflammatory drugs (NSAIDs), even in some patients without renal impairment. In patients with normal renal function, these effects have been attributed to a hyporeninemic-hypoaldosteronism state. Caution is advised in patients with hyperkalemia.
3 sources
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
Hypertension
ModerateNonsteroidal anti-inflammatory drugs (NSAIDs), including topicals, can lead to new onset of hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events. NSAIDs should be used with caution in patients with hypertension. Blood pressure should be monitored closely during the initiation of NSAID therapy and throughout the course of therapy.
12 sources
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Dolobid (diflunisal)." Merck & Co., Inc (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
Show all 12 sourcesShow fewer sources
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Meclofenamate Sodium (meclofenamate)." Mylan Pharmaceuticals Inc (2012):
- "Product Information. Flector Patch (diclofenac topical)." Actavis U.S. (Alpharma USPD) (2016):
Liver Diseases
ModerateBorderline elevations of 1 or more liver tests may occur in up to 15% of patients treated with nonsteroidal anti-inflammatory drugs (NSAIDs). These laboratory abnormalities may progress, remain unchanged, or regress with continuing therapy. Elevations of ALT or AST (at least 3 times the upper limit of normal) have been reported in about 1% of patients in clinical trials. In addition, rare (sometimes fatal) cases of severe hepatotoxicity, including liver necrosis, hepatic failure, jaundice, and fulminant hepatitis have been reported. Therapy with NSAIDs should be administered cautiously in patients with preexisting liver disease. Periodic monitoring of liver function is recommended during prolonged therapy. NSAIDs are also highly protein-bound and some are extensively metabolized by the liver. Metabolic activity and/or plasma protein binding may be altered in patients with hepatic impairment. A dosage reduction may be required in some cases.
17 sources
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
- "Product Information. Nalfon (fenoprofen)." Xspire Pharma (2002):
- "Product Information. Indocin (indomethacin)." Merck & Co., Inc (2002):
- "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories (2002):
- "Product Information. Toradol (ketorolac)." Roche Laboratories (2002):
- "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc (2002):
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
- "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical (2001):
Show all 17 sourcesShow fewer sources
- "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals (2001):
- "Product Information. Relafen (nabumetone)." SmithKline Beecham (2001):
- "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals (2001):
- "Product Information. Dolobid (diflunisal)." Merck & Co., Inc (2001):
- "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn (2001):
- "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Daypro (oxaprozin)." Searle (2001):
- "Product Information. Celebrex (celecoxib)." Searle (2001):
- "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim (2001):
Nephrolithiasis
ModerateSulindac metabolites have rarely been reported as the major or a minor component in renal stones in association with other calculus components. Therapy with sulindac should be administered cautiously with adequate hydration in patients with a history of nephrolithiasis.
1 source
- "Product Information. Clinoril (sulindac)." Merck & Co., Inc (2001):
Therapeutic duplication
Drug classes that overlap with Sulindac, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
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