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Drug Interactions With Sulindac
When certain medications are taken together, it is possible to develop drug interactions. With sulindac, some of the medications that can lead to interactions include angiotensin II receptor blockers, cyclosporine, and other nonsteroidal anti-inflammatory drugs. Besides decreasing the medicines' effectiveness, these interactions may cause side effects such as kidney damage, bleeding, or stomach ulcers. If drug interactions are a concern in your situation, your healthcare provider may adjust your dosages or monitor you more closely.
from eMedTV.comSulindac (Clinoril®) can potentially interact with several different medicines. Some of these medications include the following:
- Angiotensin-converting enzyme inhibitors (ACE inhibitors), including:
- Benazepril (Lotensin®), benazepril-hydrochlorothiazide (Lotensin HCT®), or benazepril-amlodipine (Lotrel®)
- Captopril (Capoten®) or captopril-hydrochlorothiazide (Capozide®)
- Enalapril (Vasotec®), enalapril-hydrochlorothiazide (Vaseretic®), or enalapril-felodipine (Lexxel®)
- Fosinopril (Monopril®) or fosinopril-hydrochlorothiazide (Monopril-HCT®)
- Lisinopril (Prinivil®, Zestril®) or lisinopril-hydrochlorothiazide (Prinzide®, Zestoretic®)
- Quinapril (Accupril®) or quinapril-hydrochlorothiazide (Accuretic®, Quinaretic™)
- Ramipril (Altace®)
- Angiotensin II receptor blockers (ARBs), such as:
- Azilsartan (Edarbi™) or azilsartan/chlorthalidone (Edarbyclor™)
- Candesartan (Atacand®) or candesartan-hydrochlorothiazide (Atacand HCT®)
- Eposartan (Teveten®) or eposartan-hydrochlorothiazide (Teveten® HCT)
- Irbesartan (Avapro®) or irbesartan-hydrochlorothiazide (Avalide®)
- Losartan (Cozaar®) or losartan-hydrochlorothiazide (Hyzaar®)
- Olmesartan (Benicar®), olmesartan-hydrochlorothiazide (Benicar HCT®), or amlodipine and olmesartan (AZOR™)
- Telmisartan (Micardis®) or telmisartan-hydrochlorothiazide (Micardis® HCT)
- Valsartan (Diovan®) or valsartan-hydrochlorothiazide (Diovan HCT®)
- Beta blockers, such as:
- Acebutolol (Sectral®)
- Atenolol (Tenormin®)
- Betaxolol (Kerlone®)
- Bisoprolol (Zebeta®)
- Carvedilol (Coreg®, Coreg CR®)
- Esmolol (Brevibloc®)
- Labetalol (Trandate®)
- Metoprolol (Lopressor®, Toprol-XL®)
- Nadolol (Corgard®)
- Nebivolol (Bystolic®)
- Penbutolol (Levatol®)
- Propranolol (Inderal®, Inderal® LA, InnoPran XL™)
- Sotalol (Betapace®)
- Timolol
- Bile acid sequestrant cholesterol medications, including:
- Cholestyramine (Prevalite®, Questran®, Questran® Light)
- Colesevelam (WelChol®)
- Colestipol (Colestid®)
- Corticosteroids, including (but not limited to):
- Betamethasone (Celestone®)
- Cortisone
- Dexamethasone (Decadron®)
- Fludrocortisone (Florinef®)
- Hydrocortisone (Cortef®)
- Methylprednisolone (Depo-Medrol®, Medrol®)
- Prednisolone (Orapred®, Pediapred®)
- Prednisone
- Triamcinolone (Kenalog®, Aristospan®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- Digoxin (Digitek®, Lanoxin®)
- Diuretics, such as:
- Amiloride (Midamor®) or amiloride-HCTZ (Moduretic®)
- Bumetanide (Bumex®)
- Chlorothiazide (Diuril®)
- Chlorthalidone (Thalitone®)
- Ethacrynic acid (Edecrin®)
- Furosemide (Lasix®)
- Hydrochlorothiazide (Esidrix®, HydroDIURIL®, Microzide®, Oretic®)
- Metolazone (Zaroxolyn®)
- Spironolactone (Aldactone®) or spironolactone-HCTZ (Aldactazide®)
- Torsemide (Demadex®)
- Triamterene (Dyrenium®) or triamterene/HCTZ (Dyazide®, Maxzide®)
- Lithium (Eskalith®, Lithobid®)
- Medications that "thin" the blood or otherwise increase bleeding risk (such as anticoagulant and antiplatelet drugs), such as:
- Antithrombin (ATryn®, Thrombate III®)
- Apixaban (Eliquis®)
- Argatroban
- Aspirin (Bayer® and others)
- Bivalirudin (Angiomax®)
- Cilostazol (Pletal®)
- Clopidogrel (Plavix®)
- Dabigatran (Pradaxa®)
- Dipyridamole (Persantine®)
- Drotrecogin alfa (Xigris®)
- Eptifibatide (Integrilin®)
- Fondaparinux (Arixtra®)
- Heparin or heparin-like products, including dalteparin (Fragmin®), enoxaparin (Lovenox®), or tinzaparin (Innohep®)
- Lepirudin (Refludan®)
- Other nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- Celecoxib (Celebrex®)
- Diclofenac (Cambia™, Cataflam®, Flector®, Solaraze® Gel, Voltaren®, Voltaren® Gel, Voltaren®-XR, Voltaren Ophthalmic®, Zipsor™)
- Etodolac (Lodine®, Lodine® XL)
- Ibuprofen (Motrin®, Advil®, Nuprin®)
- Indomethacin (Indocin®, Indocin SR®)
- Ketoprofen (Orudis®, Actron®, Oruvail®)
- Ketorolac (Toradol®)
- Meloxicam (Mobic®)
- Nabumetone (Relafen®)
- Naproxen (Naprosyn®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®)
- Oxaprozin (Daypro®)
- Piroxicam (Feldene®)
- Others (see List of NSAIDs for a more complete list of these medications)
- Pentoxifylline (Trental®)
- Prasugrel (Effient®)
- Thrombolytics, such as:
- Alteplase (Activase®)
- Reteplase (Retavase®)
- Streptokinase (Streptase®)
- Tenecteplase (TNKase®)
- Ticagrelor (Brilinta®)
- Ticlopidine (Ticlid®)
- Tirofiban (Aggrastat®)
- Warfarin (Coumadin®, Jantoven®)
- Methotrexate (Rheumatrex®, Trexall®)
- Probenecid
- SSRI or SNRI medications, including:
- Citalopram (Celexa®)
- Duloxetine (Cymbalta®)
- Desvenlafaxine (Pristiq®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Levomilnacipran (Fetzima™)
- Milnacipran (Savella™)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®, Brisdelle™)
- Sertraline (Zoloft®)
- Venlafaxine (Effexor®, Effexor XR®).
Several herbal and nutritional supplements can also interact with sulindac and may increase the risk of bleeding. Examples of these include, but are not limited to:
- Dong quai
- Feverfew
- Garlic
- Ginger
- Ginkgo biloba
- Ginseng
- St. John's wort
- Fish oil supplements.
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD