Sulinex

Indications

Sulindac is used to relieve pain, swelling and stiffness in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis (a long-term inflammation of the spine). It is also used for short periods to treat acute gout attacks and painful, inflamed shoulders.

How It Works

Sulindac is a non-steroidal anti-inflammatory drug (NSAID). It is changed in the liver into its active form, which blocks the COX enzymes that make prostaglandins, the substances that cause pain and inflammation.

Dosage and Administration

• Adults, arthritis: usually 150 mg to 200 mg twice a day. The maximum is 400 mg a day.
• Acute gout: usually 200 mg twice a day for about 7 days, or as the doctor advises.
• Painful shoulder: usually 200 mg twice a day for 7 to 14 days.
• Children: not recommended.

Take with food or milk and a full glass of water. Use the lowest dose that works for the shortest time needed. Drink plenty of fluids while taking it.

Interactions

Taking it with Warfarin or other blood thinners, Aspirin, other NSAIDs, steroid tablets such as Prednisolone, or antidepressants such as Sertraline increases the risk of stomach bleeding. It can raise the levels of Lithium and Methotrexate. It can weaken the effect of blood pressure medicines and water tablets, and with ACE inhibitors or ARBs it can harm the kidneys. Ciclosporin and Tacrolimus with sulindac increase the risk of kidney damage. Do not take with Diflunisal.

Contraindications

• Allergy to sulindac, or asthma, hives or a runny nose triggered by Aspirin or other NSAIDs.
• Active stomach ulcer or bleeding, or a history of repeated ulcers or bleeding.
• Severe heart failure, or severe kidney or liver disease.
• The last 3 months of pregnancy.
• Pain relief around heart bypass surgery.

Side Effects

Common: indigestion, stomach pain, nausea, diarrhoea or constipation, wind, dizziness, headache, ringing in the ears and rash.

Get urgent medical help if you have black or tarry stools or vomit blood or material like coffee grounds, chest pain, sudden weakness on one side of the body or slurred speech, breathlessness or swelling of the ankles, passing very little urine, yellowing of the skin or eyes, severe stomach pain spreading to the back, fever with a rash, blistering or peeling skin, or swelling of the face or difficulty breathing.

Pregnancy and Lactation

Avoid during pregnancy unless the doctor says it is needed, especially from 20 weeks onward, as it can affect the baby's kidneys and heart. Never take it in the last 3 months of pregnancy. It is not recommended while breastfeeding; ask your doctor for a safer pain reliever.

Precautions and Warnings

NSAIDs can raise the risk of heart attack and stroke, especially at high doses or with long use. Use with care in older people and in heart disease, high blood pressure, a history of stomach ulcers, asthma, kidney or liver problems and kidney stones. Your doctor may check blood tests during long-term use.

Overdose

An overdose can cause stomach pain, nausea, vomiting, drowsiness, dizziness and headache. Severe overdose can cause stomach bleeding, kidney failure, fits and breathing problems. Seek medical help straight away.

Therapeutic Class

Non-steroidal anti-inflammatory drug (NSAID), acetic acid derivative.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.