Sulindac, Oral

What are other names for this medicine?

Type of medicine: nonsteroidal anti-inflammatory drug (NSAID)

Generic and brand names: sulindac, oral; Clinoril

What is this medicine used for?

This medicine is a nonsteroidal anti-inflammatory drug (NSAID). It is used to provide relief from:

• the symptoms of arthritis
• pain associated with conditions such as bursitis, menstrual cramps, gout, headache, and muscle strains

This medicine may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before you take this medicine, be sure to tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a heart attack, stroke, or recent heart surgery
• asthma
• bleeding problems or blood disorders such as anemia
• heart failure or problems with swelling in ankles, feet, or hands
• high blood pressure
• kidney or liver disease
• nasal polyps
• phenylketonuria (PKU). The chewable tablet may contain phenylalanine.
• problems urinating
• stomach or intestinal ulcers or bleeding
• lupus or other connective tissue disease

Tell your provider if you take steroids such as prednisone or medicine that reduces the chance of blood clots forming such as warfarin (Coumadin).

Females of childbearing age: Tell your healthcare provider if you are pregnant or breast-feeding. This medicine is not recommended for use in late pregnancy because it may harm the baby. Do not breast-feed while taking this medicine without your health care provider's approval.

How do I use it?

Take this medicine exactly as your healthcare provider prescribes. If your healthcare provider has not given you specific instructions, follow the directions that come with the medicine package. Do not take more or take it longer than prescribed. Ask your healthcare provider or pharmacist about anything you do not understand.

Check the label on the medicine for directions about your specific dose. Take this medicine with a full glass (8 ounces) of water. You may take this medicine with or without food. Taking it with food, milk, or antacids may lessen the chance the drug will upset your stomach.

If you are taking this medicine for arthritis, take it regularly as prescribed by your healthcare provider.

If you are taking aspirin to prevent a heart attack or stroke, talk with your healthcare provider before you take this NSAID medicine. NSAIDs may make aspirin less effective. Your healthcare provider can tell you how much time you should allow between taking aspirin and taking this NSAID medicine.

This medicine may come in different forms. If you take delayed- or extended-release tablets or capsules, swallow them whole. Do not break, crush, or chew them. Ask your pharmacist if you have delayed- or extended-release tablets or capsules.

If you have the liquid form of this medicine, shake it well before using. Use a special measuring spoon rather than a common kitchen spoon to make sure you are getting the right dose.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: stomach pain, nausea, vomiting, vomiting or coughing up blood, dizziness, drowsiness, confusion, black or bloody stools, decreased urination, fever, shallow or trouble breathing, headache, ringing in the ears, numbness, tingling, seizures, fainting, coma.

What should I watch out for?

Warning: Occasionally, this medicine may cause bleeding, ulcers, or perforation of the stomach or intestines. These problems may occur without warning symptoms. You may be at higher risk if you smoke, are over the age of 65 or in poor health, drink alcohol, or take this medicine for a long time. If you have abdominal pain, a black tarry stool, or a bloody stool, stop taking this medicine and contact your healthcare provider right away.

This medicine has been linked with increased risk for high blood pressure. Also, taking this medicine for a long time may make it more likely that you will have a heart attack or stroke. Talk with your healthcare provider about this.

You may have swelling of the ankles, feet, or hands while taking this medicine. If this becomes bothersome, contact your healthcare provider.

This medicine should not be used right before or after a heart surgery called coronary artery bypass graft (CABG). Talk with your healthcare provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may cause an allergic reaction in people who have asthma or who have had allergic reactions to aspirin or other painkillers. If you develop hives, itching, a rash, tightness in your chest, or trouble breathing, stop taking this medicine and contact your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.

Do not take other pain relievers or drink alcohol while you are taking this medicine unless your healthcare provider approves. They may increase the risk of stomach upset.

Check the labels of all nonprescription and prescription medicines you take. Taking other medicines that contain NSAIDs while you take this medicine may lead to an overdose. Ask your health care provider or pharmacist if you have any questions.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

If you take this medicine for a long time, you may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives, itching, rash, tightness in your chest or trouble breathing), extreme headache with stiff neck.

Serious (report these to your healthcare provider right away): Confusion; feeling faint; mouth or lip sores; hearing problems or ringing in your ears; vision changes; yellowing of your skin or eyes; loss of appetite; bloody or black tarry stools; severe vomiting; severe stomach pain; swelling in ankles, feet, or hands or any unexplained swelling; decreased urination or trouble urinating; severe or unusual weakness or tiredness; unusual bleeding or bruising; chest pain; shortness of breath; slurring of speech; sudden weakness in one part or side of your body; skin rash or blisters with fever; severe itching.

Other: Mild fever, chills, muscle pain, stomach pain, diarrhea, nausea, tiredness, gas, headache, dizziness, constipation.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), trandolapril (Mavik), and moexipril (Univasc)
• alcohol
• angiotensin II blockers such as candesartan (Atacand), losartan (Cozaar), and valsartan (Diovan)
• aspirin or other salicylates
• antiseizure medicines such as phenytoin (Dilantin) and fosphenytoin (Cerebyx)
• beta blockers such as metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), bisoprolol (Zebeta), timolol, propranolol (Inderal, Inderal LA), and nadolol (Corgard)
• bile acid sequestrants such as cholestyramine (Questran), colesevelam (WelChol), and colestipol (Colestid)
• celecoxib (Celebrex)
• corticosteroids such as prednisone and methylprednisolone (Medrol, Solu-Medrol)
• diabetes medicines such as insulin, glyburide (DiaBeta, Glynase, Micronase), metformin (Glucophage, Glucovance), pioglitazone (Actos), and rosiglitazone (Avandia)
• digoxin (Lanoxin)
• dimethyl sulfoxide (DMSO, Rimso-50)
• diuretics such as triamterene (Dyrenium, Dyazide, Maxzide), spironolactone (Aldactone), chlorothiazide (Diuril), hydrochlorothiazide (Microzide), furosemide (Lasix), bumetanide (Bumex), and ethacrynic acid (Edecrin)
• immunosuppressants such as cyclosporine (Sandimmune, Neoral, Gengraf), and tacrolimus (Prograf)
• lithium (Lithobid, Eskalith)
• medicines that contain NSAIDs such as cough and cold medicines or other pain or fever medicines
• medicines to treat Alzheimer's such as galantamine (Razadyne ER, Razadyne) and tacrine (Cognex)
• medicines to treat or prevent blood clots such as warfarin (Coumadin), abciximab (ReoPro), argatroban, lepirudin (Refludan), bivalirudin (Angiomax), tirofiban (Aggrastat), pentosan polysulfate sodium (Elmiron), clopidogrel (Plavix), ticlopidine (Ticlid), and dipyridamole (Persantine)
• methotrexate
• natural remedies such as chaparral, comfrey, feverfew, flaxseed, fish oil, garlic, ginseng, ginkgo, kava, ma huang, pennyroyal, and valerian
• pentosan polysulfate sodium (Elmiron)
• sulfonamides such as sulfadiazine, sulfisoxazole (Gantrisin), and sulfasalazine (Azulfidine)
• probenecid
• quinolone antibiotics such as levofloxacin (Levaquin), ofloxacin (Floxin), and ciprofloxacin (Cipro)
• SSRI antidepressants such as sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro)

Do not drink alcohol while taking this medicine. Also, do not take other painkillers while you are taking this medicine without your healthcare provider's approval.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.