Analgesic

Sulindac

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Sulindac, Clinoril

  • See Also
  1. See NSAID
  • Indications
  1. See NSAID
  2. FDA Approved Indications in adults
    1. Rheumatoid Arthritis
    2. Osteoarthritis
    3. Acuty Gouty Arthritis
    4. Musculoskeletal pain (Bursitis, Tendinitis)
  • Contraindications
  1. See NSAID
  • Mechanism
  1. See NSAID
  2. NSAID in the acetic acid class (indole)
  • Medications
  1. Sulindac (Clinoril): 150 mg, 200 mg
  • Dosing
  1. Adult
    1. Sulindac (Clinoril) 150 to 200 mg orally twice daily
    2. Maximum: 200 mg/day
  2. Child (not FDA approved, off-label)
    1. Juvenile Rheumatoid Arthritis: 4 mg/kg/day orally divided twice daily
  • Adverse Effects
  1. See NSAID
  2. Drug-Induced Pancreatitis
    1. However, Sulindac has also been investigated for the management of Chronic Pancreatitis
    2. Sugerman (1989) Am Surg 55(9):536-8 +PMID: 2774359 [PubMed]
    3. Bai (2012) BMC Gastroenterol 12:115 +PMID: 22920325 [PubMed]
  3. Hypersensitivity Reaction (severe, life threatening)
    1. Jett GK (1984) Ann Emerg Med 13(6):462-4 +PMID: 6731964 [PubMed]
  • Safety
  1. See NSAID
  2. Avoid in Lactation
  3. Avoid NSAIDs in pregnancy outside the first part of the second trimester (13 to 20 weeks)
    1. Teratogenic in first trimester
    2. Risk of premature ductus arteriosus closure in the fetus in third trimester
    3. Most NSAIDs carry a legacy system Pregnancy Category B or C designation (aside from third trimester)
      1. However, many obstetricians avoid NSAIDs entirely in pregnancy (even in second trimester)
  • Resources
  1. Sulindac (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=96c73bd2-4577-487d-a642-bd8f91e94c3a
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia