sulindac
Sulindac works well to treat pain and swelling in different types of arthritis and in certain shoulder injuries. Sulindac should be used at the lowest dose possible for the shortest duration of time to manage your symptoms. That's because it can cause serious side effects, such as stroke, heart attack, and stomach bleeds.
What is Sulindac?
What is Sulindac used for?
- Osteoarthritis
- Rheumatoid arthritis
- Arthritis of the spine (ankylosing spondylitis)
- Gout (gouty arthritis)
- Sharp shoulder pain (acute subacromial bursitis and supraspinatus tendinitis)
How Sulindac works
Sulindac is a non-steroidal anti-inflammatory drug (NSAID). It works by blocking proteins in your body that cause pain and swelling.
Drug facts
Side effects of Sulindac
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Stomach pains (10%)
- Heartburn (3-9%)
- Nausea (3-9%)
- Diarrhea (3-9%)
- Constipation (3-9%)
- Rash (3-9%)
- Dizziness (3-9%)
- Headache (3-9%)
Less Common Side Effects
- Passing gas
- Stomach cramps
- Itchy and dry skin
- Nervousness
- Ringing in the ear
- Swelling of the arms and legs
Sulindac serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Heart attack: dizziness, tiredness, cold sweat, trouble breathing, chest pain or tightness, anxiety
- Stroke: tiredness, lightheadedness, blurred vision, difficulty speaking, difficulty walking, weakness on one side of the body
- Stomach bleeds: blood in your vomit, stool that looks like black coffee grounds, pain in your stomach that doesn't go away
- Heart failure: trouble breathing, tiredness, swelling in your body, sudden weight gain
- Kidney damage: nausea, vomiting, tiredness, loss of appetite, changes in how much you urinate
- Liver damage: fever, chills, fatigue, nausea, vomiting, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine
- Severe asthma attack: chest pain, cough, difficulty breathing, wheezing
- Serious allergic and skin reaction: fever, rash, body aches, cough, swelling of the face, peeling skin, painful blisters all over your body
The following Sulindac side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Excess air or gas in the stomach or intestines
itching skin
passing gas
stomach cramps
swelling
Rare
Back or leg pains
bleeding gums
blistering, peeling, or loosening of the skin
bloody or black, tarry stools
bloody or cloudy urine
blurred or loss of vision
burning feeling in the chest or stomach
burning while urinating
chills
clay-colored stools
confusion
cough or hoarseness
cracks in the skin
dark urine
decreased urine output
difficult or labored breathing
difficult or painful urination
difficulty with swallowing
dilated neck veins
discoloration of urine
disturbed color perception
dizziness
double vision
extreme fatigue
fainting
feeling of warmth
flu-like symptoms
general body swelling
general feeling of discomfort or illness
groin pain
halos around lights
increased sensitivity of the skin to sunlight
increased sweating
increased thirst
indigestion
irregular breathing
joint or muscle pain
large, flat, blue, or purplish patches in the skin
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
loss of appetite
loss of heat from the body
lower back or side pain
muscle aches, pains, or weakness
nervousness
night blindness
noisy breathing
nosebleeds
numbness or tingling in the hands, feet, or lips
overbright appearance of lights
painful or difficult urination
pains in the stomach, side, or abdomen, possibly radiating to the back
pale skin
persistent bleeding or oozing from puncture sites, mouth, or nose
pinpoint red or purple spots on the skin
pounding in the ears
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
redness of the face, neck, arms and occasionally, upper chest
redness or other discoloration of the skin
redness, swelling, or soreness of the tongue
seizures
severe or continuing stomach pain
severe sunburn
shortness of breath
slow or fast, irregular, pounding, or racing heartbeat or pulse
sores, ulcers, or white spots in the mouth or on the lips
stiff neck or back
stomach upset
swelling of the face, fingers, feet, or lower legs
swelling or inflammation of the mouth
swollen or painful glands
tenderness in the stomach area
tightness in the chest
troubled breathing
tunnel vision
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal pain
vomiting of blood or material that looks like coffee grounds
watery or bloody diarrhea
weakness or heaviness of the legs
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Change in consciousness
decreased awareness or responsiveness
loss of consciousness
severe sleepiness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Continuing ringing or buzzing or other unexplained noise in the ears
hearing loss
Rare
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
burning, dry, or itching eyes
decreased hearing
difficulty with moving
discharge, excessive tearing
discouragement
false sense of well-being
feeling of constant movement of self or surroundings
feeling sad or empty
hair loss or thinning of the hair
hallucinations
irritability
loss of interest or pleasure
metallic or bitter taste
mood swings
muscle cramping or stiffness
personality changes
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
restlessness
sensation of spinning
sleepiness or unusual drowsiness
sore or dry mucous membranes
swelling or redness in the joints
trouble with concentrating
trouble with sleeping
unable to sleep
vaginal bleeding
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
Pros and cons of Sulindac
Pros
- Available as a less expensive generic medication
- Works well to lower pain and inflammation
- Lasts longer than some other NSAIDs, so you only need to take it twice daily
Cons
- Can cause stomach bleeding or stomach ulcers
- Not recommended for use starting the second trimester of pregnancy or later
- Not a good option for people with certain conditions, such as heart problems, history of stroke, or kidney problems
Pharmacist tips for Sulindac
- Take sulindac with food or milk to ease stomach-related side effects, such as stomach pain and nausea.
- Sulindac helps lower your pain and swelling, but it won't prevent your condition from getting worse. Depending on the cause of your pain, there might be things you can do to prevent it from getting worse. These include physical therapy, exercise, or taking other medications. Discuss with your provider to see what the best options are for you.
- Sulindac can cause rare, but potentially life-threatening skin reactions. If you notice fever, body aches, cough, peeling skin, and painful blisters all over your body (especially on the skin around the eyes, mouth, throat, or genitals), stop sulindac and talk to your healthcare provider right away.
- Sulindac can cause stomach bleeds, a very serious side effect. Symptoms of stomach bleeds include blood in your vomit, stool that looks like black coffee grounds, and pain in your stomach that doesn't go away. If you experience these symptoms, get medical help right away.
- Sulindac can cause anemia (low red blood cell levels). Let your provider know if you experience symptoms of anemia, such as feeling tired or weak, having pale skin, trouble breathing, or cold hands and feet.
- It's not recommended to take sulindac with other NSAIDs, such as ibuprofen (Advil) or naproxen (Aleve). Doing so puts you at higher risk for stomach bleeds, stroke, and heart attack. NSAIDs are commonly found in over-the-counter and prescription pain and cold medications. Talk with your healthcare provider or pharmacist if you're not sure whether you're already taking an NSAID.
Common questions about Sulindac
Arthritis is a condition where there's swelling, stiffness, and pain at the joints. Osteoarthritis, rheumatoid arthritis, gouty arthritis, and ankylosing spondylitis are different types of arthritis. While they share some similar symptoms, they develop differently in your body. Osteoarthritis happens when your cartilage, the "cushion" between your joints, wears out over time and your bones rub against each other. Rheumatoid arthritis occurs when your body's own immune system, which works to protect you from infections, attacks your joints instead. Gouty arthritis (gout) happens when there's too much uric acid in your body and it forms crystals in your joints, typically starting in the big toe. Ankylosing spondylitis is arthritis that mainly affects the joints along the spine. Healthcare providers don't treat these conditions the same. But sulindac can lower joint pain and swelling in all four conditions.
Sharp shoulder pain (acute subacromial bursitis and supraspinatus tendinitis) is pain and swelling in the rotator cuff area of your shoulder. The rotator cuff connects your arm to your shoulder. It helps you move, rotate, and raise your arm. Subacromial bursitis is a sharp, painful swelling of a fluid sac in your rotator cuff. This sac normally helps to cushion your shoulder joint so your arm can move and rotate smoothly. Supraspinatus tendinitis is a painful swelling of a tendon in the rotator cuff. Both these conditions are commonly seen in athletes who do a lot of overhead movements, such as pitching in baseball, playing golf, and swimming. Sulindac can be used in both types of rotator cuff injury to lower pain and swelling.
Sulindac works by blocking proteins called cyclooxygenase 1 and 2 (COX-1 and COX-2) enzymes from making prostaglandins. Prostaglandins are chemicals that have many roles in your body. When you get a cut or bruise, these chemicals can cause pain and swelling at the location of your injury. They also protect your gut from stomach acid, help your kidneys work normally, and balance blood flow throughout your body. When you take sulindac, you're not only preventing prostaglandins from causing pain and swelling, you're blocking them from working in other parts of your body as well. That's why taking sulindac puts you at risk for certain side effects, such as stomach pain, kidney damage, stroke, and heart attack.
Taking both sulindac and ibuprofen (Advil) is typically not recommended. These medications are NSAIDs and taking them together can raise your risk of serious side effects, such as stroke, heart attack, and stomach bleeds. If your current dose of sulindac is not enough to control your pain, talk to your provider to see what other options are good for you.
It's possible to take sulindac and acetaminophen (Tylenol) together because they work differently to ease your pain. Discuss with your provider to see if taking both medications together is a possible option for you.
How to save using GoodRx
Risks and warnings for Sulindac
Sulindac can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart attack and stroke
- Risk factors: History of heart problems | History of heart bypass surgery | Taking higher doses of sulindac | Taking sulindac for a long time
Sulindac can raise your risk of having blood clots, heart attacks, or strokes. This can happen as early as within the first weeks of starting this medication. People with heart problems, those taking higher doses of sulindac, and those taking sulindac for a long time are at greater risk for these side effects. That’s why it’s important to take the lowest possible dose for the shortest possible time. If you have heart problems, talk to your healthcare provider before starting this medication. Don't take sulindac if you've had or will be having heart bypass surgery. Call 911 or seek immediate medical help if you experience chest pain, trouble breathing, weakness on one side of your body, or trouble speaking or walking.
Stomach bleeding and ulcers
- Risk factors: History of stomach bleeding or ulcers | Older adults | Taking aspirin (Aspir-Low), other NSAIDs, corticosteroids, or blood thinners | Drinking alcohol | Smoking | Having poor health | Taking sulindac for a long time | Taking higher doses of sulindac
Sulindac can cause stomach bleeding and ulcers. It can also make it more difficult for your body to form blood clots, which can be dangerous. There are many conditions and medications that raise your risk of these problems, so speak with your provider before starting this medication. Stomach bleeding and ulcers can occur without warning or symptoms, so it's best to take the lowest possible dose for the shortest possible time to minimize your risk. If you take sulindac for a long time, you might need to get regular lab work to check if you have any bleeding inside your body. If you notice blood in your vomit, stool that looks like black coffee grounds, or if you have pain in your stomach that doesn't go away, stop this medication and talk to your healthcare provider right away.
High blood pressure, heart failure, and swelling of your arms and legs
- Risk factors: History of high blood pressure | History of heart failure
Sulindac can make it more difficult for your kidneys to pass urine. This can raise your blood pressure, and it can also cause your body to hold onto more water. Over time, this might lead to new or worsen existing blood pressure problems, heart failure, and swelling of your arms and legs. Sulindac can also interact with certain medications used to treat these conditions, such as furosemide (Lasix), lisinopril (Zestril), and losartan (Cozaar). Monitor your blood pressure closely when you take sulindac. It's not recommended to use sulindac if you have heart failure, unless the benefit of this medication is greater than the risk of side effects. Let your provider know right away if you notice any changes in your blood pressure or experience symptoms such as trouble breathing, tiredness, swelling in your body, or sudden weight gain.
Liver damage
- Risk factors: History of liver damage | Taking high doses of sulindac
Very rarely, sulindac can cause life-threatening liver damage. Your dose might be lower if you already have a history of liver damage. Talk to your healthcare provider right away if you experience symptoms, such as fever, chills, fatigue, nausea, vomiting, stomach pain, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine, you might need to stop this medication.
Kidney problems
- Risk factors: Older adults | Taking sulindac for a long time | Kidney problems | Heart failure | Liver problems | Loss of body fluid through conditions such as severe vomiting, bleeding, or diarrhea | Taking certain high blood pressure medications, such as water pills and ACEIs
Sulindac can damage your kidneys by slowing down blood flow to the kidneys. The risk is higher if you take this medication for a long time, take certain blood pressure medications (like ACEIs or water pills), or have certain conditions (like kidney or liver problems). This medication isn't recommended if you have very severe kidney problems, so discuss the risks and benefits of taking it with your provider. Your dose might be lower if you have a history of kidney damage. Let your healthcare provider know if you notice a change in how often you urinate after starting sulindac. Kidney damage usually goes away once you stop taking this medication.
Very rarely, sulindac causes kidney stones. Symptoms of kidney stones include sharp pain on either side of your lower back, nausea, vomiting, and blood in the urine. If you have a history of kidney stones, remember to drink water and keep hydrated while taking this medication. This will lower your risk of getting more stones.
Swelling in the pancreas
Sulindac can cause pancreatitis, a swelling of the pancreas. If you experience symptoms of pancreatitis, such as pain that starts in your stomach and spreads to your back, nausea, vomiting, and fever, stop this medication and get medical help right away.
Severe asthma attack
- Risk factors: Asthma and stuffy nose with or without nasal polyps | Allergic reaction to aspirin
Sulindac can cause your airways to tighten, which might lead to severe asthma attacks. Be careful using this medication if you have asthma. People who have experienced asthma attacks triggered by aspirin (Aspir-Low) or other NSAIDs in the past should avoid sulindac. Call 911 right away if your throat tightens and you can't breathe.
Severe allergic and skin reaction
Sulindac might cause sudden and very serious skin reactions, such as Stevens-Johnson syndrome (SJS). Symptoms include fever, body aches, cough, peeling skin, and painful blisters all over your body (especially the skin around the eyes, mouth, throat, or genitals). This medication might also cause drug reaction with eosinophilia and systemic symptoms (DRESS). Early signs of DRESS include fever and swollen lymph nodes. Lymph nodes are small groups of glands located in areas such as the neck and armpits. Symptoms of DRESS can also include rash, swelling of the face, and in severe cases, multiple organ damage. Stop the medication and get medical help right away at the earliest signs of serious allergic and skin reactions.
Harm to unborn babies
- Risk factors: Currently pregnant
If sulindac is taken during or after the second trimester of pregnancy, it can lower the amniotic fluid (the fluid that surrounds the baby in the womb). This can occur as soon as 2 days after starting the medication and result in serious kidney problems in your unborn baby. Babies born to mothers who take sulindac starting the third trimester of pregnancy or later can also develop heart problems. This medication is typically not used in pregnancy unless the benefit is greater than the risk of side effects and harm to the unborn baby. Talk to your provider if you're thinking of getting pregnant or become pregnant while taking sulindac.
Sulindac dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 150mg | 60 tablets | $20.78 | $0.35 |
| 200mg | 60 tablets | $22.93 | $0.38 |
Typical dosage for Sulindac
Your dose might differ depending on your individual treatment needs, and on whether you have liver or kidney problems.
-
Osteoarthritis: The typical dose starts at 150 mg by mouth twice daily with food. The maximum daily dose is 400 mg.
-
Rheumatoid arthritis: The typical dose starts at 150 mg by mouth twice daily with food. The maximum daily dose is 400 mg.
-
Arthritis of the spine (ankylosing spondylitis): The typical dose starts at 150 mg by mouth twice daily with food. The maximum daily dose is 400 mg.
-
Gout (gouty arthritis): The typical dose is 200 mg by mouth twice daily with food. The maximum daily dose is 400 mg. Treatment usually lasts 7 days.
-
Sharp shoulder pain (acute subacromial bursitis/supraspinatus tendinitis): The typical dose is 200 mg by mouth twice daily with food. The maximum daily dose is 400 mg. Treatment usually lasts 7-14 days.
Interactions between Sulindac and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abciximab
- Aceclofenac
- Acemetacin
- Acenocoumarol
- Amiloride
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amtolmetin Guacil
- Anagrelide
- Apixaban
- Ardeparin
- Argatroban
- Aspirin
- Balsalazide
- Bemiparin
- Bendroflumethiazide
- Benzthiazide
- Betamethasone
- Betrixaban
- Bismuth Subsalicylate
- Bivalirudin
- Bromfenac
- Budesonide
- Bufexamac
- Bumetanide
- Cangrelor
- Celecoxib
- Certoparin
- Chlorothiazide
- Chlorthalidone
- Choline Magnesium Trisalicylate
- Choline Salicylate
- Cilostazol
- Citalopram
- Clomipramine
- Clonixin
- Clopamide
- Clopidogrel
- Cortisone
- Cyclopenthiazide
- Cyclosporine
- Dabigatran Etexilate
- Dalteparin
- Danaparoid
- Deflazacort
- Desipramine
- Desirudin
- Desmopressin
- Desvenlafaxine
- Dexamethasone
- Dexibuprofen
- Dexketoprofen
- Diazoxide
- Dibenzepin
- Diclofenac
- Diflunisal
- Digoxin
- Dipyridamole
- Dipyrone
- Dothiepin
- Doxepin
- Droxicam
- Duloxetine
- Edoxaban
- Enoxaparin
- Eplerenone
- Epoprostenol
- Eptifibatide
- Escitalopram
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Feverfew
- Floctafenine
- Flufenamic Acid
- Fluocortolone
- Fluoxetine
- Flurbiprofen
- Fluvoxamine
- Fondaparinux
- Furosemide
- Ginkgo
- Gossypol
- Heparin
- Hydrochlorothiazide
- Hydrocortisone
- Hydroflumethiazide
- Ibuprofen
- Iloprost
- Imipramine
- Indapamide
- Indomethacin
- Inotersen
- Ketoprofen
- Lepirudin
- Levomilnacipran
- Lithium
- Lofepramine
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Magnesium Salicylate
- Meadowsweet
- Meclofenamate
- Mefenamic Acid
- Melitracen
- Meloxicam
- Mesalamine
- Methotrexate
- Methyclothiazide
- Methylprednisolone
- Metolazone
- Milnacipran
- Morniflumate
- Nabumetone
- Nadroparin
- Naproxen
- Nefazodone
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nortriptyline
- Olsalazine
- Opipramol
- Oxaprozin
- Oxyphenbutazone
- Paramethasone
- Parecoxib
- Parnaparin
- Paroxetine
- Pemetrexed
- Pentosan Polysulfate Sodium
- Pentoxifylline
- Phenindione
- Phenprocoumon
- Phenylbutazone
- Phenyl Salicylate
- Piketoprofen
- Piroxicam
- Polythiazide
- Prasugrel
- Prednisolone
- Prednisone
- Proglumetacin
- Propyphenazone
- Proquazone
- Protein C
- Protriptyline
- Reboxetine
- Reviparin
- Rivaroxaban
- Rofecoxib
- Salicylamide
- Salicylic Acid
- Salsalate
- Sertraline
- Sibutramine
- Sodium Salicylate
- Spironolactone
- Sulfasalazine
- Tacrolimus
- Tenofovir Disoproxil Fumarate
- Tenoxicam
- Tianeptine
- Tiaprofenic Acid
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tirofiban
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Trazodone
- Treprostinil
- Triamterene
- Trichlormethiazide
- Trimipramine
- Trolamine Salicylate
- Valdecoxib
- Venlafaxine
- Vilazodone
- Vorapaxar
- Vortioxetine
- Warfarin
- Xipamide
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Alacepril
- Atenolol
- Azilsartan
- Azilsartan Medoxomil
- Benazepril
- Betaxolol
- Bisoprolol
- Candesartan Cilexetil
- Captopril
- Carteolol
- Carvedilol
- Celiprolol
- Dicumarol
- Enalapril
- Enalaprilat
- Eprosartan
- Esmolol
- Fosinopril
- Irbesartan
- Labetalol
- Levobunolol
- Lisinopril
- Losartan
- Metipranolol
- Metoprolol
- Moexipril
- Nadolol
- Nebivolol
- Olmesartan Medoxomil
- Oxprenolol
- Penbutolol
- Perindopril Erbumine
- Pindolol
- Practolol
- Propranolol
- Quinapril
- Ramipril
- Sotalol
- Spirapril
- Telmisartan
- Timolol
- Trandolapril
- Valsartan
How much does Sulindac cost?
$20.78
Sulindac contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Sulindac will not be safe for you to take.
- Asthma, hives, or allergic reactions after taking aspirin (Aspir-Low) or other NSAIDs
- Heart bypass surgery
What are alternatives to Sulindac?
Sulindac images
