Indication

Rheumatoid arthritis, Osteoarthritis, Acute gouty arthritis, Ankylosing spondylitis, Acute painful shoulder

Administration

Should be taken with food.

Adult Dose

Oral\r\nAnkylosing spondylitis; Osteoarthritis; Rheumatoid arthritis\r\nAdult: For symptomatic treatment: 150 mg bid; may adjust subsequent doses based on response. Max: 400 mg/day. \r\n\r\nAcute painful shoulder\r\nAdult: For symptomatic treatment: 200 mg bid; may reduce dose after satisfactory response achieved. Max: 400 mg/day. Treatment duration: 7-14 days is usually adequate.\r\n\r\nAcute gouty arthritis\r\nAdult: For symptomatic treatment: 200 mg bid; may reduce dose after satisfactory response achieved. Max: 400 mg/day. Treatment duration: 7 days is usually adequate.\r\n\r\nHepatic impairment: Acute and chronic hepatic disease: May need dosage reduction.

Child Dose

Safety & efficacy not established\r\n\r\n

Renal Dose

Renal impairment: May need dosage reduction. Not recommended in severe renal impairment.

Contraindication

Hypersensitivity. Pregnancy (3rd trimester), treatment of peri-operative pain in CABG surgery .

Mode of Action

Sulindac is a prodrug which undergoes reversible reduction to its active sulfide metabolites. It inhibits prostaglandin synthesis by decreasing cyclooxygenase activity.

Precaution

$4e

Side Effect

1-10%\r\nGI pain (10%),Constipation (3-9%),Diarrhea (3-9%),Dizziness (3-9%),Dyspepsia (3-9%),Headache (3-9%),Nausea (3-9%),Rash (3-9%),Abdominal cramps (1-3%),Anorexia (1-3%),Edema (1-3%),Nervousness (1-3%),Pruritus (1-3%),Tinnitus (1-3%),Vomiting (1-3%)\r\n\r\n<1%\r\nHypersensitivity reactions,Thrombocytopenia,Ecchymosis,Purpura,Leukopenia,Agranulocytosis,Neutropenia,Bone marrow depression,CHF (<1%),Hematuria (<1%),Renal impairment (including renal failure),Interstitial nephritis,Nephrotic syndrome\r\n\r\nPotentially Fatal: Anaphylaxis reactions; cross-sensitivity reactions in patients with known aspirin triad reactions; Steven-Johnson Syndrome and toxic epidermal necrolysis.

Pregnancy Category Note

Pregnancy Category: C; D in 3rd trimester.

Interaction

Concomittent use with dimethyl sulfoxide may result in peripheral neuropathy. Increased nephrotoxicity with ciclosporin; increased risk of methotrexate toxicity; increased risk of bleeding with other NSAIDs, warfarin and thrombolytic agents. Antagonises effect of antihypertensives. Unpredictable interactions with lithium.