Side Effects of Sulindac (Clinoril)
Sulindac, referred as the brand Clinoril, is a nonsteroidal anti-inflammatory (NSAID) medication which works by reducing substances in the body that cause pain and inflammation and overall relieve pain. It is used to treat rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis (chronic arthiritis of the joints in the spine), gout (arthirits caused by a blockage of uric acid crystals in the joints) or certain types of bursitis (inflammation of sacs between your joints) and tendonitis (inflammation of a tendon).
Before Starting Clinoril Treatment
Do not take Clinoril if you are allergic to it, had an asthma attack or severe allergic reaction after taking aspirin or an NSAID, or before or after heart bypass surgery (coronary artery bypass graft, or CABG) (Clinoril label reported by the FDA).
The FDA also recommends to not use Clinoril during the last 3 months of pregnancy because it may harm the unborn baby or while you breast-feed because it is unkown if Clinoril can pass onto breast milk.
Inform your healthcare provider if you have the following conditions:
- Heart disease
- High blood pressure
- High cholesterol
- History of heart attack, stroke, blood clot, stomach ulcers, or bleeding
- Liver or kidney disease or fluid retention
While taking Clinoril, you should avoid drinking alcohol as it may increase your risk of stomach bleeding or taking aspirin.
The FDA advises to seek emergency medical help if you observe signs of an allergic reaction (rash, hives, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue) or signs of a heart attack or stroke (chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, feeling short of breath, blood in vomit or stool, dark and/or tarry stools).
Get emergency medical help if you also experience liver problems such as nausea, fatigue, lethargy, pruritus (severe itching), jaundice (yellowing of the skin or the whites of the eyes), right upper quadrant tenderness, and flu-like symptoms, or skin reactions (rash and blisters, fever), kidney problems like little or no urinating, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath, unusual bruising or bleeding, and unusual weight gain (Clinoril label as published by the FDA).
Serious Side Effects
Clinoril can increase the risk of heart attack or stroke, bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines, and serious skin reactions, which may result in hospitalization or even death. These events can occur without any warning.
There is a higher risk of getting an ulcer or bleeding with a past history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs, using NSAIDS in a high dose and longer use, smoking, drinking alcohol, older age, and advanced liver disease.
Common Side Effects
The common side effects of Clinorial are:
- Upset stomach
Certain medications interact with Clinoril. Bisphosphonates such as alendronate, risedronate, can increase the risk of stomach or bowel problems.
There is a higer risk of stomach bleeding with the usage of anticoagulants (Warfarin), aspirin, corticosteroids (prednisone), heparin, other NSAIDs like ibuprofen, or selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine.
Probenecid because it can increase the risk of Sulindac’s side effects. The side effects of cyclosporine, lithium, methotrexate, quinolones (ciprofloxacin), or sulfonylureas (glipizide) may be increased by Clinoril. In addition, the effectiveness of angiotensin-converting enzyme (ACE) inhibitors like enalapril, angiotensin receptor blockers (losartan), or diuretics (furosemide, hydrochlorothiazide) may be decreased by Sulindac.
About Pharmacogenetic Testing
The drug metabolizing enzymes CYP2C9, flavin-containing mono-oxygenase 3 (FMO3) and FMO6 might play a significant role the metabolism of Clinoril. Variations in these genes can possibly affect pain relieving and side effect of NSAIDs, including Clinoril. Pharmacogenetic testing to identify these variations might enable your healthcare provider to optimize your treatment with Clopiril.
Know Your Risk With the Rxight® Genetic Test
Rxight® genetic testing gives you an individualized analysis of 18 genes and alleles of enzymes involved in the metabolism of over 200 prescription and over-the-counter (OTC) medications. Depending on genetic variations, adverse reactions may be experienced or you may feel the benefits of the medication. With Rxight®, you and your healthcare provider will be able to determine what medicines do not respond effectively and which ones do.
Contributors to this Article:
Michael Sapko, MD, PhD; and Deborah Kallick, PhD, Medicinal Chemistry
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