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Sulindac, a nonsteroidal anti-inflammatory drug (NSAID), comes with several safety considerations you should be aware of before using it. Below are important warnings and precautions to ensure safe use of this medication. Discuss all risks and benefits with your healthcare provider.

• Heart Risks: This medication can increase the risk of heart attack, stroke, and blood clots, especially in individuals with pre-existing heart conditions or those taking higher doses for extended periods. Avoid using sulindac before or after heart bypass surgery. Seek immediate medical attention if you experience symptoms like chest pain, shortness of breath, or weakness on one side of the body.

• Gastrointestinal Bleeding: Sulindac may cause serious stomach or intestinal bleeding or ulcers, sometimes without warning signs. This risk is heightened in older adults, those with a history of ulcers, or those taking certain other medications. Discontinue use and contact your healthcare provider if you notice symptoms such as persistent stomach pain, black stools, or vomit resembling coffee grounds.

• Hypertension and Fluid Retention: This drug may cause high blood pressure, heart failure, and swelling due to fluid retention. Monitor your blood pressure while on sulindac, and inform your provider of any significant changes or symptoms like difficulty breathing or sudden weight gain.

• Liver and Kidney Concerns: Rarely, sulindac can cause severe liver or kidney damage. Symptoms to watch for include jaundice, dark urine, or changes in urination frequency. Individuals with existing liver or kidney conditions should exercise caution and may require a reduced dose.

• Pancreatitis: Sulindac can cause inflammation of the pancreas, with symptoms such as severe abdominal pain radiating to the back. Discontinue use and seek medical help if you suspect pancreatitis.

• Asthma: This medication could trigger severe asthma attacks, particularly in those with a history of asthma related to NSAID use. Avoid sulindac if you have experienced such reactions in the past.

• Allergic Reactions: Serious skin reactions, including Stevens-Johnson syndrome and DRESS, can occur. Symptoms include rash, fever, or swollen lymph nodes. Stop taking sulindac and seek medical attention if these symptoms develop.

• Pregnancy Risks: Sulindac can harm an unborn baby, particularly affecting amniotic fluid levels and causing potential heart issues in the third trimester. Use is generally not recommended during pregnancy unless absolutely necessary. Discuss with your provider if you are or plan to become pregnant.

Contraindications: Do not use sulindac if you have experienced asthma, hives, or allergic reactions after taking aspirin or other NSAIDs, or if you are undergoing or have recently had heart bypass surgery.

In case of an overdose, seek emergency medical attention immediately. Always consult with your healthcare provider to determine the appropriateness of this medication for your specific health needs.

Common side effects:

• upset stomach
• nausea
• vomiting
• gas
• diarrhea
• constipation
• dizziness
• headache
• stomach pains
• heartburn
• rash

Serious side effects:

• unusual tiredness
• swelling of the ankles or feet
• sudden weight gain
• changes in urine
• blood in the urine
• persistent nausea
• loss of appetite
• abdominal pain
• yellowing of the skin or eyes
• dark urine
• fever
• swelling in the face or throat
• severe dizziness
• trouble breathing
• heart attack
• stroke
• stomach bleeding
• severe asthma attacks
• chest pain
• difficulty breathing
• weakness on one side of the body
• persistent stomach pain

Interactions with high risk of serious adverse effects and should be avoided:

• Ketorolac

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Clopidogrel
• Warfarin
• Dabigatran
• Enoxaparin
• Ibuprofen
• Naproxen
• Aspirin (except low-dose)
• Methotrexate
• Lithium
• Diuretics

Interactions with low risk that usually do not require a change in therapy:

• ACE inhibitors (e.g., Lisinopril, Benazepril)
• Angiotensin II receptor blockers (e.g., Losartan, Valsartan)
• Corticosteroids (e.g., Prednisone, Dexamethasone)
• Furosemide