Generic

Sulindac

Indications

Sulindac is used to treat the symptoms of-

• Rheumatoid arthritis.
• Osteoarthritis
• Ankylosing spondylitis is a kind of arthritis that affects the spine.
• Inflammation in the periarticular space
• Acute shoulder pain
• Gouty arthritis is a kind of arthritis that occurs suddenly.
• Diabetic neuropathy is a condition caused by diabetes.
• Diabetic retinopathy is a kind of retinopathy caused by diabetes.

Pharmacology

Sulindac is a non-steroidal antirheumatic drug that acts as an anti-inflammatory, analgesic, and antipyretic. Non-steroidal anti-inflammatory drugs’ mechanism of action is most likely based on inhibiting prostaglandin synthase. Sulindac has two main changes once it is absorbed. It is oxidized to sulphone and subsequently reduced to sulphide in a reversible manner. The physiologically active form is the sulphide metabolite, which inhibits prostaglandin production.

Dosage & Administration

Sulindac should be administered orally twice a day with food. The maximum dosage is 400 mg per day. Dosages above 400 mg per day are not recommended. In osteoarthritis, rheumatoid arthritis & ankylosing spondylitis, the recommended starting dosage is 150 mg. In acute painful shoulder & acute gouty arthritis the recommended dosage is 200 mg twice a day. The dosage may be lowered or raised depending on the response. After a satisfactory response has been achieved, the dosage may be reduced according to the response. Or, as directed by the registered physicians.

Interaction

Sulindac and its sulphide metabolite have a high protein binding capacity. The patient should be closely followed until it is clear that no changes to their anticoagulant or hypoglycemic dose are necessary. Sulindac’s active sulfide metabolite has been demonstrated to be less bioavailable when taken with aspirin. The use of paracetamol and sulindac together for an extended period of time may raise the risk of adverse renal consequences. While getting such combination therapy, the patient is under strict medical monitoring. Sulindac and its sulfone metabolite may have higher plasma concentrations, but the active sulfide metabolite may have lower plasma concentrations.

Contraindications

Patients who are known to be allergic to Sulindac, as well as those who have had Aspirin or other non-steroidal anti-inflammatory drugs trigger severe asthmatic episodes, urticaria, or rhinitis. Sulindac is also not recommended for those who have had active gastro-intestinal bleeding or peptic ulcers in the past. It should not be administered to minors, pregnant women, or women who are nursing.

Side Effect

Sulindac and its sulphide metabolite have a high protein binding capacity. The patient should be closely followed until it is clear that no changes to their anticoagulant or hypoglycemic dose are necessary. Sulindac’s active sulfide metabolite has been demonstrated to be less bioavailable when taken with aspirin. The use of paracetamol and sulindac together for an extended period of time may raise the risk of adverse renal consequences. While getting such combination therapy, the patient is under strict medical monitoring. Sulindac and its sulfone metabolite may have higher plasma concentrations, but the active sulfide metabolite may have lower plasma concentrations. Fever and chills, skin rashes or other cutaneous signs, hepatotoxicity, renal toxicity (including renal failure), leukopenia, thrombocytopenia, eosinophilia, inflamed glands or lymph nodes, and arthralgia have all been recorded as symptoms of a hypersensitivity syndrome. There have been reports of leucopenia, purpura, thrombocytopenia, aplastic anemia, haemolytic anemia, agranulocytosis, epitaxis, hyperglycemia, hyperkalaemia, and vaginal hemorrhage. Hepatitis, jaundice, and renal failure have also been reported.

Pregnancy & Lactation

Quetiapine’s safety and effectiveness during human pregnancy have yet to be determined. As a result, quetiapine should only be taken during pregnancy if the benefits outweigh the dangers, and the dose and duration of therapy should be kept as low as feasible. It is unknown how much Quetiapine is secreted in human milk. Breast-feeding mothers should be warned about using Quetiapine while they are nursing.

Precautions & Warnings

Patients with poor renal function, blood problems, epilepsy, parkinsonism, or mental illnesses should use sulindac with care. Sulindac’s half-life is extended in patients with hepatic impairment, thus the daily dosage may need to be reduced. Anemia is occasionally reported in people taking sulindac plus NSAIDs.

Therapeutic Class

Non-steroidal Anti-inflammatory Drugs, Drugs for Osteoarthritis, Drugs for Rheumatoid Arthritis, Drugs for Gout (NSAIDs)

Storage Conditions

Keep the temperature below 25°C and away from light and moisture. Keep out of children’s reach.

Pharmaceutical Name

Eskayef Pharmaceuticals Ltd.