Also indexed as: Apo-Sulin®, Clinoril®,
Novo-Sulindac®, Nu-Sulindac®
Sulindac is used to treat rheumatoid
arthritis, osteoarthritis and ankylosing
spondylitis, a rheumatic disorder involving the spine and large joints. It also treats both
acute painful shoulder and gouty arthritis. Sulindac is in a class of medications known as
non-steroidal anti-inflammatory drugs (NSAIDs).
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May be Beneficial: Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them. |
Potassium*
|
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results. |
Alcohol
Lithium*
White willow*
|
Check: Other—Before taking any of these supplements or eating any of
these foods with your medication, read this article in full for details. |
Folic acid*
|
| Side effect reduction/prevention |
None known
|
| Supportive interaction |
None known
|
| Reduced drug
absorption/bioavailability |
None known
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Potassium
Four people who took sulindac developed high blood levels of potassium, which returned to
normal within a few days after the drug was stopped.1 Controlled research is needed
to determine whether potassium supplements or a high potassium diet might aggravate this
problem. Until more information is available, people taking sulindac and potassium
supplements, potassium containing salt substitutes, or large amounts of fruits and vegetables
should have potassium blood levels checked regularly by their doctor.
Folic
acid
Sulindac blocks the activity of enzymes that depend on folic acid2 and may, like
aspirin, reduce the amount of folic acid in red blood cells.3 Further research is
needed to determine whether supplementing folic acid changes the effects of sulindac therapy
or prevents a deficiency of this vitamin in the body.
Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts
to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion
of lithium from the body, resulting in higher blood levels of the mineral, though sulindac may
have an opposite effect.4 Since major changes in lithium blood levels can produce
unwanted side effects or interfere with its efficacy, NSAIDs should be used with caution, and
only under medical supervision, in people taking lithium supplements.
Interactions with Herbs
White willow bark
(Salix alba)
White willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce
anti-inflammatory effects after they have been converted to salicylic acid in the body. The
administration of salicylates like aspirin to individuals taking oral NSAIDs may result in
reduced blood levels of NSAIDs.5 Though no studies have investigated interactions
between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more
information is available.
Interactions with Foods and Other Compounds
Green
tea
Current research is exploring the possibility sulindac and other NSAIDs might inhibit cancer growth.6 7 Test tube
studies have shown catechins, which are compounds found in green tea, significantly enhance
the ability of sulindac to cause the death of and inhibit the growth of lung cancer cells.8 Controlled research is
needed to determine whether green tea and sulindac might inhibit the growth of certain cancers
in humans.
Alcohol
Drinking large quantities of alcoholic beverages over a long period may block the breakdown of
sulindac, resulting in higher than normal blood levels of the drug.9 Consequently,
side effects and tissue damage caused by sulindac might occur unless an adjustment is made in
the amount of drug taken each day.
References
(To view, roll mouse over heading; to hide, click on heading)
1. Nesher G, Zimran A, Hershko C. Hyperkalemia associated with sulindac
therapy. J Rheumatol 1986;13:1084–5.
2. Baggott JE, Morgan SL, Ha T et al. Inhibition of folate-dependent
enzymes by non-steroidal anti-inflammatory drugs. Biochem J
1992;282:197–202.
3. Alter HJ, Zvaifler NJ, Rath CE. Interrelationship of rheumatoid
arthritis, folic acid, and aspirin. Blood 1971;38:405–16.
4. Olin BR, ed. Central Nervous System Drugs, Analgesics and
Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and
Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
5. Olin BR, ed. Central Nervous System Drugs, Analgesics and
Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and
Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
6. Lim JT, Piazza GA, Han EK et al. Sulindac derivatives inhibit growth
and induce apoptosis in human prostate cancer cell lines. Biochem Pharmacol
1999;58:1097–107.
7. Ahnen DJ. Colon cancer prevention by NSAIDs: what is the mechanism of
action? Eur J Surg Suppl 1998;582:111–4.
8. Suganuma M, Okabe S, Sueoka N et al. Green tea and cancer
chemoprevention. Mutat Res 1999;428:339–44.
9. Gallanosa AG, Spyker DA. Sulindac hepatotoxicity: a case report and
review. J Toxicol Clin Toxicol 1985;23:205–38.
Copyright © 2006 Healthnotes, Inc. All rights reserved.
www.healthnotes.com
Please read the
disclaimer about the limitations of the information provided here. Do NOT rely solely on
the information in this article.
Learn more about Healthnotes, the
company.
Learn more about the authors of Using Medicines
with Vitamins and Herbs
The information presented in Healthnotes is for informational purposes
only. It is based on scientific studies (human, animal, or in vitro), clinical
experience, or traditional usage as cited in each article. The results reported may not
necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over the counter medication is also available. Consult your doctor,
practitioner, and/or chemist for any health problem and before using any supplements or before
making any changes in prescribed medications. Information expires March 2007.
View Basket
