Clinoril Drug Interactions

Dimethyl Sulfoxide: DMSO (dimethyl sulfoxide) should not be used with sulindac. Concomitant administration has been reported to reduce the plasma levels of the active sulfide metabolite and may potentially reduce efficacy. In addition, this combination has been reported to cause peripheral neuropathy.
Methotrexate: Caution should be used if CLINORIL is administered concomitantly with methotrexate. Non-steroidal anti-inflammatory drugs have been reported to decrease the tubular secretion of methotrexate and potentiate the toxicity.
Cyclosporine: Administration of non-steroidal anti-inflammatory drugs concomitantly with cyclosporine has been associated with an increase in cyclosporine-induced toxicity, possibly due to decreased synthesis of renal prostacyclin. NSAIDs should be used with caution in patients taking cyclosporine and renal function should be monitored carefully.
Acetylsalicylic Acid: The concomitant administration of acetylsalicylic acid with sulindac in normal volunteers significantly depressed the plasma levels of the active sulfide metabolite. In a clinical study, the combination showed an increase in the incidence of gastrointestinal side effects. Since the addition of acetylsalicylic acid did not have a favorable effect on the therapeutic response to CLINORIL, the combination is not recommended.
Other NSAIDS: The concomitant use of CLINORIL with other NSAIDs is not recommended due to the increased possibility of gastrointestinal toxicity, with little or no increase in efficacy.
Oral anticoagulants and hypoglycemic agents: Although sulindac and the sulfide metabolite are highly bound protein, studies, in which CLINORIL was given at a dose of 400 mg daily, have shown no clinically significant interaction with oral anticoagulants or oral hypoglycemic agents. However, patients should be monitored carefully until it is certain that no change in their anticoagulant or hypoglycemic dosage is required.
Diflunisal: The concomitant administration of CLINORIL and diflunisal in normal volunteers resulted in lowering of the plasma levels of the active sulindac sulfide metabolite by approximately one-third.