Sulindac - Revision history

Ctol2: /* Side Effects */

2020-10-20T05:31:05Z

Side Effects

← Older revision		Revision as of 01:31, 20 October 2020
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	{\| class="wikitable"		{\| class="wikitable"
	!style="text-align: left; width: 15%""\| Blood		!style="text-align: left; width: 15%""\| Blood
	\|Localized spontaneous bleeding, bruising and prolonged bleeding time have been reported		\|Localized spontaneous bleeding, bruising and prolonged bleeding time have been reported.
	\|-		\|-
	!style="text-align: left"\| Asthma		!style="text-align: left"\| Asthma
	\|Can be worsen		\|Can be worsen.
	\|-		\|-
	!style="text-align: left"\| Cardiovascular risk		!style="text-align: left"\| Cardiovascular risk

Ctol2: /* Side Effects */

2020-10-20T05:30:46Z

Side Effects

← Older revision		Revision as of 01:30, 20 October 2020
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	{\| class="wikitable"		{\| class="wikitable"
	!style="text-align: left; width: 15%""\| Blood		!style="text-align: left; width: 15%""\| Blood
	\|~~localized~~ spontaneous bleeding, bruising and prolonged bleeding time have been reported		\|Localized spontaneous bleeding, bruising and prolonged bleeding time have been reported
	\|-		\|-
	!style="text-align: left"\| Asthma		!style="text-align: left"\| Asthma

Ctol2: /* How should I take the tablet? */

2020-10-20T05:30:17Z

How should I take the tablet?

← Older revision		Revision as of 01:30, 20 October 2020
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	== FAQ ==		== FAQ ==
	=== How should I take the tablet? ===		=== How should I take the tablet? ===
	Should always be taken with food. Nearly all patients benefit from an ulcer protective drug (e.g. antacids, or famotidine 20mg or omeprazole ~~20 mg~~ at bedtime).		Should always be taken with food. Nearly all patients benefit from an ulcer protective drug (e.g. antacids, or [[famotidine]] 20mg or [[omeprazole]] 20mg at bedtime).

	=== What should I avoid while taking? ===		=== What should I avoid while taking? ===
	Avoid alcohol consumption.		Avoid alcohol consumption.

Ctol2: /* Contraindication */

2020-10-20T05:28:36Z

Contraindication

Ctol2: /* Drug Interaction */

2020-10-20T05:27:35Z

Drug Interaction

Ctol2: /* Drug Interaction */

2020-10-20T05:26:45Z

Drug Interaction

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	*Hyperkaelemia (high potassium levels)		*Hyperkaelemia (high potassium levels)
	*Hypernatremia (high sodium levels)		*Hypernatremia (high sodium levels)
	*~~hypertension~~		*Hypertension

	===Contraindication===		===Contraindication===

Ctol2: /* Monitoring */

2020-10-20T05:25:37Z

Monitoring

← Older revision		Revision as of 01:25, 20 October 2020
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	*Blood pressure checks will reveal development of hypertension.		*Blood pressure checks will reveal development of hypertension.
	*Periodic serum electrolyte (sodium, potassium, chloride) measurements,		*Periodic serum electrolyte (sodium, potassium, chloride) measurements,
	*~~complete~~ blood counts and		*Complete blood counts, and
	*~~assessment~~ of liver enzymes as well as creatinine (renal function) should be performed.		*Assessment of liver enzymes as well as creatinine (renal function) should be performed.

	This is particularly important if Indomethacin is given together with an ACE inhibitor or with potassium-sparing diuretic (e.g. spironolactone), because these combinations can lead to hyperkalemia and/or serious kidney failure.		This is particularly important if [[Indomethacin]] is given together with an ACE inhibitor or with potassium-sparing diuretic (e.g. [[spironolactone]]), because these combinations can lead to hyperkalemia and/or serious kidney failure.

	===Drug Interaction===		===Drug Interaction===

Ctol2: /* Side Effects */

2020-10-20T05:23:17Z

Side Effects

← Older revision		Revision as of 01:23, 20 October 2020
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	NSAIDs in general		NSAIDs in general
	{\| class = "wikitable"		{\| class = "wikitable"
	!style="text-align: left; width: 15%"\| Common ~~side effects~~		!style="text-align: left; width: 15%"\| Common Side Effects
	\|Gastrointestinal toxicity and bleeding, headaches, rash and very dark or black stool (a sign of intestinal bleeding). Like other NSAIDs, its use is associated with an increased risk of cardiovascular events such as heart attack and stroke.		\|Gastrointestinal toxicity and bleeding, headaches, rash and very dark or black stool (a sign of intestinal bleeding). Like other NSAIDs, its use is associated with an increased risk of cardiovascular events such as heart attack and stroke.

	\|-		\|-
	!style="text-align: left"\| Adverse ~~side effects~~		!style="text-align: left"\| Adverse Side Effects
	\|Depression, drowsiness, tinnitus, confusion, insomnia, psychiatric disturbances, convulsion.		\|Depression, drowsiness, tinnitus, confusion, insomnia, psychiatric disturbances, convulsion.
	\|}		\|}

	{\| class="wikitable"		{\| class="wikitable"
	!Blood		!style="text-align: left; width: 15%""\| Blood
	\|localized spontaneous bleeding, bruising and prolonged bleeding time have been reported		\|localized spontaneous bleeding, bruising and prolonged bleeding time have been reported
	\|-		\|-
	!Asthma		!style="text-align: left"\| Asthma
	\|Can be worsen		\|Can be worsen
	\|-		\|-
	!Cardiovascular risk		!style="text-align: left"\| Cardiovascular risk
	\|Chronic ibuprofen use has been found correlated with risk of progression to hypertension and myocardial infarction (heart attack). Both the U.S. Food and Drug Administration (FDA) and The European Medicines Agency (EMA) issues warnings of increased heart attack and stroke risk.		\|Chronic ibuprofen use has been found correlated with risk of progression to hypertension and myocardial infarction (heart attack). Both the U.S. Food and Drug Administration (FDA) and The European Medicines Agency (EMA) issues warnings of increased heart attack and stroke risk.
	\|-		\|-
	!Skin		!style="text-align: left"\| Skin
	\|NSAIDs have been associated with the onset of bullous pemphigoid. It can also cause serious skin adverse events such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, which can be fatal.		\|NSAIDs have been associated with the onset of bullous pemphigoid. It can also cause serious skin adverse events such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, which can be fatal.
	\|-		\|-
	!Geriatrics		!style="text-align: left"\| Geriatrics
	\|Use of sulindac is not recommended in people with peptic ulcer disease or increased gastrointestinal bleed risk, including those over 75 years of age, or those taking medications associated with bleeding risk. Adverse events have been found to be dose-dependent and associated with length of treatment.		\|Use of sulindac is not recommended in people with peptic ulcer disease or increased gastrointestinal bleed risk, including those over 75 years of age, or those taking medications associated with bleeding risk. Adverse events have been found to be dose-dependent and associated with length of treatment.
	\|}		\|}

Ctol2: /* Side Effects */

2020-10-20T05:20:21Z

Side Effects

← Older revision		Revision as of 01:20, 20 October 2020
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	NSAIDs in general		NSAIDs in general
	{\| class = "wikitable"		{\| class = "wikitable"
	!style="text-align: left"\| Common side effects		!style="text-align: left; width: 15%"\| Common side effects
	\|Gastrointestinal toxicity and bleeding, headaches, rash and very dark or black stool (a sign of intestinal bleeding). Like other NSAIDs, its use is associated with an increased risk of cardiovascular events such as heart attack and stroke.		\|Gastrointestinal toxicity and bleeding, headaches, rash and very dark or black stool (a sign of intestinal bleeding). Like other NSAIDs, its use is associated with an increased risk of cardiovascular events such as heart attack and stroke.

Ctol2 at 03:41, 15 October 2020

2020-10-15T03:41:45Z

← Older revision		Revision as of 23:41, 14 October 2020
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	[[Category: Drugs]][[Category : Non-opioid Analgesic (NSAID) ]]		[[Category: Drugs]][[Category : Non-opioid Analgesic (NSAID) ]]
	'''Sulindac'''(:中文 [[舒林酸]]) is a nonsteroidal anti-inflammatory drug, an NSAID. As an NSAID, meloxicam is an analgesic, anti-inflammatory and antipyretic. It is useful in the treatment of acute or chronic inflammatory conditions.		'''Sulindac''' (中文: [[舒林酸]]) is a nonsteroidal anti-inflammatory drug, an NSAID. As an NSAID, meloxicam is an analgesic, anti-inflammatory and antipyretic. It is useful in the treatment of acute or chronic inflammatory conditions.

	Sulindac is used in musculoskeletal and joint disorders such as ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis, and also in the short-term management of acute gout and peri-articular conditions such as bursitis and tendinitis. It has also bben sued to reduce fever.		Sulindac is used in musculoskeletal and joint disorders such as ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis, and also in the short-term management of acute gout and peri-articular conditions such as bursitis and tendinitis. It has also bben sued to reduce fever.

← Older revision		Revision as of 01:28, 20 October 2020
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	===Contraindication===		===Contraindication===
	*Allergy to indomethacin, aspirin or other NSAIDs		*Allergy to indomethacin, aspirin or other NSAIDs.
	*History of allergic reactions (bronchospasm, rhinitis, urticaria) following the use of other NSAIDs such as aspirin		*History of allergic reactions (bronchospasm, rhinitis, urticaria) following the use of other NSAIDs such as [[aspirin]].
	*Third-trimester pregnancy		*Third-trimester pregnancy.
	*Active stomach and/or duodenal ulceration or gastrointestinal bleeding, or history of peptic ulcer disease		*Active stomach and/or duodenal ulceration or gastrointestinal bleeding, or history of peptic ulcer disease.
	*Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis		*Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
	*Severe congestive heart failure (NYHA III/IV)		*Severe congestive heart failure (NYHA III/IV).
	*Severe pre-existing liver damage		*Severe pre-existing liver damage.
	*Severe chronic kidney disease (creatinine clearance <30 mi/min)		*Severe chronic kidney disease (creatinine clearance <30 mi/min).
	*Caution in patients with pre-existing hepatic porphyria, as diclofenac may trigger attacks		*Caution in patients with pre-existing hepatic porphyria, as diclofenac may trigger attacks.
	*Caution in patients with severe, active bleeding such as cerebral hemorrhage		*Caution in patients with severe, active bleeding such as cerebral hemorrhage.
	*Caution in patients with fluid retention or heart failure		*Caution in patients with fluid retention or heart failure.
	*Caution in patients with Parkinson’s disease, epilepsy, psychotic disorders (sulindac may worsen these conditions)		*Caution in patients with Parkinson’s disease, epilepsy, psychotic disorders (sulindac may worsen these conditions).
	*Concurrent with potassium sparing diuretics		*Concurrent with potassium sparing diuretics.
	*Can lead to onset of new hypertension or worsening of pre-existing hypertension		*Can lead to onset of new hypertension or worsening of pre-existing hypertension.

	===Precautions===		===Precautions===

← Older revision		Revision as of 01:27, 20 October 2020
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	*Increases the blood thinning effects of warfarin because it displaces them from their plasma protein binding and increases their free concentrations in the bloodstream.		*Increases the blood thinning effects of warfarin because it displaces them from their plasma protein binding and increases their free concentrations in the bloodstream.
	*Increase the risk of adverse effects of lithium, methotrexate and cardiac glycosides by lowering their excretion via the kidneys.		*Increase the risk of adverse effects of lithium, methotrexate and cardiac glycosides by lowering their excretion via the kidneys.
	*Risk of nephrotoxicity may be increased if given with ACE inhibitors, ciclosporin, tacrolimus or diuretics		*Risk of nephrotoxicity may be increased if given with ACE inhibitors, ciclosporin, tacrolimus or diuretics.
	*Combination with antihypertensive drugs such as ACE inhibitors, sartans and diuretics can decrease their effectiveness as well as increase the risk for kidney toxicity.		*Combination with antihypertensive drugs such as ACE inhibitors, sartans and diuretics can decrease their effectiveness as well as increase the risk for kidney toxicity.
	*Antihypertensive effects of ACEIs, beta blockers and diuretics may be reduced		*Antihypertensive effects of ACEIs, beta blockers and diuretics may be reduced.
	*Use of more than one NSAID together (including aspirin) should be avoided because of the increased risk of adverse effects.		*Use of more than one NSAID together (including aspirin) should be avoided because of the increased risk of adverse effects.
	*It adds to the risk of gastrointestinal bleeding and ulceration when used with steroids, the SSRIs, the SNRI venlafaxaine, the antiplatelet clopidogrel, bisphosphonates or pentoxifylline.		*It adds to the risk of gastrointestinal bleeding and ulceration when used with steroids, the SSRIs, the SNRI venlafaxaine, the antiplatelet clopidogrel, bisphosphonates or pentoxifylline.
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	Many NSAIDs, but particularly indomethacin, cause lithium retention by reducing its excretion by the kidney. Thus, indomethacin users have an elevated risk of lithium toxicity. For patients taking lithium (e.g. for treatment of bipolar disorder), less toxic NSAIDs such as sulindac is preferred.		Many NSAIDs, but particularly indomethacin, cause lithium retention by reducing its excretion by the kidney. Thus, indomethacin users have an elevated risk of lithium toxicity. For patients taking lithium (e.g. for treatment of bipolar disorder), less toxic NSAIDs such as sulindac is preferred.
	All NSAIDs, including indomethacin, also increase plasma renin activity and aldosterone levels, and increase sodium and potassium retention. Vasopressin activity is also enhanced. Together these may lead to:		All NSAIDs, including indomethacin, also increase plasma renin activity and aldosterone levels, and increase sodium and potassium retention. Vasopressin activity is also enhanced. Together these may lead to:
	*Edema (swelling due to fluid retention)		*Edema (swelling due to fluid retention),
	*Hyperkaelemia (high potassium levels)		*Hyperkaelemia (high potassium levels),
	*Hypernatremia (high sodium levels)		*Hypernatremia (high sodium levels),
	*Hypertension		*Hypertension.

	===Contraindication===		===Contraindication===