Sulindac (Clinoril)
Indications
- Arthritis
- Dysmenorrhea (see Dysmenorrhea)
- Fever (see Fever)
- Pain
- Post-Operative Pain
- Soft Tissue/Musculoskeletal Injury
- To Decrease the Risk of Malignancy
Contraindications
Pharmacology
Metabolism
Administration
Adverse Effects
Endocrinologic Adverse Effects
Drug-Induced Hyporeninemic Hypoaldosteronism (see Hypoaldosteronism)
- Physiology
- Class effect, common to all NSAID’s
- Dose-dependent COX-inhibition -> decreased renal prostaglandin synthesis -> results in drug-induced hyporeninemic hypoaldosteronism
- Clinical
Gastrointestinal Adverse Effects
Acute Pancreatitis (see Acute Pancreatitis): definite association with acute pancreatitis
- Physiology: class effect, common to all NSAID’s
Hematologic Adverse Effects
Pulmonary Adverse Effects
Aspirin-Intolerant Asthma (see Asthma)
- Physiology: class effect, common to multiple NSAID’s
- Associated Agents
- Acetylsalicylic Acid (Aspirin) (see Acetylsalicylic Acid)
- Diclofenac (Aclonac, Cataflam, Voltaren) (see Diclofenac)
- Diflunisal (Dolobid)
- Fenbufen
- Fenoprofen (see Fenoprofen): case reports
- Ibuprofen (Advil, Brufen, Motrin, Nurofen) (see Ibuprofen): case reports
- Indomethacin (Indocin) (see Indomethacin)
- Loxoprofen
- Meloxicam (see Meloxicam)
- Naproxen (Naprosyn, Aleve) (see Naproxen): appears to be more frequent with naproxen than other NSAID’s
- Nimesulide
- Phenylbutazone
- Piroxicam (Feldene) (see Piroxicam)
- Pranoprofen
- Sulindac (Clinoril): case reports
- Tenidap
- Tiaprofenic Acid
- Tolfenamic Acid
- Diagnosis
- Lung Biopsy: poorly defined granulomas with infiltrating eosinophils
- Clinical
- Cough
- Dyspnea
- Fever
- Peripheral Eosinophilia
- Pulmonary Infiltrates
Renal Adverse Effects
- Physiology: class effect, common to all NSAID’s
- Mechanism: due to drug-induced hyporeninemic hypoaldosteronism
Increased Renal Sodium Reabsorption with Peripheral Edema
- Risk Factors
- Physiology: decreased PGE2 -> increased renal sodium reabsorption
- Class Effect: common to all NSAID’s
- Dose-Dependent Effect
- Clinical: typically occurs during the first week of therapy
- Physiology: due to NSAID-induced hyporeninemic hypoaldosteronism
- Clinical
References