Drug interactions
Betrixaban + Sulindac
Severity: Major
Betrixaban and Sulindac: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Combining sulindac with the factor Xa inhibitor betrixaban increases the risk of bleeding, including gastrointestinal hemorrhage. NSAIDs impair platelet function and can damage the gastric mucosa on top of the anticoagulant effect.
What this interaction means in plain words
Betrixaban and Sulindac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive pharmacodynamic effect: factor Xa inhibition plus NSAID platelet inhibition and mucosal injury.
What to do
Avoid concurrent NSAID use where possible and choose an alternative analgesic such as paracetamol. If unavoidable, use gastroprotection and monitor for signs of bleeding and hemoglobin changes.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Sulindac
- Ketorolac intranasal + Sulindac Contraindicated
- Ketorolac + Sulindac Contraindicated
- Aceclofenac + Sulindac Major
- Acetylsalicylic acid + Sulindac Major
- Alteplase + Sulindac Major
- Amiloride + Sulindac Major
Frequently asked questions
Can I take Betrixaban with Sulindac?
MediHelp rates the interaction as major. Betrixaban and Sulindac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Combining sulindac with the factor Xa inhibitor betrixaban increases the risk of bleeding, including gastrointestinal hemorrhage. NSAIDs impair platelet function and can damage the gastric mucosa on top of the anticoagulant effect.
How serious is the interaction between Betrixaban and Sulindac?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent NSAID use where possible and choose an alternative analgesic such as paracetamol. If unavoidable, use gastroprotection and monitor for signs of bleeding and hemoglobin changes.
What other medicines interact with Sulindac?
MediHelp also lists interactions of Sulindac with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Sulindac page.
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