Drug interactions
Dabigatran + Sulindac
Severity: Major
Dabigatran and Sulindac: major interaction.
Last updated
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
Concurrent use of sulindac and dabigatran increases the risk of clinically significant bleeding, particularly gastrointestinal bleeding. NSAIDs impair platelet function and damage the mucosa on top of the anticoagulant effect.
What this interaction means in plain words
Dabigatran 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 of direct thrombin inhibition and NSAID-induced platelet inhibition and mucosal injury.
What to do
Avoid NSAIDs in patients on dabigatran when possible and use paracetamol for analgesia. If unavoidable, give gastroprotection, use the shortest duration and monitor for bleeding and renal function.
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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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 Dabigatran with Sulindac?
MediHelp rates the interaction as major. Dabigatran 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. Concurrent use of sulindac and dabigatran increases the risk of clinically significant bleeding, particularly gastrointestinal bleeding. NSAIDs impair platelet function and damage the mucosa on top of the anticoagulant effect.
How serious is the interaction between Dabigatran 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 NSAIDs in patients on dabigatran when possible and use paracetamol for analgesia. If unavoidable, give gastroprotection, use the shortest duration and monitor for bleeding and renal function.
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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