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Drug interactions

Diclofenac + Sulindac

Severity: Major

Diclofenac 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

Using two NSAIDs together adds no therapeutic benefit and increases the risk of gastrointestinal bleeding, renal injury and cardiovascular events.

What this interaction means in plain words

Diclofenac 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.

Diclofenac belongs to Musculoskeletal; Sulindac belongs to Musculoskeletal.

Evidence level: High

Why it happens

Duplicate cyclooxygenase inhibition causes additive mucosal, platelet and renal prostaglandin effects.

What to do

Avoid concurrent use of two systemic NSAIDs; use a single agent at the lowest effective dose.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Diclofenac with Sulindac?

MediHelp rates the interaction as major. Diclofenac 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. Using two NSAIDs together adds no therapeutic benefit and increases the risk of gastrointestinal bleeding, renal injury and cardiovascular events.

How serious is the interaction between Diclofenac 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 use of two systemic NSAIDs; use a single agent at the lowest effective dose.

What other medicines interact with Diclofenac?

MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.

Full monographs, dosing and an interaction checker in the MediHelp app

Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.

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