Drug interactions
Metolazone + Sulindac
Severity: Moderate
Metolazone and Sulindac: moderate 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
NSAIDs such as sulindac can blunt the diuretic and antihypertensive effect of thiazide-like diuretics through sodium and water retention. Together with a diuretic, they can also raise the risk of reduced renal perfusion and acute kidney injury, especially in volume-depleted or elderly patients.
What this interaction means in plain words
Metolazone and Sulindac can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Metolazone belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
Inhibition of renal prostaglandin synthesis by sulindac reduces renal blood flow and sodium excretion, counteracting metolazone.
What to do
Monitor blood pressure, fluid status, weight and renal function (creatinine, electrolytes) when starting or stopping sulindac. Keep the NSAID dose and duration as low as possible and maintain hydration.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Other interactions of Metolazone
Frequently asked questions
Can I take Metolazone with Sulindac?
MediHelp rates the interaction as moderate. Metolazone and Sulindac can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. NSAIDs such as sulindac can blunt the diuretic and antihypertensive effect of thiazide-like diuretics through sodium and water retention. Together with a diuretic, they can also raise the risk of reduced renal perfusion and acute kidney injury, especially in volume-depleted or elderly patients.
How serious is the interaction between Metolazone and Sulindac?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure, fluid status, weight and renal function (creatinine, electrolytes) when starting or stopping sulindac. Keep the NSAID dose and duration as low as possible and maintain hydration.
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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