Drug interactions
Naproxen + Sulindac
Severity: Major
Naproxen 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
Using two NSAIDs together adds no therapeutic benefit and increases the risk of gastrointestinal ulceration, bleeding, renal injury and fluid retention. Hyperkalemia and cardiovascular risk may also be additive.
What this interaction means in plain words
Naproxen 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.
Naproxen belongs to Musculoskeletal; Sulindac belongs to Musculoskeletal.
Why it happens
Duplicate cyclooxygenase inhibition causing additive loss of gastric and renal prostaglandin protection and platelet inhibition.
What to do
Avoid concurrent use of two systemic NSAIDs and choose a single agent at the lowest effective dose. If a switch is made, stop the first NSAID before starting the other.
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 Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen Major
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 Naproxen with Sulindac?
MediHelp rates the interaction as major. Naproxen 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 ulceration, bleeding, renal injury and fluid retention. Hyperkalemia and cardiovascular risk may also be additive.
How serious is the interaction between Naproxen 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 and choose a single agent at the lowest effective dose. If a switch is made, stop the first NSAID before starting the other.
What other medicines interact with Naproxen?
MediHelp also lists interactions of Naproxen with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Naproxen page.
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