Drug interactions
Pegaspargase + Sulindac
Severity: Moderate
Pegaspargase 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
Pegaspargase can cause coagulation abnormalities and thrombocytopenia, while sulindac inhibits platelet function and irritates the gastric mucosa. Used together, the risk of bleeding may be increased.
What this interaction means in plain words
Pegaspargase 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.
Pegaspargase belongs to Oncology; Sulindac belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic effects on hemostasis: asparaginase-related coagulopathy plus NSAID-induced platelet inhibition.
What to do
Monitor platelet count, fibrinogen and coagulation parameters and watch for bleeding. Avoid the NSAID when platelets are low or coagulopathy is significant.
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 Pegaspargase
- Etodolac + Pegaspargase Major
- Ketorolac + Pegaspargase Major
- Mefenamic acid + Pegaspargase Major
- Acetylsalicylic acid + Pegaspargase Moderate
- Argatroban + Pegaspargase Moderate
- Celecoxib + Pegaspargase Moderate
Frequently asked questions
Can I take Pegaspargase with Sulindac?
MediHelp rates the interaction as moderate. Pegaspargase 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. Pegaspargase can cause coagulation abnormalities and thrombocytopenia, while sulindac inhibits platelet function and irritates the gastric mucosa. Used together, the risk of bleeding may be increased.
How serious is the interaction between Pegaspargase 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 platelet count, fibrinogen and coagulation parameters and watch for bleeding. Avoid the NSAID when platelets are low or coagulopathy is significant.
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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