Drug interactions
Piroxicam + Sulindac
Severity: Major
Piroxicam 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 two NSAIDs gives no added efficacy and increases the likelihood of gastrointestinal bleeding and ulceration, renal injury and cardiovascular events.
What this interaction means in plain words
Piroxicam 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.
Piroxicam belongs to Musculoskeletal; Sulindac belongs to Musculoskeletal.
Why it happens
Duplicate cyclooxygenase inhibition leads to additive gastrointestinal, renal and antiplatelet toxicity.
What to do
Avoid combining systemic NSAIDs; use one agent at the lowest effective dose. Add paracetamol if more analgesia is needed.
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
Other interactions of Piroxicam
- Ketorolac intranasal + Piroxicam Contraindicated
- Ketorolac + Piroxicam Contraindicated
- Aceclofenac + Piroxicam Major
- Acemetacin + Piroxicam Major
- Acetylsalicylic acid + Piroxicam Major
- Alteplase + Piroxicam Major
Frequently asked questions
Can I take Piroxicam with Sulindac?
MediHelp rates the interaction as major. Piroxicam 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 two NSAIDs gives no added efficacy and increases the likelihood of gastrointestinal bleeding and ulceration, renal injury and cardiovascular events.
How serious is the interaction between Piroxicam 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 combining systemic NSAIDs; use one agent at the lowest effective dose. Add paracetamol if more analgesia is needed.
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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