Drug interactions
Rivaroxaban + Sulindac
Severity: Major
Rivaroxaban 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
Sulindac impairs platelet function and can injure the gastrointestinal mucosa, so adding it to rivaroxaban raises the risk of clinically significant bleeding. Pharmacokinetic changes are not the main issue.
What this interaction means in plain words
Rivaroxaban 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.
Rivaroxaban belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
Additive hemostatic impairment: factor Xa inhibition plus NSAID platelet inhibition and mucosal damage.
What to do
Avoid NSAIDs where possible and use paracetamol instead. If unavoidable, use the shortest course, consider gastroprotection and monitor for bleeding and hemoglobin.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Rivaroxaban and Sulindac, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Frequently asked questions
Can I take Rivaroxaban with Sulindac?
MediHelp rates the interaction as major. Rivaroxaban 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. Sulindac impairs platelet function and can injure the gastrointestinal mucosa, so adding it to rivaroxaban raises the risk of clinically significant bleeding. Pharmacokinetic changes are not the main issue.
How serious is the interaction between Rivaroxaban 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 NSAIDs where possible and use paracetamol instead. If unavoidable, use the shortest course, consider gastroprotection and monitor for bleeding and hemoglobin.
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.
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.
