Drug interactions
Spironolactone + Sulindac
Severity: Major
Spironolactone 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
NSAIDs can blunt the diuretic and antihypertensive effect of spironolactone and impair renal function. They also reduce renin and aldosterone and renal potassium excretion, so combined use increases the risk of hyperkalemia and acute kidney injury.
What this interaction means in plain words
Spironolactone 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.
Spironolactone belongs to Cardiovascular; Sulindac belongs to Musculoskeletal.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal blood flow and potassium excretion, adding to aldosterone antagonism by spironolactone.
What to do
Monitor serum potassium and creatinine within the first week and periodically thereafter, especially in elderly patients or those with renal impairment or heart failure. Avoid the NSAID if potassium or creatinine rises.
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 Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Spironolactone with Sulindac?
MediHelp rates the interaction as major. Spironolactone 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. NSAIDs can blunt the diuretic and antihypertensive effect of spironolactone and impair renal function. They also reduce renin and aldosterone and renal potassium excretion, so combined use increases the risk of hyperkalemia and acute kidney injury.
How serious is the interaction between Spironolactone 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: Monitor serum potassium and creatinine within the first week and periodically thereafter, especially in elderly patients or those with renal impairment or heart failure. Avoid the NSAID if potassium or creatinine rises.
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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