Drug interactions
Sulindac + Ticagrelor
Severity: Major
Sulindac and Ticagrelor: 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
Ticagrelor inhibits platelet aggregation and sulindac adds antiplatelet effects and gastric mucosal injury. The combination raises the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Sulindac and Ticagrelor 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 belongs to Musculoskeletal; Ticagrelor belongs to Cardiovascular.
Why it happens
Additive impairment of hemostasis: P2Y12 receptor blockade plus NSAID cyclooxygenase inhibition and GI mucosal damage.
What to do
Avoid regular NSAID use in patients on ticagrelor and use paracetamol instead. If an NSAID is unavoidable, use a short course with gastroprotection and monitor for bleeding.
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 Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
Frequently asked questions
Can I take Sulindac with Ticagrelor?
MediHelp rates the interaction as major. Sulindac and Ticagrelor 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. Ticagrelor inhibits platelet aggregation and sulindac adds antiplatelet effects and gastric mucosal injury. The combination raises the risk of gastrointestinal and other bleeding.
How serious is the interaction between Sulindac and Ticagrelor?
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 regular NSAID use in patients on ticagrelor and use paracetamol instead. If an NSAID is unavoidable, use a short course with gastroprotection and monitor for bleeding.
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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