Drug interactions
Sulindac + Tolfenamic acid
Severity: Major
Sulindac and Tolfenamic acid: 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
Taking two NSAIDs together adds no therapeutic advantage and increases the risk of gastrointestinal ulceration and bleeding, renal impairment and hyperkalemia. The adverse effects are additive.
What this interaction means in plain words
Sulindac and Tolfenamic acid 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; Tolfenamic acid belongs to Musculoskeletal.
Why it happens
Both drugs inhibit cyclooxygenase, producing additive loss of protective gastric prostaglandins, platelet inhibition and reduced renal prostaglandin-dependent perfusion.
What to do
Avoid concurrent use of two systemic NSAIDs and use a single agent at the lowest effective dose. If a switch is needed, stop one drug before starting the other.
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 Tolfenamic acid
Frequently asked questions
Can I take Sulindac with Tolfenamic acid?
MediHelp rates the interaction as major. Sulindac and Tolfenamic acid 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. Taking two NSAIDs together adds no therapeutic advantage and increases the risk of gastrointestinal ulceration and bleeding, renal impairment and hyperkalemia. The adverse effects are additive.
How serious is the interaction between Sulindac and Tolfenamic acid?
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 concurrent use of two systemic NSAIDs and use a single agent at the lowest effective dose. If a switch is needed, stop one drug before starting the other.
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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