Drug interactions
Sulindac + Voclosporin
Severity: Major
Sulindac and Voclosporin: 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
Voclosporin is a calcineurin inhibitor that causes dose-related nephrotoxicity, and NSAIDs also reduce renal perfusion. The combination increases the risk of acute kidney injury and a decline in eGFR.
What this interaction means in plain words
Sulindac and Voclosporin 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; Voclosporin belongs to Miscellaneous.
Why it happens
Calcineurin inhibitor afferent arteriolar vasoconstriction combined with NSAID inhibition of vasodilatory prostaglandins reduces renal blood flow.
What to do
Avoid NSAIDs where possible in patients on voclosporin. If used, monitor eGFR and serum creatinine closely and stop the NSAID if renal function worsens.
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 Voclosporin
- Clarithromycin + Voclosporin Contraindicated
- Cyclosporin + Voclosporin Contraindicated
- Ensitrelvir + Voclosporin Contraindicated
- Itraconazole + Voclosporin Contraindicated
- Ketoconazole + Voclosporin Contraindicated
- Posaconazole + Voclosporin Contraindicated
Frequently asked questions
Can I take Sulindac with Voclosporin?
MediHelp rates the interaction as major. Sulindac and Voclosporin 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. Voclosporin is a calcineurin inhibitor that causes dose-related nephrotoxicity, and NSAIDs also reduce renal perfusion. The combination increases the risk of acute kidney injury and a decline in eGFR.
How serious is the interaction between Sulindac and Voclosporin?
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 in patients on voclosporin. If used, monitor eGFR and serum creatinine closely and stop the NSAID if renal function worsens.
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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