Drug interactions
Sulindac + Vorapaxar
Severity: Major
Sulindac and Vorapaxar: 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
Vorapaxar inhibits platelet aggregation and sulindac impairs platelet function and can injure the gastric mucosa. Together they raise the risk of bleeding, especially gastrointestinal bleeding.
What this interaction means in plain words
Sulindac and Vorapaxar 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.
Why it happens
Additive antiplatelet effects: PAR-1 antagonism by vorapaxar plus reversible COX-1 inhibition by sulindac, with NSAID mucosal injury.
What to do
Avoid regular NSAID use in patients on vorapaxar where possible, and consider gastroprotection if unavoidable. Monitor for signs of bleeding and check 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?
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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
Frequently asked questions
Can I take Sulindac with Vorapaxar?
MediHelp rates the interaction as major. Sulindac and Vorapaxar 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. Vorapaxar inhibits platelet aggregation and sulindac impairs platelet function and can injure the gastric mucosa. Together they raise the risk of bleeding, especially gastrointestinal bleeding.
How serious is the interaction between Sulindac and Vorapaxar?
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 vorapaxar where possible, and consider gastroprotection if unavoidable. Monitor for signs of bleeding and check 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.
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