Drug interactions
Sulindac + Warfarin
Severity: Major
Sulindac and Warfarin: 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
Sulindac impairs platelet function and can cause gastrointestinal ulceration, and may slightly increase the anticoagulant effect of warfarin. The combination substantially raises the risk of serious bleeding.
What this interaction means in plain words
Sulindac and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effects of NSAID antiplatelet action and mucosal injury with vitamin K antagonist anticoagulation, with possible minor pharmacokinetic influence on warfarin.
What to do
Avoid the combination and use paracetamol or another non-NSAID option. If it cannot be avoided, monitor INR more often, consider gastroprotection and watch 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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Sulindac with Warfarin?
MediHelp rates the interaction as major. Sulindac and Warfarin 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 impairs platelet function and can cause gastrointestinal ulceration, and may slightly increase the anticoagulant effect of warfarin. The combination substantially raises the risk of serious bleeding.
How serious is the interaction between Sulindac and Warfarin?
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 the combination and use paracetamol or another non-NSAID option. If it cannot be avoided, monitor INR more often, consider gastroprotection and watch 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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