Clinoril

Generic name: Sulindac

What is Clinoril?

Clinoril is a nonsteroidal anti-inflammatory drug (NSAID) used to treat osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute painful shoulder (acute subacromial bursitis/supraspinatus tendinitis), and acute gouty arthritis.

What is the most important information I should know about Clinoril?

NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction (heart attack), and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.

Clinoril is not to be used for the treatment of perioperative pain before or after coronary artery bypass graft (CABG) surgery.

NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events. Taking Clinoril in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects.

If you experience nausea, fatigue, lethargy, "flu-like" symptoms, abnormal itching, or yellowing of skin or eyes contact your doctor immediately for these may be signs of a more serious problems.

Do not drive or perform other possibly unsafe tasks until you know how you react to Clinoril because this drug may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines.

Do not take aspirin while you are using Clinoril unless your doctor tells you to.

Clinoril may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

Who should not take Clinoril?

You should not take this medication for the treatment of perioperative pain if you are having heart bypass surgery, also called coronary artery bypass graft (CABG) surgery.

Do not take Clinoril if you have a known hypersensitivity to the medication or if you have experienced allergic reactions to other NSAIDs.

What should I tell my doctor before I take the first dose of Clinoril?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Clinoril. Also, talk to your doctor about your complete medical history, especially if you have liver or kidney disease, diabetes, stomach or bowel problems (such as bleeding or ulcers), kidney stones, history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), mouth inflammation, heart problems, bleeding or clotting problems, high blood pressure, a history of alcohol abuse, or if you are pregnant or breastfeeding.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Acute Painful Shoulder and Acute Gouty Arthritis

Adults: The recommended dosage is 200 milligrams (mg) twice a day. For acute painful shoulder, therapy lasting for 7 to 14 days is usually adequate. In acute gouty arthritis, therapy for 7 days is usually adequate.

Osteoarthritis, Rheumatoid Arthritis, and Ankylosing Spondylitis

Adults: The recommended starting dose is 150 mg twice a day. The dosage may be increased or decreased based on patient response. The maximum dosage is 400 mg per day.

Safety and efficacy in pediatric patients has not been established.

What should I avoid while taking Clinoril?

Do not drive or perform other possibly unsafe tasks until you know how you react to Clinoril because this drug may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines; avoid the consumption of alcohol.

Do not take aspirin while you are using Clinoril unless your doctor tells you to.

How should I take Clinoril?

Take Clinoril by mouth twice a day with food. Taking this medication with food may not lower the risk of bowel or stomach problems. Take Clinoril with a full glass of water (8 oz.). Drinking extra fluids while you are taking Clinoril is recommended. Check with your doctor for instructions.

What are possible food and drug interactions associated with Clinoril?

If Clinoril is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Clinoril with the following: ACE-inhibitors such as enalapril, angiotensin II antagonists such as losartan, aspirin, corticostertoids, cyclosporine, diflunisal, diuretics (water pills), DMSO, lithium, methotrexate, NSAIDs, oral anticoagulants, oral hypoglycemic (antidiabetes) agents, probenecid

What are the possible side effects of Clinoril?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: gastrointestinal pain, dyspepsia, nausea with or without vomiting, diarrhea, constipation, flatulence, anorexia and gastrointestinal cramps. Rash, headache, and dizziness may also occur.

Serious side effects of NSAIDs may include:

Heart attack, stroke, high blood pressure, heart failure from body swelling, kidney problems including kidney failure, low red blood cells, life-threatening skin reactions, life-threatening allergic reactions, liver problems including liver failure, asthma attacks in people who have asthma

Can I receive Clinoril if I am pregnant or breastfeeding?

As with other NSAIDs, avoid Clinoril in late pregnancy (last 3 months), because it may cause premature closure of the ductus arteriosis. Clinoril should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk.

What should I do if I miss a dose of Clinoril?

If you miss a dose of Clinoril and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

How should I store Clinoril?

Store Clinoril at room temperature. Store away from heat, moisture, and light. Do not store in the bathroom.