Drug reference
Pain and inflammation in rheumatic disease and other musculoskeletal disorders | Acute gout ▶BY MOUTH ▶Adult: 200 mg twice daily for maximum duration 7–10 days in peri-articular disorders, dose may be reduced according to response; acute gout should respond within 7 days; maximum 400 mg per day
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Active gastro-intestinal bleeding. active gastro-intestinal ulceration. history of gastro- intestinal bleeding related to previous NSAID therapy. history of gastro-intestinal perforation related to previous NSAID therapy. history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes). history of recurrent gastro-intestinal ulceration (two or more distinct episodes). severe heart failure
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Allergic disorders. cardiac impairment (NSAIDs may impair renal function). cerebrovascular disease. coagulation defects. connective-tissue disorders. dehydration (risk of renal impairment). elderly (risk of serious side-effects and fatalities). heart failure. history of gastro-intestinal disorders (e.g. ulcerative colitis, Crohn’s disease). history of renal stones (ensure adequate hydration). ischaemic heart disease. peripheral arterial disease. risk factors for cardiovascular events. uncontrolled hypertension
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Contra-indicated in patients with a history of hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other NSAID.
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→Appendix 1: NSAIDs
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Acute psychosis. agranulocytosis. alopecia . angioedema. appetite decreased. arrhythmia. asthenia. asthma. bone marrow disorders. cholecystitis. confusion. constipation. Crohn’s disease aggravated. depression. diarrhoea. dizziness. drowsiness. dyspnoea. dysuria. eye disorder. fever. gastrointestinal discomfort. gastrointestinal disorders. gynaecomastia. haemolytic anaemia. haemorrhage. hallucination. headache. hearing loss. heart failure. hepatic disorders. hyperglycaemia. hyperhidrosis. hyperkalaemia. hypersensitivity. hypersensitivity vasculitis. hypertension. increased risk of arterial thromboembolism. increased risk of infection. Musculoskeletal system insomnia. leucopenia. malaise. meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible). mucosal abnormalities. muscle weakness. nausea. nephritis tubulointerstitial. nephrotic syndrome. nerve disorders. nervousness. neutropenia. oedema. oral disorders. palpitations. pancreatitis. paraesthesia. photosensitivity reaction. psychiatric disorder. renal impairment. respiratory disorders. seizure. severe cutaneous adverse reactions (SCARs). skin reactions. syncope. taste altered. thrombocytopenia. tinnitus. urine abnormalities. urine discolouration. vertigo. vision disorders. vomiting SIDE-EFFECTS, FURTHER INFORMATION For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non- steroidal anti-inflammatory drugs. p. 1193
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Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment.
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Avoid unless the potential benefit outweighs the risk. Avoid during the third trimester (risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn); onset of labour may be delayed and duration may be increased.
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Use with caution during breast-feeding.
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Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
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Avoid if possible or use with caution. Avoid in severe impairment. Dose adjustments The lowest effective dose should be used for the shortest possible duration. Monitoring In renal impairment monitor renal function; sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Sulindac (Non-proprietary) Sulindac 100 mg Sulindac 100mg tablets | 56 tablet P £48.00 DT = £29.79 Sulindac 200 mg Sulindac 200mg tablets | 56 tablet P £96.00 DT = £38.30
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200 mg twice daily for maximum duration
First-line fragment. Read the complete Indications and Dose section above.
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