Drug Information
Sulindac is used to treat rheumatoid arthritis, osteoarthritis and ankylosing spondylitis, a rheumatic disorder involving the spine and large joints. It also treats both acute painful shoulder and gouty arthritis. Sulindac is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).
Common brand names:
Clinoril
Summary of Interactions with Vitamins, Herbs, & Foods
Types of interactions:
Beneficial
Adverse
Check
Replenish Depleted Nutrients
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Potassium
Four people who took sulindac developed high blood levels of potassium, which returned to normal within a few days after the drug was stopped.1 Controlled research is needed to determine whether potassium supplements or a high potassium diet might aggravate this problem. Until more information is available, people taking sulindac and potassium supplements, potassium containing salt substitutes, or large amounts of fruits and vegetables should have potassium blood levels checked regularly by their doctor.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Potential Negative Interaction
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White Willow
White willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs.2 Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Explanation Required
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Folic Acid
Sulindac blocks the activity of enzymes that depend on folic acid3 and may, like aspirin, reduce the amount of folic acid in red blood cells.4 Further research is needed to determine whether supplementing folic acid changes the effects of sulindac therapy or prevents a deficiency of this vitamin in the body.
The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
References
1. Nesher G, Zimran A, Hershko C. Hyperkalemia associated with sulindac therapy. J Rheumatol 1986;13:1084–5.
2. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
3. Baggott JE, Morgan SL, Ha T et al. Inhibition of folate-dependent enzymes by non-steroidal anti-inflammatory drugs. Biochem J 1992;282:197–202.
4. Alter HJ, Zvaifler NJ, Rath CE. Interrelationship of rheumatoid arthritis, folic acid, and aspirin. Blood 1971;38:405–16.
