Sulindac

Brands

Clinoril, Apo-Sulin (Canada), Novo-Sundac (Canada)

Availability

  • Comes in human form:
    • Tablets: 100 mg, 150 mg, or 200 mg

Pharmacology

Sulindac is a nonsteroidal, anti-rheumatic agent. It possesses anti-inflammatory, analgesic and anti-pyretic properties. Its therapeutic action is interference with the formation of prostaglandins. Prostaglandins are substances that occur naturally in the body that cause inflammation, and make nerves more sensitive to pain impulses.

In rats, sulindac was found to cross placental barrier minimally, and to be excreted in rat maternal milk. It is also found to be excreted in urine.

Indications

Primary use: osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.

Colorectal tumors/polyps

(In cases where surgical removal of the tumor/polyps is not an option, this drug may be helpful in providing comfort to the rat by: inhibiting the rate of growth and formation, and allowing for passage of feces.)

Drug Interactions or Contraindications

  • Not recommended where active gastrointestinal bleeding is present.
  • The concomitant use of sulindac with other NSAIDs is not recommended due to the increased possibility of gastrointestinal toxicity.
  • Due to fluid retention properties of NSAIDs (nonsteroidal anti-inflammatory drugs), the effect of diuretics may be reduced, and increased dosage of diuretics may be needed. Care should be taken if a rat has been placed on Lasix, or hydrochlorothiazide.

Adverse Reactions

CV: heart failure, edema (swelling)

GI: ulcers, occult blood loss, constipation, loss of appetite

GU: interstitial nephritis.

Skin: pruritus (itching)

Other: prolongs bleeding time

Dosage Recommendations

*Note: side effects with sulindac tend to be dose related. Therefore, it is advisable to use the lowest dose required to achieve desired response.

5 mg/kg to 10 mg/kg, PO, once daily1

*Note: because of the potential for GI ulceration with long term use of sulindac it is recommended that an anti-ulcer agent (e.g., sucralfate) be used concurrently.

Considerations

  • Drug should be given with food.
  • Care should be taken if giving to a rat where liver and/or renal impairment is thought to be present.
  • *Note: nonsteroidal anti-inflammatory medicines may mask clinical signs of infection. It is often recommended , if deciding to use NSAIDs or steroids in rats long term, to add a broad-spectrum antibiotic as part of the treatment regimen.
  • Sulindac (like other medications of similar characteristics) should be discontinued prior to any type of surgery, in rats, due to mild interference with clotting.
  • Notify veterinarian if bruising or bleeding occurs in rat while on this medication.
  • Keep container tightly closed, and protect from sunlight and heat.

References

  1. Skinner, S., Penney, A., & O’Brien, P. (1991). Sulindac inhibits the rate of growth and appearance of colon tumors in the rat. Arch Surg, 126(9), 1094-6. Retrieved December 15, 2008, from the PubMed database.

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