Search results for:

sulindac

sulindac
  • Restricted Medications Non-Formulary
Brand names: Clinoril
Form Strength
TABLET, ORAL 150 mg; 200 mg
Display Other Nonsteroidal Anti-inflammatory Agents Class: 28080492
Medication comments:
Per policy, orders for these non-formulary agents will be changed to formulary equivalents.
Non-Formulary Agent Formulary Equivalent
sulindac (Clinoril) 150 mg BID naproxen (Naprosyn) 375 mg BID
sulindac (Clinoril) 200 mg BID naproxen (Naprosyn) 500 mg BID
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication: sulindac (Clinoril)
Criteria 1: Potentially inappropriate medication use in older adults. (Table 2)
Drug(s) non-COX-2-selective NSAIDs, oral
Rationale Increased risk of GI bleeding or peptic ulcer disease in high-risk groups, including those >75 years old or taking oral or parenteral corticosteroids, anticoagulants, or antiplatelet agents; use of proton-pump inhibitor or miSOPROStol reduces but does not eliminate risk. Upper GI ulcers, gross bleeding or perforation caused by NSAIDs occur in ~1% of patients treated for 3-6 months and in ~2%-4% of patients treated for 1 year; these trends continue with longer duration of use. Also can increase blood pressure and induce kidney injury. Risks are dose-related.
Recommendation Avoid chronic use unless other alternatives are not effective and the patient can take a gastroprotective agent (proton-pump inhibitor or miSOPROStol).
Avoid short-term scheduled use in combination with oral or parenteral corticosteroids, anticoagulants or antiplatelet agents unless other alternatives are not effective and the patient can take a gastroprotective agent (proton-pump inhibitor or miSOPROStol).
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3)
Drug(s) ⇆ disease or syndrome NSAIDs and COX-2 inhibitors ⇄ Heart failure
Rationale Potential to promote fluid retention and/or exacerbate heart failure.
Recommendation Use with caution in patients with heart failure who are asymptomatic; avoid in patients with symptomatic heart failure.
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Drug(s) ⇆ disease or syndrome non-COX-2 selective NSAIDs ⇄ History of gastric or duodenal ulcers
Rationale May exacerbate existing ulcers or cause new/additional ulcers
Recommendation Avoid unless other alternatives are not effective and the patient can take a gastroprotective agent (i.e., proton-pump inhibitor or miSOPROStol).
 Quality of evidence: Moderate, Strength of Recommendation: Strong
 
Criteria 5: medications that should be avoided or have their dosage reduced with varying levels of kidney function in older adults. (Table 6)
CrCl (mL/min) at which action is required <30
Rationale NSAIDs (oral and parenteral) may increase the risk of acute kidney injury and a further decline in kidney function.
Recommendation Avoid
 Quality of evidence: Moderate, Strength of Recommendation: Strong
Last updated: Sep. 24, 2025
UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556



This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.
Copyright © 2025 Rpharmy, LLC ­ All Rights Reserved