Indications  

Clinoril is a prescription medicine indicated for acute or long-term use in the relief of signs and symptoms of the following: 

• Osteoarthritis (joint lining breakdown) 
• Rheumatoid arthritis (joint lining swelling) 
• Ankylosing spondylitis (spine arthritis) 
• Acute gouty arthritis (severe joint pain and swelling due to substance build-up) 
• Acute painful shoulder:  
  • Acute subacromial bursitis (shoulder joint inflammation) 
  • Supraspinatus tendinitis (muscle-to-bone tissue inflammation) 

As a nonsteroidal anti-inflammatory drug (NSAID), Clinoril works by inhibiting the body’s production of pain, fever, and inflammation-causing substances. 

Uses and Dosage 

Before taking Clinoril and with each prescription refill, thoroughly review its medication guide and patient information leaflet. Consult your physician or pharmacist for any inquiries or uncertainties. 

Clinoril dosage is individualized according to the patient’s medical condition and treatment response.  

Physicians usually prescribe this medication at the lowest effective dose for the shortest duration possible to minimize the risk of stomach bleeding and other potential side effects. 

Typically, Clinoril is taken twice daily with food, with a maximum dosage of 400 mg daily. Doses exceeding 400 mg per day are not advised. 

For optimal results, take this medication regularly around the same time(s) daily, exactly as prescribed by your doctor.  

Inform your doctor if your condition deteriorates. 

Side Effects 

Listed below are the potential adverse effects that may arise from taking Clinoril. If any of them persist or worsen, notify your doctor promptly. 

Common Side Effects 

• Nausea 
• Vomiting 
• Stomach pain 
• Indigestion 
• Loss of appetite  
• Diarrhea 
• Constipation 
• Gas 
• Headache 
• Dizziness 
• Nervousness 
• Itching 
• Rash 
• Ringing in the ears 

Serious Side Effects 

• Changes in vision 
• Shortness of breath (even with mild exertion) 
• Swelling or rapid weight gain 
• Signs of stomach bleeding:  
  • Bloody or tarry stools 
  • Coughing up blood 
  • Vomit that resembles coffee grounds 
• Signs of liver problems: 
  • Nausea 
  • Upper stomach pain 
  • Itching 
  • Fatigue 
  • Flu-like symptoms 
  • Loss of appetite 
  • Dark urine 
  • Clay-colored stools 
  • Jaundice (yellowing of the skin or eyes) 
• Signs of pancreatitis:  
  • Severe pain in the upper stomach spreading to the back 
  • Nausea 
  • Vomiting 
• Signs of kidney problems: 
  • Little or no urination 
  • Painful or difficult urination 
  • Swelling in the feet or ankles 
  • Fatigue 
  • Shortness of breath 
• Indication of low red blood cells (anemia): 
  • Pale skin 
  • Unusual tiredness 
  • Feeling light-headed 
  • Short of breath 
  • Cold hands and feet 

Stop taking Clinoril and call your doctor right away if you experience any of the above-listed severe side effects. 

Allergic Reactions 

Severe allergic reactions to Clinoril are uncommon; however, seek immediate medical attention if you experience symptoms such as: 

• Hives 
• Sneezing 
• Runny nose 
• Wheezing 
• Difficult breathing 
• Swelling in the face or throat 

A severe skin reaction may also occur. Seek immediate medical attention if you experience symptoms such as: 

• Fever 
• Sore throat 
• Burning eyes 
• Skin pain 
• Red or purple skin rash with blistering and peeling 

This list does not contain all the potential side effects of Clinoril. If you encounter any unlisted effects, notify your doctor promptly. 

Cautions 

Before starting treatment with Clinoril, inform your doctor and pharmacist if you have any known hypersensitivities, especially to: 

• Sulindac 
• Aspirin  
• Other NSAIDs (e.g., ibuprofen, naproxen, celecoxib) 
• Any other medications 
• Any of the ingredients present in Clinoril tablets 

To ensure Clinoril is safe for you, disclose to your physician your medical background, specifically regarding the following: 

• Asthma, with a past of deteriorating breathing post consumption of aspirin or other NSAIDs 
• Blood disorders (e.g., anemia, bleeding, or clotting problems) 
• Growths in the nose (nasal polyps) 
• Heart disease (e.g., previous heart attack) 
• Hypertension (high blood pressure) 
• Kidney stones 
• Liver disease 
• Stroke 
• Swelling (e.g., edema, fluid retention) 
• Stomach, intestinal, or esophagus problems, such as bleeding, heartburn, or ulcers 

Tell your doctor and pharmacist about all the medications you are currently taking, including prescription and non-prescription drugs, supplements, and herbal products, to avoid potential drug interactions. 

Some products that may interact with Clinoril include:  

• Aliskiren 
• ACE inhibitors (e.g., benazepril or lisinopril) 
• Angiotensin II receptor blockers (e.g., losartan or valsartan) 
• Cidofovir 
• Corticosteroids (e.g., dexamethasone or prednisone) 
• Dimethyl sulfoxide (DMSO) 
• Lithium 
• Methotrexate 
• Diuretics (e.g., furosemide) 

Clinoril can elevate the risk of bleeding when combined with other medications with similar bleeding potential. These include: 

• Anti-platelet drugs like clopidogrel 
• Blood thinners such as dabigatran, enoxaparin, warfarin, and others 

Many medications contain pain relievers and fever reducers (e.g., aspirin and NSAIDs like ibuprofen, ketorolac, and naproxen) similar to sulindac, increasing the risk of side effects. Check all the labels of your medications carefully. If directed to take low-dose aspirin to prevent heart attack or stroke, continue unless instructed otherwise.  

Clinoril increases the risk of fatal heart attack or stroke. It should not be used before or after heart bypass surgery (coronary artery bypass graft CABG). 

Clinoril carries the risk of potentially fatal stomach or intestinal bleeding, which can occur unexpectedly, particularly among older adults while taking this medication. 

The use of Clinoril can increase sensitivity to sunlight. Minimize sun exposure, avoid tanning booths and sunlamps, and use sunscreen with protective clothing when outdoors. Notify your doctor immediately if you experience sunburn or develop skin blisters or redness. 

Pregnant women should refrain from taking Clinoril unless directed by their doctor. Administration of NSAIDs during the last 20 weeks of pregnancy can result in significant heart or kidney issues for the unborn baby and potential complications in the pregnancy. 

The transfer of sulindac into breast milk is uncertain. Avoid breastfeeding while taking this medication and seek advice from a medical professional beforehand.