Apo Sulin (Sulindac) belongs to the class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It is used to relieve mild to moderately severe pain accompanied by inflammation. It can be used to relieve pain in conditions such as Rheumatoid Arthritis, osteoarthritis, ankylosing spondylitis, and shoulder pain due to Bursitis or Tendinitis.

Your doctor may have suggested Apo Sulin (Sulindac) for conditions other than those listed in these drug information articles. As well, some forms of Apo Sulin (Sulindac) may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking Apo Sulin (Sulindac), speak to your doctor. Do not stop taking Apo Sulin (Sulindac) without consulting your doctor.

Do not give Apo Sulin (Sulindac) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take Apo Sulin (Sulindac) if their doctor has not prescribed it.

The recommended dose of Apo Sulin (Sulindac) ranges from 300 mg to 400 mg daily in 2 divided doses, taken with food or milk. Once your condition improves, your doctor may recommend a lower dose.

Do not take Apo Sulin (Sulindac) more often or for a longer period of time than as prescribed by your doctor.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Apo Sulin (Sulindac) exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Apo Sulin (Sulindac) at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes Apo Sulin (Sulindac). If you are concerned about side effects, discuss the risks and benefits of Apo Sulin (Sulindac) with your doctor.

The following side effects have been reported by at least 1% of people taking Apo Sulin (Sulindac). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal or stomach cramps, pain, or discomfort (mild to moderate)
• Diarrhea
• dizziness, drowsiness, or lightheadedness
• headache (mild to moderate)
• heartburn, indigestion, nausea, or vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Stop taking the medication and seek immediate medical attention if any of the following occur:

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Apo Sulin (Sulindac).

Apo Sulin (Sulindac) is available as 150 mg and 200 mg tablets.

Apo Sulin (Sulindac) should not be taken by anyone who:

• is allergic to Apo Sulin (Sulindac) or to any of the ingredients of the medication
• is breast-feeding
• is pregnant
• is under 18 years of age
• has a history of significantly impaired kidney function
• has had an allergic reaction to Asa or other anti-inflammatory medications
• has or has recently had an inflammatory disease of the stomach and intestines such as stomach or intestinal ulcer, or Ulcerative Colitis

There may be an interaction between Apo Sulin (Sulindac) and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Apo Sulin (Sulindac). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Apo Sulin (Sulindac).

Drowsiness/reduced alertness: Some people have reported headache, dizziness, lightheadedness, and confusion while taking Apo Sulin (Sulindac). Avoid operating motor vehicles and doing other potentially hazardous activities until you have determined the effect Apo Sulin (Sulindac) has on you.

Fluid and electrolyte balance: As with many other nonsteroidal anti-inflammatory drugs (NSAIDs), fluid retention and edema have been reported with use of Apo Sulin (Sulindac). People with the following medical conditions should be closely monitored by their doctor while taking Apo Sulin (Sulindac):

• any other condition that might lead to fluid retention
• certain heart conditions
• high blood pressure
• Kidney Disease
• recovering from surgical operations under general anesthesia

Heart problems: NSAID medications may increase the risk of heart attacks, strokes, and Blood Clots. The risk is greater with higher doses and long-term use. People at risk of heart problems, such as those with high blood pressure, High Cholesterol, Diabetes, peripheral arterial disease, heart failure, or Coronary Artery Disease, should discuss with their doctor how Apo Sulin (Sulindac) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Apo Sulin (Sulindac), and whether any special monitoring is needed.

Infection: Apo Sulin (Sulindac) may mask the signs of an infection, such as a fever.

Kidney function: Long-term use of Apo Sulin (Sulindac) may lead to a higher risk of reduced kidney function. This is most common for people who already have kidney disease, liver disease, or heart failure; for people who are take diuretics (water pills); and for seniors.

Liver function: Apo Sulin (Sulindac) may cause liver problems. If you have a liver condition, you may need more frequent check-ups with your doctor. If you develop signs of a liver problem (such as yellow skin or eyes, dark urine, pale stools, abdominal pain, or itchy skin), stop taking the medication and see your doctor as soon as possible.

Potassium: There is a risk of high blood potassium with the use of Apo Sulin (Sulindac). People most at risk are seniors, those having conditions such as diabetes, or kidney failure, or those taking beta-blockers (e.g., Metoprolol, Atenolol), angiotensin converting enzyme inhibitors (ACE inhibitors; e.g., Ramipril, Enalapril), or some diuretics (water pills; e.g., Hydrochlorothiazide).

Stomach problems: Stomach ulcers, perforation, and bleeding from the stomach have been known to occur during therapy with Apo Sulin (Sulindac). These complications can occur at any time, and are sometimes severe enough to require immediate medical attention. The risk of ulcers and bleeding are increased for people taking higher doses of NSAIDs for longer periods of time.

Apo Sulin (Sulindac) should be taken under close medical supervision by people prone to irritation of the stomach and intestines, particularly those who have had a stomach ulcer, bloody stools, or diverticulosis or other inflammatory disease of the stomach or intestines (such as ulcerative colitis or Crohn's Disease). In these cases, your doctor must weigh the benefits of treatment against the possible risks.

Stop taking the medication and contact your doctor immediately if you experience symptoms or signs suggestive of stomach ulcers or bleeding in the stomach (black, tarry stools). These reactions can occur at any time during treatment without warning.

Surgery: If you are going to have any kind of surgery (including dental surgery), tell your doctor or dentist that you are taking Apo Sulin (Sulindac).

Pregnancy: Apo Sulin (Sulindac) is not recommended for pregnant women because its safety during pregnancy has not been established. If you become pregnant while taking Apo Sulin (Sulindac), contact your doctor immediately.

Breast-feeding: It is not known if Apo Sulin (Sulindac) passes into breast milk. If you are a breast-feeding mother and are taking Apo Sulin (Sulindac), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Apo Sulin (Sulindac) have not been established for children.

Seniors: Seniors, as well as those who are frail or debilitated, appear to have a higher risk of side effects with Apo Sulin (Sulindac). The lowest effective dose should be used, and seniors should be closely followed by their doctors while taking Apo Sulin (Sulindac).