Sulindac

Sulindac

File:Sulindac structure.svg
Systematic (IUPAC) name
{(1Z)-5-fluoro-2-methyl-1-[4-(methylsulfinyl)benzylidene]-1H-indene-3-yl}acetic acid
Clinical data
Pregnancy category	AU: C US: C (Risk not ruled out)
Routes of administration	Oral
Legal status
Legal status	UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability	Approximately 90% (Oral)
Metabolism	?
Biological half-life	7.8 hours, metabolites up to 16.4 hours
Excretion	Renal (50%) and fecal (25%)
Identifiers
CAS Number	38194-50-2
ATC code	M01AB02 (WHO)
PubChem	CID 5352
DrugBank	APRD01243
Chemical data
Formula	C20H17FO3S
Molar mass	356.412 g/mol[[]]
(verify)

Sulindac is a non-steroidal anti-inflammatory drug of the arylalkanoic acid class that is marketed in the UK & U.S. by Merck as Clinoril.

Uses

Like other NSAIDs, it is useful in the treatment of acute or chronic inflammatory conditions. Sulindac is a prodrug, derived from sulfinylindene, that is converted in the body to the active NSAID. More specifically, the agent is converted by liver enzymes to a sulfide that is excreted in the bile and then reabsorbed from the intestine. This is thought to help maintain constant blood levels with reduced gastrointestinal side effects. Some studies have shown sulindac to be relatively less irritating to the stomach than other NSAID's except for drugs of the COX-2 inhibitor class. The exact mechanism of its NSAID properties is unknown, but it is thought to act on enzymes COX-1 and COX-2, inhibiting prostaglandin synthesis.

Its usual dosage is 150-200 milligrams twice per day, with food. It should not be used by persons with a history of major allergic reactions (urticaria or anaphylaxis) to aspirin or other NSAIDs, and should be used with caution by persons having pre-existing peptic ulcer disease. Sulindac is much more likely than other NSAIDs to cause damage to the liver or pancreas.

Sulindac seems to have a property, independent of COX-inhibition, of reducing the growth of polyps and precancerous lesions in the colon, especially in association with familial adenomatous polyposis, and may have other anti-cancer properties.

Sulindac is an effective tocolytic and may be used in the treatment of preterm labour. In common with other NSAIDs, sulindac is currently being investigated for its role in the treatment of Alzheimer's disease.

Since it was found that the sulfoxide functional group can be reduced by methionine sulfoxide reductase A (MsrA), a possible anti-oxidative capability is being discussed.

Sulindac Inhibits Canonical Wnt Signaling by Blocking the PDZ Domain of the Protein Dishevelled.

Side Effects

In September 2010 a federal jury in New Hampshire awarded $21 million to a woman blinded and scarred by Sulindac drug she took for shoulder pain. Karen Bartlett, of Plaistow, said she suffered extreme burns to her skin, mucus membranes and eyes after taking the anti-inflammatory drug sulindac. After three days of deliberations, the jury found Wednesday that Philadelphia-based Mutual Pharmaceutical Co. was liable for her injuries and should compensate her $21 million. The jury found the company should have known the drug was unreasonably dangerous to consumers.

References

• 
  The Selected References list for the foregoing PubMed abstract contains nine (9) further references with "Suldinac" in their titles.

Sulindac Inhibits Canonical Wnt Signaling by Blocking the PDZ Domain of the Protein Dishevelled.

Lee HJ, Wang NX, Shi DL, Zheng JJ.

Department of Structural Biology,Stop 311, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-3678 (USA), Fax: (+1) 901-595-3168 http://www.stjude.org/zheng.

External links

• RxList information on Sulindac
• Drug Profile
• Jury Awards $21 Million

bs:Sulindak vi:Sulindac