CITRO SODA Price

Overview

Welcome to Dwaey, specifically on CITRO SODA page.
This medicine contains an important and useful components, as it consists of
Glucose, Sodium bicarbonate, Sodium citrate, Tartaric acidis available in the market in concentration

Name

Sulindac

Precaution

Before using **Sulindac**, patients must consult their healthcare provider, particularly in the following situations: - **Allergies**: Sulindac is an **NSAID** (Nonsteroidal Anti-Inflammatory Drug), and people with a history of **allergic reactions** to NSAIDs, including **aspirin**, should avoid its use. This includes individuals who have experienced **asthma**, **angioedema**, or **urticaria** after taking aspirin or other NSAIDs. - **Gastrointestinal Conditions**: Sulindac can cause **gastric irritation**, **ulcers**, or **bleeding**. Patients with a history of **gastrointestinal diseases** (such as **peptic ulcers**, **Crohn's disease**, or **ulcerative colitis**) should use Sulindac cautiously, as it may worsen these conditions. - **Renal or Liver Disease**: Sulindac is metabolized by the **liver** and eliminated by the **kidneys**, so it should be used with caution in patients with **renal** or **hepatic** impairment. Kidney function should be closely monitored, especially in elderly patients or those with pre-existing conditions. - **Heart Disease**: Long-term use of NSAIDs, including sulindac, may increase the risk of **cardiovascular events** such as **heart attack**, **stroke**, and **heart failure**, particularly in individuals with **pre-existing cardiovascular conditions** or those taking **diuretics**, **ACE inhibitors**, or **angiotensin receptor blockers**. - **Pregnancy and Lactation**: Sulindac is generally contraindicated during the **third trimester** of pregnancy, as it may affect fetal circulation and cause premature closure of the **ductus arteriosus**. It should only be used during pregnancy if absolutely necessary, under the guidance of a healthcare provider. Sulindac also passes into **breast milk**, so nursing mothers should consult a doctor before use.

Indication

Sulindac is primarily used to treat conditions associated with **inflammation** and **pain**, including: - **Osteoarthritis**: Sulindac is often prescribed to relieve the pain and inflammation associated with **osteoarthritis**. It helps reduce joint swelling, discomfort, and stiffness. - **Rheumatoid Arthritis**: It is also indicated for the management of **rheumatoid arthritis**, a chronic inflammatory condition affecting the joints. - **Acute Gouty Arthritis**: Sulindac is used to treat the **acute flare-ups of gout**, a condition characterized by sudden and severe pain, usually in the joints. - **Ankylosing Spondylitis**: This drug is effective in treating **ankylosing spondylitis**, a condition causing inflammation in the spine. - **Other Off-Label Uses**: Sulindac may be used off-label for conditions such as **tendinitis**, **bursitis**, and other musculoskeletal disorders, where inflammation and pain are prominent symptoms.

Contra indication

Sulindac is contraindicated in several situations, including: - **Active Peptic Ulcer Disease**: Due to its potential to cause **gastric irritation**, **ulceration**, and **bleeding**, Sulindac should not be used in patients with **active peptic ulcers** or a history of **gastric bleeding**. - **Severe Liver Dysfunction**: Sulindac is contraindicated in patients with **severe hepatic impairment**, as the drug is metabolized by the liver and could accumulate to toxic levels. - **Severe Renal Impairment**: Patients with **severe renal impairment** or **end-stage kidney disease** should not take Sulindac, as it can exacerbate renal dysfunction. - **Hypersensitivity**: Sulindac is contraindicated in patients with known hypersensitivity or **allergic reactions** to **sulfonamides** or other NSAIDs. - **Third-Trimester of Pregnancy**: Due to the risk of premature closure of the **ductus arteriosus** and other fetal complications, Sulindac is contraindicated during the **third trimester** of pregnancy.

Side Effect

Sulindac, like other NSAIDs, can cause a range of side effects. Some common and serious effects include: - **Common Side Effects**: - **Gastrointestinal issues**: **Nausea**, **indigestion**, **dyspepsia**, and **gastric pain** are common, especially if taken on an empty stomach. - **Headaches**: Some patients report experiencing headaches while taking sulindac. - **Dizziness and Drowsiness**: These side effects can occur, especially when standing up quickly or during prolonged use. - **Rashes**: Skin rashes may develop in some individuals. - **Serious Side Effects**: - **Gastrointestinal Bleeding**: NSAIDs can increase the risk of **gastric ulcers**, **bleeding**, and **perforation**, especially in older adults or those with a history of ulcers. - **Cardiovascular Events**: Sulindac may increase the risk of **heart attack**, **stroke**, and **heart failure**, particularly with long-term use. - **Kidney Damage**: Prolonged use of Sulindac can result in **renal toxicity** or **acute kidney injury**, particularly in individuals with pre-existing kidney problems. - **Liver Damage**: Sulindac can cause **liver enzyme elevation** and, in rare cases, **liver failure**. Monitoring liver function is recommended during treatment. - **Severe Allergic Reactions**: In rare cases, sulindac may cause **anaphylaxis**, **angioedema**, or other severe allergic reactions, necessitating immediate medical attention.

Pregnancy Category ID

3

Mode of Action

Sulindac belongs to the class of **NSAIDs**, and its primary mode of action is based on the inhibition of **cyclooxygenase (COX)** enzymes, which play a key role in the production of **prostaglandins**: - **Inhibition of COX Enzymes**: Sulindac inhibits **COX-1** and **COX-2** enzymes, which are responsible for the conversion of **arachidonic acid** into **prostaglandins**. - **Reduction of Prostaglandins**: By blocking COX enzymes, sulindac reduces the synthesis of **prostaglandins**, which are compounds involved in inflammation, pain, and fever. - **Anti-inflammatory and Analgesic Effects**: The reduction in prostaglandin production results in the alleviation of **pain**, **swelling**, and **fever**, making Sulindac effective in treating inflammatory conditions like arthritis and gout.

Interaction

Sulindac may interact with various medications, affecting the drug’s action or the effectiveness of other treatments: - **Anticoagulants (e.g., Warfarin)**: NSAIDs, including Sulindac, can increase the risk of **bleeding** when used in combination with **anticoagulants** like warfarin. Monitoring of **INR** levels is recommended. - **Diuretics and Antihypertensive Drugs**: Sulindac may reduce the effectiveness of **diuretics** (e.g., **furosemide**) and **ACE inhibitors**, as it can impair renal function, leading to elevated blood pressure. - **Lithium**: Sulindac may increase **lithium levels**, leading to **toxicity**. Blood lithium levels should be monitored in patients taking both drugs. - **Methotrexate**: Sulindac may increase **methotrexate toxicity**, particularly at higher doses. Caution is advised when combining these drugs. - **Corticosteroids**: Using Sulindac in conjunction with **steroids** may increase the risk of **gastrointestinal bleeding** or **ulceration**. - **Aspirin**: Sulindac should be used with caution when taken with **aspirin**, as the combination may increase the risk of **gastrointestinal side effects**, such as ulcers and bleeding.

Pregnancy Category Note

Pregnancy Category: C; D in 3rd trimester.

Adult Dose

The typical dosage for **adults** varies based on the condition being treated: - **Osteoarthritis and Rheumatoid Arthritis**: The recommended dose is **150 mg** per day, taken in divided doses (e.g., 75 mg twice daily). The dose can be increased to **200 mg per day** if necessary. - **Acute Gouty Arthritis**: For acute gout attacks, **Sulindac** is often given as **200 mg twice a day** for **7-14 days** until symptoms resolve. - **Ankylosing Spondylitis**: The dose typically starts at **150 mg per day**, taken in divided doses, and can be increased as needed to control symptoms.

Child Dose

Sulindac is generally **not recommended** for children under **14 years of age**, as its safety and efficacy in pediatric populations have not been well established. For older children, the dose would be **determined based on weight**, and should be done under a healthcare provider’s guidance. **Consulting with a healthcare provider** before starting Sulindac is crucial to ensure it is appropriate for your condition, and to receive proper guidance on dosing, potential side effects, and interactions with other medications.

Renal Dose

Sulindac should be used with caution in individuals with **renal impairment**. In patients with mild renal dysfunction, the dose may remain the same, but **monitoring renal function** is essential. In cases of **severe renal impairment**, sulindac should be avoided or given at a **reduced dose**, with careful monitoring of kidney function throughout treatment.

Administration

Information not available