Sulindac, sold as Clinoril, is a non-steroidal anti-inflammatory drug (NSAID). These drugs are typically used to treat conditions associated with pain and inflammation, such as rheumatoid arthritis, headaches or migraines, and dysmenorrhoea. Sulindac is believed to be a non-selective NSAID, meaning that it inhibits both prostaglandin G/H synthase 1 and 2 (COX-1 and COX-2). In this pathway, sulindac, a prodrug, is administered orally. Once in the body, it is metabolized to form the active form of sulindac, which then inhibits the COX-1 and COX-2 enzymes. These enzymes are normally responsible for the formation of prostaglandin G2 from arachidonic acid, well as the formation of prostaglandin H2 from prostaglandin G2. These prostaglandins are responsible for inflammation and fever, as well as muscle contractions in labour and menstruation. With the COX-1 and COX-2 enzymes being inhibited by sulindac, prostaglandins cannot be produced, and inflammation and fever can be reduced. Compared to other NSAIDs, sulindac is less likely to damage the kidneys and cause gastrointestinal effects such as ulcers, but is more likely to damage the liver and pancreas.

Sulindac Pathway References

Arachidonic Acid Metabolism References