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Sulindac (Copal)

A sulfinylindene derivative prodrug whose sulfinyl moiety is converted in vivo to an active NSAID analgesic. Specifically, the prodrug is converted by liver enzymes to a sulfide which is excreted in the bile and then reabsorbed from the intestine. This helps to maintain constant blood levels with reduced gastrointestinal side effects.

Also Known As:

Copal; Clinoril; Aclin; Alphapharm Brand of Sulindac; Apo-Sulin; Apotex Brand of Sulindac; Arthrobid; Arthrocine; Cahill May Roberts Brand of Sulindac; Chemia Brand of Sulindac; Chibret; Kenalin; Kendrick Brand of Sulindac; Klinoril; MK-231; Merck Brand of Sulindac; Merck Sharp & Dohme Brand of Sulindac; Novo-Sundac; Novopharm Brand of Sulindac; Nu-Pharm Brand of Sulindac; Nu-Sulindac; Sulindal; Apo Sulin; MK 231; MK231; Novo Sundac; Nu Pharm Brand of Sulindac; Nu Sulindac; 1H-Indene-3-acetic acid, 5-fluoro-2-methyl-1-((4-(methylsulfinyl)phenyl)methylene)-, (Z)-

Networked: 815 relevant articles (90 outcomes, 184 trials/studies)

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Drug Context: Research Results

Experts

1.	Rigas, Basil: 19 articles (05/2015 - 12/2002)
2.	Huang, Liqun: 13 articles (05/2015 - 10/2010)
3.	Gerner, Eugene W: 12 articles (01/2015 - 01/2006)
4.	Xie, Gang: 10 articles (05/2015 - 10/2010)
5.	Kopelovich, Levy: 8 articles (02/2015 - 03/2003)
6.	Giardiello, Francis M: 8 articles (10/2005 - 03/2002)
7.	Ouyang, Nengtai: 7 articles (05/2015 - 10/2010)
8.	Weissbach, Herbert: 7 articles (11/2014 - 12/2003)
9.	Mackenzie, Gerardo G: 7 articles (08/2013 - 10/2010)
10.	Meyskens, Frank L: 7 articles (10/2010 - 06/2008)

Related Diseases

1.	Neoplasms (Cancer) 09/01/1991 - "There was a significantly greater increase in size of the tumors in the control group (56.4 mm for 26 tumors) compared with the rats receiving sulindac (9.3 mm for 14 tumors). " 09/01/2004 - "Combined treatment with sulindac and ursodeoxycholate was more effective than either agent alone for the prevention of tumors throughout the entire intestine. " 01/01/2015 - "In the CT setting, sulindac alone and DFMO/sulindac combination were effective in reducing tumor number, but not tumor burden growth rate. " 08/15/2001 - "In Apc1638(+/-) mice, targeted inactivation of p21 increased intestinal tumor formation in a gene-dose-dependent manner, but inactivation of p21 completely eliminated the ability of sulindac to both inhibit mitotic activity in the duodenal mucosa and to inhibit Apc-initiated tumor formation. " 01/01/2012 - "In this study, we have shown that the combination of sulindac and DCA enhances the selective killing of A549 and SCC25 cancer cells under the conditions used. "
2.	Adenomatous Polyposis Coli (Familial Adenomatous Polyposis) 03/15/2001 - "Sulindac, a nonsteroidal antiinflammatory drug effective against colorectal tumorigenesis in familial adenomatous polyposis syndrome, suppressed the formation of foci. " 01/01/2006 - "The aim of the present study was to elucidate the effect of sulindac on uncolectomized familial adenomatous polyposis (FAP). " 01/01/1990 - "The aim of this study was to assess the effectiveness of sulindac therapy for eradication of micropolyps in 8 patients with familial polyposis coli. " 12/01/2015 - "Sulindac is chemopreventive and has utility in patients with familial adenomatous polyposis; however, side effects preclude its long-term use. " 04/01/2007 - "The NSAID (non-steroidal anti-inflammatory drug) sulindac is a potent inhibitor of intestinal carcinogenesis in the C57BL/6J-Apc(Min)/J mouse model and is used to treat humans with FAP (familial adenomatous polyposis). "
3.	Polyps 02/20/1996 - "A second study reported that intervention with the NSAID sulindac for 9 months in young patients with FAP resulted in a significant reduction in both polyp number and size in the rectosigmoid colon. " 11/01/2008 - "Sulindac is effective in the reduction and often in the elimination of numerous smaller pouch polyps. " 11/01/2008 - "Future studies are necessary to determine the role of sulindac and other chemotherapeutic agents in preventing the development of these polyps." 08/01/2007 - "Participants in the Phase IIb study served as a vanguard for a randomized, placebo-controlled prospective Phase III trial of the combination of DFMO and sulindac with the primary study endpoint the prevention of colon polyps. " 09/01/1995 - "Despite attempts to reduce polyp mass by regular endoscopic polypectomy, daily transfusions of blood products, and a trial of the non-steroidal anti-inflammatory agent sulindac, his condition gradually deteriorated and he died of septicaemia."
4.	Adenoma (Adenomas) 08/01/1995 - "Low-dose rectal sulindac maintenance therapy is highly effective in achieving complete adenoma reversion without relapse in 87 percent of patients after 33 months. " 01/01/2008 - "Follow-up studies showed positive but variable long-term efficacy for colorectal adenomas, but sulindac appears to lack significant benefit in regressing duodenal adenomas or preventing initial occurrence of adenomas in APC mutation carriers. " 08/18/2005 - "Long-term use of sulindac seems to be effective in reducing dysplasia grade and tubulovillous adenoma of retained colorectal adenoma of FAP patients. " 08/01/2011 - "A Phase III trial treating resected adenoma patients with DFMO plus sulindac demonstrated marked reduction of metachronous adenomas, advanced adenomas and multiple adenomas compared to placebo. " 04/04/2002 - "During the course of the study, adenomas developed in 9 of 21 subjects (43 percent) in the sulindac group and 11 of 20 subjects in the placebo group (55 percent) (P=0.54). "
5.	Colonic Neoplasms (Colon Cancer) 10/01/2010 - "Phospho-sulindac (OXT-328), a novel sulindac derivative, is safe and effective in colon cancer prevention in mice." 07/01/2014 - "Together, our study provides a therapeutic justification of combined inhibition of CXCR2 and sulindac treatment in colon cancer prevention. " 07/01/2011 - "Study results show that P-S/DFMO is an efficacious drug combination for colon cancer prevention and also show the safety of P-S, which may overcome the limiting side effects of conventional sulindac. " 01/01/2011 - "This study demonstrates that the effect of sulindac treatment in a mouse model of colon cancer may be relevant to the human counterpart and highlights the effect of sulindac treatment on metallohydrolases." 01/01/2011 - "To determine whether this effect is relevant to the human condition, HT-29 human colon cancer cells were treated with sulindac and its metabolites, and compared to results obtained from in vivo mouse studies. "

Related Drugs and Biologics

1.	Ibuprofen (Motrin)
2.	Tamoxifen
3.	Indomethacin (Indometacin)
4.	Non-Steroidal Anti-Inflammatory Agents (NSAIDs)
5.	Aspirin (Acetylsalicylic Acid)
6.	celecoxib (Celebrex)
7.	Naproxen (Naprosyn)
8.	Piroxicam (Feldene)
9.	Diclofenac (SR 38)
10.	Tolmetin (Tolmetin Sodium)

Related Therapies and Procedures

1.	Colectomy
2.	Chemoprevention
3.	Heterologous Transplantation (Xenotransplantation)
4.	Drug Therapy (Chemotherapy)
5.	Radiotherapy