The short answer
Added bleeding from this combination is uncertain. Review the exact root product and your ulcer history with your clinician.
What this answer covers
Specified oral Harpagophytum procumbens root preparations with oral sulindac 150 or 200 mg tablets. The monograph also covers H. zeyheri; species and extract must be checked.
- Supplement or preparation
- Harpagophytum procumbens
- Medication ingredient
- sulindac
What is known about the combination
The final European root monograph reports no interactions. It does not establish that this herb increases bleeding with sulindac, and it does not provide a trial showing that the combination is safe. The current claim therefore remains uncertain.
Ulcer precautions still matter
The monograph contraindicates the covered root preparations in people with active stomach or duodenal ulcers and lists GI symptoms among possible adverse effects. Sulindac separately carries serious GI warnings. Discuss an ulcer history before using the herb for pain.
Check the root product
The monograph covers specified secondary tuberous root powders, teas and extracts from H. procumbens and/or H. zeyheri. These are not interchangeable with every product sold as devil’s claw. Bring the species, extract strength and other ingredients to the pharmacist.
Know when to get help
oral sulindac 150 or 200 mg tablets can cause serious GI bleeding even without a supplement. Seek urgent care for vomiting blood or black, tarry stools, and report persistent stomach pain or unusual bleeding. Tell your prescriber about other pain medicines, aspirin and anticoagulants. A few hours of separation has not been shown to prevent an added bleeding effect.
Evidence and practical considerations
Side effects & toxicity
Added bleeding from Harpagophytum procumbens with sulindac is not established.
- Exact scope
- Specified oral Harpagophytum procumbens root preparations with oral sulindac 150 or 200 mg tablets. The monograph also covers H. zeyheri; species and extract must be checked. with Exact sulindac IN 10237. Oral prodrug reversibly reduced to active sulfide and irreversibly oxidized to inactive sulfone. Metabolites do not replace the medication identity.
- Medication form and route
- Oral
What remains uncertain
- The final monograph reports no interactions; this is absence of reports, not proof of safe co-use. No exact combination trial inspected.
Factors that may matter: Exact preparation and dose; Fasting versus fed dosing; Bleeding and ulcer history; Other medicines.
Read the supporting source summaries
Source 1: Current prescribing information
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: Prescription oral oral sulindac 150 or 200 mg tablets users; short human pharmacology studies where described.
GI and renal warnings remain despite comparatively low fecal blood loss in a short volunteer study. Hyperkalemia is reported; active sulfide and inactive sulfone have distinct roles.
How this applies: Exact current product label. Exact sulindac IN 10237. Oral prodrug reversibly reduced to active sulfide and irreversibly oxidized to inactive sulfone. Metabolites do not replace the medication identity.
Exact oral product label; no measured botanical co-use incidence. Ingredient, route, preparation and comparator differences must be retained.
Source 2: Final regulatory herbal monograph
ema.europa.eu · Source check Sep 10, 2026
Population: Adults using specified tuberous secondary root preparations.
Interaction section lists none reported. Active gastric/duodenal ulcer is a contraindication; GI symptoms are reported adverse effects.
How this applies: Regulatory assessment challenges an established bleeding claim while retaining separate ulcer precautions.
No sulindac trial; lack of reports is not proof of safety. Mixed species/preparations do not establish every H. procumbens product’s behavior.
Source 3: Medication terminology
rxnav.nlm.nih.gov · Source check Sep 10, 2026
Population: Terminology.
sulindac is IN.
How this applies: Exact identity.
Not clinical evidence.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Sources checked and article drafted. | |
| Research summary published |
Article revision: 32b015aa92abbd9e
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
Use the checker to explore your other combinations. Ask a pharmacist to review the exact products, amounts and medical conditions in your complete list.
Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.