Comparative Pharmacology
Head-to-head clinical analysis: ACETAMINOPHEN AND IBUPROFEN versus ZIPSOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACETAMINOPHEN AND IBUPROFEN versus ZIPSOR.
ACETAMINOPHEN AND IBUPROFEN vs ZIPSOR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Acetaminophen is a centrally acting analgesic and antipyretic whose exact mechanism is not fully understood, but is thought to involve inhibition of cyclooxygenase (COX) in the brain and modulation of cannabinoid receptors. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that non-selectively inhibits COX-1 and COX-2, reducing prostaglandin synthesis.
Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2), reducing prostaglandin synthesis involved in inflammation, pain, and fever. It has no significant inhibition of COX-1 at therapeutic doses.
Oral: Acetaminophen 325 mg and ibuprofen 200 mg, 1-2 tablets every 6 hours as needed, not exceeding 6 tablets/24 hours.
50 mg orally three times daily
None Documented
None Documented
Acetaminophen: 2-3 hours (normal hepatic function). Ibuprofen: 2-4 hours (immediate-release); prolonged in overdose or hepatic impairment.
2-4 hours (terminal); clinical context: short half-life necessitates frequent dosing for sustained relief; prolonged in hepatic impairment
Acetaminophen: renal excretion of metabolites (glucuronide 55%, sulfate 30%, cysteine/mercapturate <10%); <5% unchanged. Ibuprofen: renal excretion of metabolites (conjugates) 90%; <10% unchanged; minor biliary/fecal.
Renal: ~60% unchanged; biliary/fecal: ~30% as metabolites; remainder as glucuronide conjugates
Category D/X
Category C
NSAID
NSAID