Comparative Pharmacology
Head-to-head clinical analysis: ARTHROTEC versus DUEXIS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARTHROTEC versus DUEXIS.
ARTHROTEC vs DUEXIS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Arthrotec is a combination of diclofenac, a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, and misoprostol, a synthetic prostaglandin E1 analog that protects the gastric mucosa by increasing mucus and bicarbonate secretion, enhancing mucosal blood flow, and promoting epithelial repair.
DUEXIS is a combination of ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, and famotidine, a histamine H2-receptor antagonist that decreases gastric acid secretion. Famotidine mitigates the risk of NSAID-induced gastric ulcers.
One tablet (diclofenac 50 mg / misoprostol 200 mcg) orally twice daily with food.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
None Documented
None Documented
Diclofenac: ~2 hours (range 1-4 h); misoprostol: 20-40 minutes (acid metabolite 1.5 h). No accumulation with repeated dosing.
Ibuprofen: 2-4 hours (terminal); requires every 6-8 hour dosing. Famotidine: 2.5-3.5 hours (normal renal function); prolonged to 20 hours or more in severe renal impairment (CrCl < 30 mL/min).
Renal: ~95% as metabolites (diclofenac: ~65% as glucuronide conjugates; misoprostol: ~80% as inactive metabolites). Biliary/fecal: <5%.
Ibuprofen: ~1% unchanged in urine, 14% as conjugated metabolites, remainder as oxidative metabolites; <1% excreted in feces. Famotidine: 65-70% unchanged in urine, 30-35% metabolized hepatic; <10% fecal.
Category C
Category C
NSAID
NSAID/H2 Antagonist Combination