Comparative Pharmacology
Head-to-head clinical analysis: COXANTO versus SULINDAC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COXANTO versus SULINDAC.
COXANTO vs SULINDAC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selective inhibitor of soluble epoxide hydrolase (sEH), increasing levels of epoxyeicosatrienoic acids (EETs), which have vasodilatory, anti-inflammatory, and antifibrotic effects.
Non-selective cyclooxygenase (COX-1 and COX-2) inhibitor, reducing prostaglandin synthesis. Prodrug converted to active sulfide metabolite which inhibits COX enzymes.
1 g intravenous every 6 hours.
150-200 mg orally twice daily, with maximum daily dose 400 mg.
None Documented
None Documented
Terminal elimination half-life: 12-15 hours (prolonged to 24-30 hours in moderate-to-severe renal impairment, requiring dose adjustment)
Clinical Note
moderateSulindac + Digitoxin
"Sulindac may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateSulindac + Deslanoside
"Sulindac may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateSulindac + Acetyldigitoxin
"Sulindac may decrease the cardiotoxic activities of Acetyldigitoxin."
Clinical Note
moderateSulindac + Ouabain
"Sulindac may decrease the cardiotoxic activities of Ouabain."
14 hours (sulfide active metabolite); 3-4 hours (parent sulindac). Steady-state attained in 3-4 days.
Renal: 70% unchanged; biliary/fecal: 20% as metabolites; 10% other
Primarily renal (about 50% as glucuronide conjugates, 25-30% as sulfide and sulfone metabolites); biliary/fecal elimination accounts for approximately 25-30%.
Category C
Category D/X
NSAID
NSAID