Comparative Pharmacology
Head-to-head clinical analysis: DUEXIS versus HYDROCODONE BITARTRATE AND IBUPROFEN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUEXIS versus HYDROCODONE BITARTRATE AND IBUPROFEN.
DUEXIS vs HYDROCODONE BITARTRATE AND IBUPROFEN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Hydrocodone is a semisynthetic opioid agonist with selectivity for mu-opioid receptors, producing analgesia and sedation. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis, thereby providing anti-inflammatory, analgesic, and antipyretic effects.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
One tablet (hydrocodone bitartrate 5 mg/ibuprofen 200 mg) orally every 4 to 6 hours as needed for pain; maximum 5 tablets per day.
None Documented
None Documented
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).
Hydrocodone: 3.8-4.5 hours (immediate release); Ibuprofen: 1.8-2.5 hours (racemic, S-enantiomer slightly shorter). Clinical context: dosing every 4-6 hours due to hydrocodone half-life.
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.
Hydrocodone: primarily renal (60-70% as metabolites, <12% unchanged); Ibuprofen: primarily renal (90% as metabolites and conjugates, <1% unchanged), minor biliary/fecal.
Category C
Category D/X
NSAID/H2 Antagonist Combination
NSAID