Comparative Pharmacology
Head-to-head clinical analysis: DUEXIS versus ONMEL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUEXIS versus ONMEL.
DUEXIS vs ONMEL
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.
ONMEL (omacetaxine mepesuccinate) inhibits protein synthesis by binding to the 80S ribosome and interfering with chain elongation, leading to apoptosis in leukemic cells.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
50 mg orally twice daily for 14 days
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).
Terminal half-life 40–60 hours (mean 50 hours); allows once-daily dosing for systemic antifungal therapy.
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.
Primarily hepatic metabolism via CYP3A4; <1% excreted unchanged in urine; >90% eliminated as metabolites in bile and feces.
Category C
Category C
NSAID/H2 Antagonist Combination
NSAID