Comparative Pharmacology
Head-to-head clinical analysis: DUEXIS versus PIROXICAM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUEXIS versus PIROXICAM.
DUEXIS vs PIROXICAM
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.
Nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, thereby decreasing inflammation, pain, and fever.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
10-20 mg orally once daily; maximum 20 mg/day.
None Documented
None Documented
Clinical Note
moderatePiroxicam + Gatifloxacin
"Piroxicam may increase the neuroexcitatory activities of Gatifloxacin."
Clinical Note
moderatePiroxicam + Rosoxacin
"Piroxicam may increase the neuroexcitatory activities of Rosoxacin."
Clinical Note
moderatePiroxicam + Levofloxacin
"Piroxicam may increase the neuroexcitatory activities of Levofloxacin."
Clinical Note
moderatePiroxicam + Trovafloxacin
"Piroxicam may increase the neuroexcitatory activities of Trovafloxacin."
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 elimination half-life is 50 hours (range 30-86 hours), allowing once-daily dosing. Prolonged in elderly (up to 80 hours) and in hepatic impairment.
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.
Approximately 60-70% renal (glomerular filtration and tubular secretion) as unchanged drug and metabolites; 30-40% fecal via biliary excretion. Less than 5% as unchanged drug in urine.
Category C
Category D/X
NSAID/H2 Antagonist Combination
NSAID