Comparative Pharmacology
Head-to-head clinical analysis: DUEXIS versus SULINDAC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUEXIS versus SULINDAC.
DUEXIS vs SULINDAC
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.
Non-selective cyclooxygenase (COX-1 and COX-2) inhibitor, reducing prostaglandin synthesis. Prodrug converted to active sulfide metabolite which inhibits COX enzymes.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
150-200 mg orally twice daily, with maximum daily dose 400 mg.
None Documented
None Documented
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."
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).
14 hours (sulfide active metabolite); 3-4 hours (parent sulindac). Steady-state attained in 3-4 days.
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 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/H2 Antagonist Combination
NSAID