Comparative Pharmacology
Head-to-head clinical analysis: DUEXIS versus VIMOVO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUEXIS versus VIMOVO.
DUEXIS vs VIMOVO
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.
VIMOVO (esomeprazole and naproxen) is a fixed-dose combination. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), decreasing prostaglandin synthesis, thereby reducing inflammation, pain, and fever. Esomeprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by inhibiting the H+/K+ ATPase in gastric parietal cells. The combination is intended to reduce the risk of NSAID-associated gastric ulcers.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
One tablet (naproxen 500 mg/esomeprazole 20 mg) orally twice daily.
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).
Naproxen: 12-17 hours (prolonged in elderly and renal impairment; dosing interval typically 12 hours). Esomeprazole: 1-1.5 hours (metabolized by CYP2C19 and CYP3A4; no accumulation after repeated dosing).
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.
Renal 50% as naproxen metabolites, <1% unchanged naproxen; less than 1% excreted unchanged in feces as esomeprazole; esomeprazole metabolites excreted in urine 80% and feces 20%.
Category C
Category C
NSAID/H2 Antagonist Combination
NSAID/PPI Combination