Comparative Pharmacology
Head-to-head clinical analysis: DUEXIS versus VIVLODEX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUEXIS versus VIVLODEX.
DUEXIS vs VIVLODEX
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.
COX-2 inhibitor; reduces prostaglandin synthesis via inhibition of cyclooxygenase-2 (COX-2) with minimal COX-1 inhibition.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
Once daily oral administration of 100 mg or 200 mg capsules. The recommended dose is 100 mg once daily; dose may be increased to 200 mg once daily if response is inadequate. Maximum daily dose: 200 mg.
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 elimination half-life of the active moiety meloxicam is approximately 20 hours (range 12-24 h), allowing once-daily dosing in chronic pain.
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.
VIVLODEX is a meloxicam NSAID prodrug. Following hydrolysis to meloxicam, excretion is primarily hepatic (metabolism) and renal (urine). Approximately 50% of meloxicam dose is excreted in urine as metabolites and <5% as parent drug; about 40% in feces. Biliary excretion is minor.
Category C
Category C
NSAID/H2 Antagonist Combination
NSAID