Comparative Pharmacology
Head-to-head clinical analysis: DUEXIS versus VOLTAREN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUEXIS versus VOLTAREN.
DUEXIS vs VOLTAREN
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.
Diclofenac inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, thereby providing anti-inflammatory, analgesic, and antipyretic effects.
One tablet (800 mg ibuprofen/26.6 mg famotidine) orally three times daily.
Oral: 50-100 mg every 8-12 hours; maximum 150 mg/day. IM: 75 mg once daily for up to 2 days. Topical gel: apply 2-4 g to affected area 4 times 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).
Terminal elimination half-life is approximately 2 hours (range 1.2–2.5 hours) for diclofenac; this short half-life supports multiple daily dosing. The half-life is not significantly altered in renal impairment but may be prolonged in hepatic disease.
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 65% of a dose is excreted renally as unchanged drug and glucuronide conjugates, with about 35% eliminated via biliary/fecal routes as metabolites.
Category C
Category C
NSAID/H2 Antagonist Combination
NSAID