Comparative Pharmacology
Head-to-head clinical analysis: INDOCIN versus VIVLODEX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: INDOCIN versus VIVLODEX.
INDOCIN vs VIVLODEX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, thereby reducing prostaglandin synthesis, which mediates inflammation, pain, and fever. It also decreases renal blood flow and may cause ductus arteriosus closure.
COX-2 inhibitor; reduces prostaglandin synthesis via inhibition of cyclooxygenase-2 (COX-2) with minimal COX-1 inhibition.
25 mg orally 2-3 times daily; maximum 200 mg/day. Intravenous: 0.5-1 mg/kg as single dose for ductus arteriosus closure.
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
Terminal elimination half-life approximately 4.5 hours (range 2.6–11.2 hours); prolonged in elderly and patients with hepatic impairment.
Terminal elimination half-life of the active moiety meloxicam is approximately 20 hours (range 12-24 h), allowing once-daily dosing in chronic pain.
Renal (60% as unchanged drug and glucuronide conjugates), biliary/fecal (33% via enterohepatic circulation).
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
NSAID