Comparative Pharmacology
Head-to-head clinical analysis: NAPROSYN versus SULINDAC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NAPROSYN versus SULINDAC.
NAPROSYN vs SULINDAC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, thereby reducing prostaglandin synthesis. This results in decreased inflammation, pain, and fever.
Non-selective cyclooxygenase (COX-1 and COX-2) inhibitor, reducing prostaglandin synthesis. Prodrug converted to active sulfide metabolite which inhibits COX enzymes.
250-500 mg orally twice daily; maximum 1500 mg/day. For extended-release: 750-1000 mg orally once daily.
150-200 mg orally twice daily, with maximum daily dose 400 mg.
None Documented
None Documented
Terminal elimination half-life is 12-17 hours. This long half-life allows twice-daily dosing, but may lead to drug accumulation in elderly or renally impaired patients.
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."
14 hours (sulfide active metabolite); 3-4 hours (parent sulindac). Steady-state attained in 3-4 days.
Renal excretion of conjugated metabolites accounts for approximately 95% of a dose, with 1-2% as unchanged naproxen. Fecal excretion is minimal (<5%).
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
NSAID