Comparative Pharmacology
Head-to-head clinical analysis: PROPOXYPHENE HYDROCHLORIDE W ASPIRIN AND CAFFEINE versus SULINDAC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: PROPOXYPHENE HYDROCHLORIDE W ASPIRIN AND CAFFEINE versus SULINDAC.
PROPOXYPHENE HYDROCHLORIDE W/ ASPIRIN AND CAFFEINE vs SULINDAC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Propoxyphene is a centrally acting opioid analgesic that binds to mu-opioid receptors. Aspirin inhibits cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis. Caffeine is a CNS stimulant that may enhance analgesia.
Non-selective cyclooxygenase (COX-1 and COX-2) inhibitor, reducing prostaglandin synthesis. Prodrug converted to active sulfide metabolite which inhibits COX enzymes.
1-2 capsules orally every 4-6 hours as needed; maximum 6 capsules per day. Each capsule contains propoxyphene hydrochloride 65 mg, aspirin 325 mg, and caffeine 32.4 mg.
150-200 mg orally twice daily, with maximum daily dose 400 mg.
None Documented
None Documented
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."
Propoxyphene: 6-12 hours (up to 36 hours in overdose); norpropoxyphene: 30-36 hours. Aspirin: 2-3 hours for low doses, up to 15-30 hours in overdose. Caffeine: 3-6 hours; prolonged in liver disease.
14 hours (sulfide active metabolite); 3-4 hours (parent sulindac). Steady-state attained in 3-4 days.
Renal elimination of propoxyphene and its metabolites (mainly norpropoxyphene) accounts for approximately 70-90% of the dose; fecal excretion is minimal (<10%). Aspirin is renally eliminated as salicylates (75-90% as conjugates, 10% free), while caffeine is primarily metabolized and its metabolites are excreted renally.
Primarily renal (about 50% as glucuronide conjugates, 25-30% as sulfide and sulfone metabolites); biliary/fecal elimination accounts for approximately 25-30%.
Category D/X
Category D/X
NSAID / Antiplatelet
NSAID