NSAIDs and Cardiovascular Diseases: Role of Reactive Oxygen Species

Table 1

List of NSAIDs with their recommended doses and levels in the circulation.

Generic name	Chemical name	Recommended dosages (may vary depending on the age and condition)	Levels in the circulation (μM and μg/mL) (dose dependent)	Trade name
Diclofenac	{2-[(2,6-Dichlorophenyl)amino]phenyl acetic  acid	25 mg–150 mg/day	^*5 μM (1.5 μg/mL) and 7 μM (2.0 μg/mL) [for 50 mg and 75 mg doses, respectively]	Zorvolex, Cataflam, Cambia, Voltaren, Voltaren gel, Arthrotec; (combined with misoprostol), Flector, Zipsor, Pennsaid
Indomethacin	[1-(4-Chlorobenzoyl)-5-methoxy-2-methyl-1H-indol-3-yl]acetic  acid	25 mg–200 mg/day	^*3 μM–6 μM (1 to 2 μg/mL)	Tivorbex, Indocin, Indocin SR, Indo-Lemmon, Indomethagan
Ketoprofen	2-(3-Benzoylphenyl) propanoic acid	25 mg–300 mg/day	^**2 μM to 22 μM (0.43 to 5.62 μg/mL) [50 mg dose]	Oruvail, Nexcede
Ibuprofen	2-(4-Isobutylphenyl) propanoic acid	100 mg–800 mg/day	^*97 μM–291 μM (20–60 μg/mL) [400 mg dose]	Advil, Motrin and Nurofen, Vicoprofen (combined with hydrocodone), Duexis (combined with famotidine)
Naproxen	(2S)-2-(6-Methoxy-2-naphthyl) propanoic acid	250 mg–1000 mg/day (both oral and IV)	^*377 μM (95 μg/mL); 500 mg dose once every 12 h or 1000 mg dose for 5 days	Naprosyn, EC-Naprosyn, Naprapac (copackaged with lansoprazole), Aleve, Accord, Anaprox DS, Anaprox Antalgin, Apranax, Treximet (combined with sumatriptan succinate) and Vimovo (combined with esomeprazole magnesium)
Sulindac	{(1Z)-5-Fluoro-2-methyl-1-[4-(methylsulfinyl)benzylidene]-1H-inden-3-yl}acetic  acid	200 mg–400 mg/day	^**1.4 μM–6 μM (0.5–2.0 μg/mL) constant for all doses	Clinoril
Ketorolac	5-Benzoyl-2,3-dihydro-1H-pyrrolizine-1-carboxylic  acid	10 mg–40 mg/day	^**39 μM (10 μg/mL)	Toradol, Sprix
Piroxicam	4-Hydroxy-2-methyl-N-(2-pyridinyl)-2H-1,2-benzothiazine-3-carboxamide  1,1-dioxide	0.2 mg–20 mg/day	^*5 μM to 6 μM (1.5 to 2 μg/mL) [single 20 mg dose] 9 μM to 24 μM (3–8 μg/mL) [for 20 mg repeated doses]	Feldene
Nimesulide	N-(4-Nitro-2-phenoxyphenyl)methanesulfonamide	100 mg twice daily	^**10 μM to 20 μM (2.86 to 4.58) mg/L [100 mg] [175]	Sulide, Nimalox, Mesulid, Xilox, Nise, Nexen, Nidolon
Diflunisal	2′,4′-Difluoro-4-hydroxy-3-biphenylcarboxylic  acid	250 mg–1000 mg	^**164 μM (41 μg/mL) [250 mg doses] 348 μM (87 μg/mL) [500 mg doses] and 496 μM (124 μg/mL) [single 1000 mg dose]	Dolobid
Flurbiprofen	2-(2-Fluoro-4-biphenylyl)propanoic  acid	50 mg–300 mg/day	^**60 μM (14 mg/L) [0.65 mg/kg of flurbiprofen IV] [176]	Ansaid
Mefenamic acid	2-[(2,3-Dimethylphenyl)amino]benzoic  acid	250 mg followed by 500 mg every 6 hours	^*83 μM (20 μg/mL) [250 mg single doses]	Ponstel
Tolmetin	[1-Methyl-5-(4-methylbenzoyl)-1H-pyrrol-2-yl]acetic  acid	5 mg–1800 mg/day	^**156 μM (40 μg/mL) [400 mg oral dose]	Tolectin, Tolectin DS, Tolectin 600

The table lists only those NSAIDs that have been mentioned in Table 3 along with their recommended doses and respective concentrations in the circulation. Most of the information regarding the dosages and levels in serum or plasma of the NSAIDs has been taken from the FDA approved site, http://www.drugs.com. Nimesulide is the only NSAID in the list that is not available in the USA. References for the plasma concentrations of flurbiprofen and nimesulide are given in the table. ^*Serum concentrations, ^**Plasma concentrations.