Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) have a long history in the
healthcare system due to their therapeutic potential. These NSAIDs cause ulcerogenicity, stomach
pains, gastrointestinal hemorrhage, mucosa bleeding, and pancreatitis when used moderately
and consistently. With researchers, managing the aforementioned adverse effects therapeutically
is getting increasingly difficult. One method for creating NSAID moieties with low penetration
as well as ulcerogenic properties is the prodrug technique. During the oral consumption
of NSAID-prodrugs, ulcerations, intestinal hemorrhage, and mucosa hemorrhage have significantly
decreased. Considering this background, this review focussed on NSAID prodrugs as
well as their justifications, the pathogenesis of NSAIDs inducing gastrointestinal toxicity, and
the role of different antioxidants and spacer groups. Prodrug moieties have more advantages
over parent medicines concerning both solubility and lipophilicity. In general, NSAID-class
prodrugs can successfully treat both acute and long-term inflammation and aches without causing
ulcerotoxicity and related gastrointestinal side effects, which reduces their burden from the
pharmacoeconomic perspective.
Keywords:
Prodrugs, NSAIDs, antioxidants, gastrointestinal toxicity, oxidative stress, gastroduodenal damage.
Graphical Abstract
[2]
Verma A, Das N, Dhanawat M, Shrivastava SK. Conjugation of some NSAIDs with 5-phenyl-2-aminothiazole for reduced ulcerogenicity. Thaiphesatchasan 2010; 34: 49-57.
[4]
Dhaneshwar SS, Buchade RS, Vetal S, Gautam H, Tewari KM, Karandikar HM. Synthesis, release kinetics and pharmacological profile of chimeric aceclofenac prodrug. Pharma Chem 2011; 3(3): 354-63.
[11]
Shaheed DQ, Mubarak AKH. Aziz libeg AA, Abbas HK, ALRekabi MD, Hussein AH. Design and synthesis of new derivatives of Ketoprofen linked to natural antioxidants (Thymol, Menthol and Guaiacol) as possible mutual prodrugs. World J Pharm Res 2015; 4(1): 310-9.
[22]
Nija B, Rasheed A, Kottaimuthu A. Development, characterization and pharmacological investigation of umbelliferone conjugates of NSAIDs. Iraqi J Pharm Sci 2021; 30(1)
[26]
Sinha M, Gautam L, Shukla PK, Kaur P, Sharma S, Singh TP. Current perspectives in NSAID-induced gastropathy. Mediators Inflamm 2013; 2013: 258209.
[27]
Mandal SK, Pati K, Bose A, et al. Various ester prodrugs of NSAIDs with low ulcerogenic activity. Int J Pharm Sci Rev Res 2019; 54: 45-9.
[33]
Manon B, Sharma PD. Design, synthesis and evaluation of diclofenac-antioxidant mutual prodrugs as safer NSAIDs. Indian J Chem 2009; 48(9): 1279-87.
[37]
Datar P, Shendge T. Design, synthesis and stability studies of mutual prodrugs of NSAID’s. ChemInform 2015.
[38]
Ali BT, Monther FM, Mohammed HM. Design, synthesis, and hydrolysis study of mutual prodrugs of NSAIDS with different antioxidants via glycolic acid spacer. Int J Comprehen Pharm 2012; 1(3): 3.
[39]
Sharma N. Synthesis, characterization & biological evaluation of mutual prodrugs of some selected NSAIDs conjugated with different antioxidant via different amino acids. Org Med Chem Int J 2017; 4(4): 1-5.