Enhancing Gastrointestinal Tolerance - The Pr...

Enhancing Gastrointestinal Tolerance - The Promise of Mutual Prodrugs in NSAID Therapy: A Review

Author Name : Jayshree P. , Harsh C., Arshiya M., Chandan G., Misba S.

ABSTRACT Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely employed for managing pain and inflammation, but their use is associated with significant gastrointestinal adverse effects. Gastrointestinal (GI) damage, ranging from dyspepsia to serious complications like ulcers, bleeding, poses a substantial challenge in long-term NSAID therapy. This comprehensive review examines the potential of mutual prodrugs in mitigating gastrointestinal (GI) problems linked to the use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). By combining the NSAIDs with another chemical species into a single molecular entity, these mutual prodrugs present a dual approach: first, by improving the pharmacokinetic properties of the NSAID, and second, by co-delivering a cytoprotective agent to shield the GI mucosa from damage. Mutual prodrugs involve covalently linking two therapeutic agents, where one component mitigates the gastrointestinal side effects of the other. Various strategies are discussed and employed in designing mutual prodrugs, including combinations of NSAIDs with gastroprotective agents such as, antioxidants, amino acids, flavonoids, glyceride, polymers etc. A wide range of strategies have been brought out for altering the initial NSAID molecule with the aim of mitigating their adverse effects on the stomach.