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Acemetacin is a non-steroidal anti-inflammatory drug (NSAID) used primarily for the treatment of pain and inflammation associated with conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and other musculoskeletal disorders. It is a carboxymethyl ester derivative of indometacin and acts as a prodrug that is metabolized in the body to its active form, indomethacin. The primary mechanism of action involves non-selective inhibition of cyclooxygenase (COX) enzymes—specifically prostaglandin G/H synthase 1 (COX-1) and prostaglandin G/H synthase 2 (COX-2)—leading to reduced synthesis of pro-inflammatory prostaglandins. Acemetacin was developed by E. Merck and Company in Germany with the aim of providing an NSAID with improved gastric tolerability compared to indometacin; clinical studies suggest it causes less gastric damage than its parent compound[1][2][3][5][6][7].
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