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Ibuprofen indometacin ester is a mutual prodrug (codrug) composed of the non-steroidal anti-inflammatory drugs (NSAIDs) ibuprofen and indomethacin linked via an ester bond. Developed and marketed in China by companies including Hangzhou Zhongmei Huadong Pharmaceutical, it is primarily indicated as an antithrombotic agent for the prevention and treatment of ischemic cardiovascular and cerebrovascular diseases, venous thrombosis, and for thrombosis prophylaxis during hemodialysis. Upon oral administration, the ester is hydrolyzed into its parent compounds, which inhibit cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. The inhibition of COX-1 in platelets reduces the synthesis of thromboxane A2, thereby inhibiting platelet aggregation. This chemical modification is intended to provide potent antiplatelet activity while potentially reducing the gastrointestinal side effects associated with the individual parent drugs. A new orally disintegrating tablet (ODT) formulation, CMCY2304, is currently under clinical investigation.
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