Effects of ibuprofen, naproxen, and sulindac on prostaglandins in men.

In contrast to other nonsteroidal anti-inflammatory drugs (NSAIDs), sulindac has been reported to inhibit systemic prostaglandins (PGs) while not affecting renal PGs. We studied 11 normal volunteers who received placebo, ibuprofen, naproxen, or sulindac in a randomized, double-blind fashion. After control periods assessing the effect of the NSAIDs alone, 40 mg of furosemide were administered. Overall, each of the drugs appeared similar. Renal function, plasma renin activity (PRA) and urinary PGs were not affected during control collections, while all three NSAIDs decreased thromboxane B2 (TxB2). After furosemide, all NSAIDs decreased fractional excretions of Na+ and Cl-, PRA, and TxB2 by equivalent degrees (P less than 0.05). Sulindac and ibuprofen decreased urinary PGE2 (P less than 0.05) while naproxen had no effect. None of these drugs affected the excretion of furosemide, but all decreased the pharmacodynamics of response to furosemide. In conclusion, the effects of these NSAIDs depended on the conditions of the study. In the basal state there were no renal effects but all decreased the renal response to furosemide.