Which of the following NSAIDs is a prodrug that is converted into its active sulfide metabolite in the liver, potentially sparing the stomach from initial direct irritation?
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Correct answer: Sulindac
Sulindac is a sulfoxide prodrug. Because it is inactive in its ingested form, it theoretically causes less direct gastric irritation; however, its active metabolite still inhibits systemic prostaglandins, which can eventually affect the gastric mucosa.
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