Napaxin Plus
Generic Name
Naproxen and Esomeprazole Magnesium
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| napaxin plus 375 mg tablet | ৳ 13.00 | ৳ 130.00 |
Description
Overview of the medicine
Napaxin Plus 375 mg tablet is a combination medication containing Naproxen, a non-steroidal anti-inflammatory drug (NSAID), and Esomeprazole, a proton pump inhibitor (PPI). It is used to relieve pain, inflammation, and stiffness while also reducing the risk of developing stomach ulcers in patients who are at high risk due to NSAID use.
Uses & Indications
Dosage
Adults
One tablet twice daily (morning and evening) at least 30 minutes before meals.
Elderly
Use with caution; consider lower doses. Renal function should be monitored.
Renal_impairment
Contraindicated in severe renal impairment. Use with caution in mild to moderate impairment; dose adjustment may be necessary.
How to Take
Take the tablet whole with water, at least 30 minutes before a meal. Do not crush, chew, or split the tablet.
Mechanism of Action
Naproxen works by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, which are involved in the synthesis of prostaglandins, mediators of pain and inflammation. Esomeprazole reduces gastric acid secretion by irreversibly blocking the H+/K+-ATPase proton pump in parietal cells, thereby preventing NSAID-induced gastric damage.
Pharmacokinetics
Onset
Naproxen: ~1 hour for pain relief. Esomeprazole: Acid suppression begins within 1 hour.
Excretion
Naproxen and its metabolites are primarily excreted in the urine. Esomeprazole metabolites are primarily excreted in the urine and feces.
Half life
Naproxen: 12-17 hours. Esomeprazole: 1-1.5 hours.
Absorption
Naproxen is rapidly and completely absorbed from the GI tract. Esomeprazole is rapidly absorbed after oral administration.
Metabolism
Naproxen is extensively metabolized in the liver by CYP enzymes. Esomeprazole is extensively metabolized in the liver by CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Known hypersensitivity to naproxen, esomeprazole, or other NSAIDs/PPIs
- Patients with asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Severe renal impairment
- Late stages of pregnancy (third trimester)
Drug Interactions
Warfarin
Increased risk of bleeding.
Clopidogrel
Reduced antiplatelet effect of clopidogrel due to esomeprazole.
Methotrexate
Increased methotrexate toxicity.
Citalopram, Escitalopram
Increased risk of GI bleeding due to esomeprazole's effect.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effect.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose symptoms may include drowsiness, heartburn, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered if recent ingestion. Hemodialysis is unlikely to be beneficial.
Pregnancy & Lactation
Pregnancy Category C (first and second trimester), D (third trimester for NSAIDs). Avoid use during the third trimester due to potential premature closure of the fetal ductus arteriosus. Use during lactation is not recommended as naproxen is excreted in breast milk.
Side Effects
Contraindications
- Known hypersensitivity to naproxen, esomeprazole, or other NSAIDs/PPIs
- Patients with asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Severe renal impairment
- Late stages of pregnancy (third trimester)
Drug Interactions
Warfarin
Increased risk of bleeding.
Clopidogrel
Reduced antiplatelet effect of clopidogrel due to esomeprazole.
Methotrexate
Increased methotrexate toxicity.
Citalopram, Escitalopram
Increased risk of GI bleeding due to esomeprazole's effect.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effect.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose symptoms may include drowsiness, heartburn, nausea, vomiting, epigastric pain, and gastrointestinal bleeding. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered if recent ingestion. Hemodialysis is unlikely to be beneficial.
Pregnancy & Lactation
Pregnancy Category C (first and second trimester), D (third trimester for NSAIDs). Avoid use during the third trimester due to potential premature closure of the fetal ductus arteriosus. Use during lactation is not recommended as naproxen is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months
Availability
Pharmacies
Approval Status
Approved
Patent Status
Generic available
Clinical Trials
Numerous clinical trials have demonstrated the efficacy of naproxen in pain and inflammation, and esomeprazole in acid suppression. Combination trials have shown superiority in reducing GI adverse events compared to naproxen alone.
Lab Monitoring
- Complete Blood Count (CBC)
- Liver function tests (LFTs)
- Renal function tests (RFTs)
Doctor Notes
- Prescribe with caution in patients with a history of cardiovascular disease or GI bleeding.
- Monitor renal function and blood pressure regularly during long-term therapy.
- Educate patients on symptoms of GI bleeding and cardiovascular events.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not exceed the recommended dose.
- Report any signs of unusual bleeding or stomach pain immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
May cause dizziness or drowsiness. Avoid driving or operating machinery if affected.
Lifestyle Advice
- Avoid alcohol consumption as it may increase the risk of stomach problems.
- Do not smoke.
- Maintain a healthy diet.
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