Napgin-Plus
Generic Name
Naproxen + Esomeprazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| napgin plus 375 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Napgin-Plus 375 mg Tablet is a combination medicine containing Naproxen (a non-steroidal anti-inflammatory drug) and Esomeprazole (a proton pump inhibitor). It is used to relieve pain and inflammation in conditions like arthritis, while also reducing the risk of stomach ulcers and other gastrointestinal problems caused by Naproxen.
Uses & Indications
Dosage
Adults
Usually one tablet (375 mg Naproxen / 20 mg Esomeprazole) once or twice daily, or as directed by the physician. Take before meals.
Elderly
Use with caution. Lower doses may be considered based on renal function and tolerability.
Renal_impairment
Use with caution. Dose adjustment may be necessary in patients with mild to moderate renal impairment. Avoid in severe renal impairment.
How to Take
Take the tablet whole with water, preferably at least 30 minutes before a meal. Do not crush, chew, or split the tablet.
Mechanism of Action
Naproxen inhibits cyclooxygenase (COX-1 and COX-2) enzymes, which are involved in the synthesis of prostaglandins, thus reducing pain and inflammation. Esomeprazole is a proton pump inhibitor that blocks the final step in gastric acid secretion, thereby reducing acid production and protecting the stomach lining from NSAID-induced damage.
Pharmacokinetics
Onset
Naproxen: Analgesia within 1-2 hours. Esomeprazole: Acid suppression within 1 hour.
Excretion
Both Naproxen and Esomeprazole and their metabolites are primarily excreted in the urine.
Half life
Naproxen: Approximately 12-17 hours. Esomeprazole: Approximately 1-1.5 hours.
Absorption
Naproxen is rapidly and completely absorbed from the GI tract. Esomeprazole is rapidly absorbed, with peak plasma concentrations occurring within 1-2 hours; its bioavailability increases with repeated dosing.
Metabolism
Naproxen is extensively metabolized in the liver by the cytochrome P450 system. Esomeprazole is extensively metabolized in the liver by CYP2C19 and CYP3A4 enzymes.
Side Effects
Contraindications
- Hypersensitivity to Naproxen, Esomeprazole, or any NSAIDs
- Active gastrointestinal bleeding or peptic ulcer disease
- Severe renal or hepatic impairment
- Severe heart failure
- Third trimester of pregnancy
- History of asthma, urticaria, or other allergic reactions after taking aspirin or other NSAIDs
Drug Interactions
Digoxin
Increased plasma digoxin levels.
Lithium
Increased plasma lithium levels.
Tacrolimus
Increased risk of nephrotoxicity.
Clopidogrel
Increased risk of bleeding.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of GI ulceration or bleeding.
Other NSAIDs or Aspirin
Increased risk of GI side effects.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
ACE Inhibitors / ARBs / Diuretics
Reduced antihypertensive effect and increased risk of renal impairment.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of GI bleeding.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, dizziness, disorientation, heartburn, nausea, vomiting, epigastric pain, and in severe cases, GI bleeding, renal dysfunction, or respiratory depression. Management is symptomatic and supportive, including gastric lavage and activated charcoal if appropriate.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential fetal harm (premature closure of the ductus arteriosus and renal dysfunction). Avoid during lactation as components may pass into breast milk.
Side Effects
Contraindications
- Hypersensitivity to Naproxen, Esomeprazole, or any NSAIDs
- Active gastrointestinal bleeding or peptic ulcer disease
- Severe renal or hepatic impairment
- Severe heart failure
- Third trimester of pregnancy
- History of asthma, urticaria, or other allergic reactions after taking aspirin or other NSAIDs
Drug Interactions
Digoxin
Increased plasma digoxin levels.
Lithium
Increased plasma lithium levels.
Tacrolimus
Increased risk of nephrotoxicity.
Clopidogrel
Increased risk of bleeding.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of GI ulceration or bleeding.
Other NSAIDs or Aspirin
Increased risk of GI side effects.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
ACE Inhibitors / ARBs / Diuretics
Reduced antihypertensive effect and increased risk of renal impairment.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of GI bleeding.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, dizziness, disorientation, heartburn, nausea, vomiting, epigastric pain, and in severe cases, GI bleeding, renal dysfunction, or respiratory depression. Management is symptomatic and supportive, including gastric lavage and activated charcoal if appropriate.
Pregnancy & Lactation
Not recommended during pregnancy, especially in the third trimester due to potential fetal harm (premature closure of the ductus arteriosus and renal dysfunction). Avoid during lactation as components may pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved for prescription use
Patent Status
Generically available (off-patent)
Clinical Trials
Extensive clinical trials have evaluated the efficacy and safety of Naproxen for pain and inflammation, and Esomeprazole for gastric acid suppression and prevention of NSAID-induced ulcers, both individually and in combination.
Lab Monitoring
- Monitor complete blood count (CBC) for long-term therapy
- Periodically assess renal function (serum creatinine, BUN)
- Monitor liver function tests (ALT, AST) if liver dysfunction is suspected
Doctor Notes
- Prescribe the lowest effective dose for the shortest possible duration consistent with individual patient treatment goals.
- Monitor for signs of GI bleeding, cardiovascular events, and renal impairment, especially in high-risk patients.
- Advise patients on proper administration and potential side effects.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not exceed the recommended dose.
- Report any unusual bleeding, black/tarry stools, or severe stomach pain immediately.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or drowsiness. If you experience these symptoms, avoid driving or operating heavy machinery.
Lifestyle Advice
- Avoid alcohol and smoking as they can worsen GI side effects.
- Maintain a healthy diet and lifestyle.
- Regular exercise as advised by your doctor.
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