Napren
Generic Name
Naproxen
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| napren 500 mg tablet | ৳ 9.03 | ৳ 54.18 |
Description
Overview of the medicine
Naproxen is a non-steroidal anti-inflammatory drug (NSAID) used for the relief of mild to moderate pain, fever, and inflammation. It works by reducing hormones that cause pain and inflammation in the body.
Uses & Indications
Dosage
Adults
For rheumatoid arthritis, osteoarthritis, ankylosing spondylitis: 250-500 mg twice daily. Maximum initial daily dose is 1250 mg; thereafter, 1000 mg daily. For acute gout: 750 mg orally, followed by 250 mg every 8 hours until the attack subsides. For dysmenorrhea: 500 mg orally as an initial dose, followed by 250 mg every 6-8 hours as needed.
Elderly
Lower doses are recommended due to increased risk of adverse effects, especially GI bleeding and renal impairment. Initiate at the lowest effective dose.
Renal_impairment
Use with caution. Dose reduction may be necessary for mild to moderate impairment. Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min).
How to Take
Take orally, preferably with food or milk to minimize gastrointestinal upset. Swallow the tablet whole with a glass of water.
Mechanism of Action
Naproxen non-selectively inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. This inhibition leads to a reduction in prostaglandin synthesis, which are mediators of inflammation, pain, and fever.
Pharmacokinetics
Onset
Onset of pain relief typically occurs within 1 hour.
Excretion
Mainly excreted in the urine (approximately 95%) as naproxen, 6-O-desmethylnaproxen, and their conjugates. A small amount is excreted in feces.
Half life
Approximately 12-17 hours.
Absorption
Rapidly and completely absorbed from the gastrointestinal (GI) tract. Peak plasma concentrations are reached within 2-4 hours after oral administration.
Metabolism
Extensively metabolized in the liver, primarily by demethylation to 6-O-desmethylnaproxen, followed by conjugation.
Side Effects
Contraindications
- Hypersensitivity to naproxen or any other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active peptic ulcer disease or gastrointestinal bleeding
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
Drug Interactions
Lithium
Increased plasma lithium levels, potentially leading to toxicity.
Methotrexate
Increased methotrexate toxicity by reducing its renal clearance.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Other NSAIDs or Aspirin
Increased risk of adverse effects, particularly GI adverse effects. Concurrent use should be avoided.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of gastrointestinal bleeding.
Diuretics (e.g., Furosemide) and ACE Inhibitors (e.g., Lisinopril)
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, heartburn, nausea, vomiting, epigastric pain, and occasionally seizures. Management involves symptomatic and supportive care. Gastric lavage or activated charcoal may be considered if ingestion was recent (within 1 hour). Hemodialysis is not effective.
Pregnancy & Lactation
Pregnancy Category C in the 1st and 2nd trimesters, Category D in the 3rd trimester. Avoid use in late pregnancy due to potential for premature closure of the fetal ductus arteriosus. Use with caution during lactation as naproxen is excreted into breast milk.
Side Effects
Contraindications
- Hypersensitivity to naproxen or any other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active peptic ulcer disease or gastrointestinal bleeding
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
- Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
Drug Interactions
Lithium
Increased plasma lithium levels, potentially leading to toxicity.
Methotrexate
Increased methotrexate toxicity by reducing its renal clearance.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Other NSAIDs or Aspirin
Increased risk of adverse effects, particularly GI adverse effects. Concurrent use should be avoided.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of gastrointestinal bleeding.
Diuretics (e.g., Furosemide) and ACE Inhibitors (e.g., Lisinopril)
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, heartburn, nausea, vomiting, epigastric pain, and occasionally seizures. Management involves symptomatic and supportive care. Gastric lavage or activated charcoal may be considered if ingestion was recent (within 1 hour). Hemodialysis is not effective.
Pregnancy & Lactation
Pregnancy Category C in the 1st and 2nd trimesters, Category D in the 3rd trimester. Avoid use in late pregnancy due to potential for premature closure of the fetal ductus arteriosus. Use with caution during lactation as naproxen is excreted into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from the date of manufacture, depending on storage conditions.
Availability
Available in pharmacies nationwide
Approval Status
Approved by regulatory authorities
Patent Status
Expired
WHO Essential Medicine
YesClinical Trials
Naproxen has been extensively studied in numerous clinical trials to evaluate its efficacy and safety in various inflammatory and painful conditions, leading to its widespread use.
Lab Monitoring
- Complete Blood Count (CBC) for anemia and bleeding risk
- Renal function tests (serum creatinine, BUN) for kidney impairment
- Liver function tests (ALT, AST) for liver damage
- Stool occult blood test for gastrointestinal bleeding (especially with long-term use)
Doctor Notes
- Prioritize lowest effective dose for shortest duration possible to minimize risks, especially in elderly and high-risk patients.
- Assess cardiovascular and gastrointestinal risk factors before initiating therapy.
- Consider co-administration with a proton pump inhibitor (PPI) or misoprostol in patients at high risk of GI complications.
- Monitor renal function, blood pressure, and CBC periodically during prolonged therapy.
Patient Guidelines
- Take exactly as prescribed by your doctor. Do not exceed the recommended dose.
- Always take with food or milk to reduce stomach upset.
- Do not take with other NSAIDs (e.g., ibuprofen, celecoxib) or aspirin without consulting your doctor.
- Report any signs of unusual bleeding, black/tarry stools, severe stomach pain, or swelling immediately.
- Avoid alcohol while taking this medicine as it may increase the risk of stomach bleeding.
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 resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Napren may cause dizziness, drowsiness, or visual disturbances. If you experience these side effects, avoid driving or operating machinery.
Lifestyle Advice
- Limit alcohol intake during treatment.
- Stay hydrated by drinking plenty of fluids.
- Follow a balanced diet and engage in moderate exercise as advised by your doctor.
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