Naprox-Plus
Generic Name
Naproxen 500 mg + Esomeprazole 20 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| naprox plus 500 mg tablet | ৳ 15.00 | ৳ 150.00 |
Description
Overview of the medicine
Naprox-Plus 500 mg tablet is a combination medicine 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 caused by conditions like arthritis, while Esomeprazole helps protect the stomach from potential gastrointestinal side effects of Naproxen.
Uses & Indications
Dosage
Adults
Usually one tablet twice daily or as directed by physician. Should be taken at least 30 minutes before food.
Elderly
Use with caution; lower doses may be considered. Monitor for adverse effects.
Renal_impairment
Not recommended for severe renal impairment; dose adjustment needed for moderate impairment with caution.
How to Take
Administer orally with food or milk to minimize gastrointestinal upset. For optimal Esomeprazole absorption, take at least 30 minutes before food. Swallow whole; do not crush or chew.
Mechanism of Action
Naproxen inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, thereby exerting anti-inflammatory, analgesic, and antipyretic effects. Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by inhibiting the H+/K+-ATPase enzyme system in the gastric parietal cells.
Pharmacokinetics
Onset
Pain relief within 1-2 hours for Naproxen. Esomeprazole acid suppression within 1 hour.
Excretion
Naproxen: Primarily via urine (95%), mainly as metabolites. Esomeprazole: Primarily via urine and feces as metabolites.
Half life
Naproxen: 12-17 hours. Esomeprazole: approximately 1.5 hours.
Absorption
Naproxen is rapidly and completely absorbed from the GI tract. Esomeprazole is rapidly absorbed after oral administration.
Metabolism
Naproxen: Extensively metabolized in the liver by cytochrome P450 enzymes (primarily CYP2C9). Esomeprazole: Extensively metabolized in the liver by CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to naproxen, esomeprazole, or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAID intake
- Active gastrointestinal bleeding or peptic ulcer
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
Drug Interactions
SSRIs
Increased risk of GI bleeding.
Warfarin
Increased risk of bleeding.
Clopidogrel
Increased risk of bleeding.
Methotrexate
Increased methotrexate toxicity.
ACE inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Diuretics (e.g., Furosemide)
Reduced diuretic effect.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include lethargy, drowsiness, epigastric pain, nausea, vomiting, and gastrointestinal bleeding. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Category C in first and second trimesters, D in third trimester (due to naproxen). Use with caution during lactation; small amounts may pass into breast milk. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to naproxen, esomeprazole, or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAID intake
- Active gastrointestinal bleeding or peptic ulcer
- Severe heart failure
- Severe renal or hepatic impairment
- Third trimester of pregnancy
Drug Interactions
SSRIs
Increased risk of GI bleeding.
Warfarin
Increased risk of bleeding.
Clopidogrel
Increased risk of bleeding.
Methotrexate
Increased methotrexate toxicity.
ACE inhibitors/ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Diuretics (e.g., Furosemide)
Reduced diuretic effect.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include lethargy, drowsiness, epigastric pain, nausea, vomiting, and gastrointestinal bleeding. Management involves symptomatic and supportive care. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Category C in first and second trimesters, D in third trimester (due to naproxen). Use with caution during lactation; small amounts may pass into breast milk. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Multiple clinical trials have demonstrated the efficacy of naproxen for pain and inflammation and esomeprazole for gastric protection, with studies supporting their fixed-dose combination in reducing NSAID-induced gastrointestinal side effects.
Lab Monitoring
- Complete blood count (CBC)
- Liver function tests (LFTs)
- Kidney function tests (KFTs) periodically, especially with long-term use
Doctor Notes
- Monitor patients with cardiovascular risk factors closely.
- Advise patients to report any GI symptoms promptly, especially black, tarry stools.
- Consider lowest effective dose for shortest duration to minimize risks.
- Educate patients on proper administration to enhance gastroprotection.
Patient Guidelines
- Take exactly as prescribed.
- Do not exceed recommended dose.
- Report any unusual bleeding or bruising immediately.
- Avoid alcohol while taking this medicine.
- Do not lie down for at least 30 minutes after taking the tablet.
Missed Dose Advice
Take the missed dose 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.
Driving Precautions
May cause dizziness or drowsiness; exercise caution when driving or operating machinery.
Lifestyle Advice
- Maintain a healthy and balanced diet.
- Avoid smoking.
- Limit alcohol intake.
- Engage in light exercise if pain allows.
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Global Brand Names
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