Nax-N
Generic Name
Naproxen Sodium
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nax n 250 mg tablet | ৳ 4.00 | N/A |
Description
Overview of the medicine
Naproxen Sodium is a non-steroidal anti-inflammatory drug (NSAID) used for the relief of mild to moderate pain, inflammation, and fever.
Uses & Indications
Dosage
Adults
For mild to moderate pain: 250 mg every 6 to 8 hours as needed. For chronic conditions (e.g., arthritis): 250-500 mg twice daily, not exceeding 1000 mg/day.
Elderly
Lower doses may be required due to increased sensitivity and potential for renal impairment. Start with 250 mg twice daily and adjust based on response and tolerability.
Renal_impairment
Caution advised. Lower doses and close monitoring recommended. Not recommended for severe renal impairment (creatinine clearance <30 mL/min).
How to Take
Take orally with food or milk to minimize gastrointestinal upset. Swallow the tablet whole with a full glass of water. Do not crush, chew, or break.
Mechanism of Action
It works by inhibiting the synthesis of prostaglandins, which are chemicals in the body that contribute to pain, inflammation, and fever. It non-selectively inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes.
Pharmacokinetics
Onset
Analgesic effect usually within 1 hour; anti-inflammatory effects may take up to several days.
Excretion
Primarily excreted in the urine (approximately 95%), mainly as naproxen (60%), 6-O-demethylnaproxen, and their conjugates.
Half life
Approximately 12-17 hours.
Absorption
Rapidly and completely absorbed from the gastrointestinal tract. Peak plasma concentrations are typically reached within 1-2 hours for naproxen sodium.
Metabolism
Extensively metabolized in the liver by O-demethylation to 6-O-demethylnaproxen, followed by conjugation.
Side Effects
Contraindications
- Hypersensitivity to naproxen, aspirin, or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active peptic ulcer or gastrointestinal bleeding
- Severe heart failure
- Severe renal impairment
- Severe hepatic impairment
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery (peri-operative pain)
Drug Interactions
SSRIs
Increased risk of GI bleeding.
Aspirin
Increased risk of GI side effects. Naproxen may interfere with the antiplatelet effect of low-dose aspirin.
Lithium
Increased lithium plasma levels and toxicity.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of GI ulceration and bleeding.
ACE inhibitors / ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of overdose may include drowsiness, heartburn, indigestion, nausea, vomiting, epigastric pain. More severe symptoms can include gastrointestinal bleeding, convulsions, renal failure, and respiratory depression. Management involves symptomatic and supportive care; gastric lavage and activated charcoal may be considered in acute overdose.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Avoid in the third trimester due to potential premature closure of the fetal ductus arteriosus. Use with caution during breastfeeding; low levels are excreted in breast milk.
Side Effects
Contraindications
- Hypersensitivity to naproxen, aspirin, or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- Active peptic ulcer or gastrointestinal bleeding
- Severe heart failure
- Severe renal impairment
- Severe hepatic impairment
- Third trimester of pregnancy
- Coronary artery bypass graft (CABG) surgery (peri-operative pain)
Drug Interactions
SSRIs
Increased risk of GI bleeding.
Aspirin
Increased risk of GI side effects. Naproxen may interfere with the antiplatelet effect of low-dose aspirin.
Lithium
Increased lithium plasma levels and toxicity.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of GI ulceration and bleeding.
ACE inhibitors / ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Diuretics (e.g., Furosemide)
Reduced diuretic and antihypertensive effects.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of overdose may include drowsiness, heartburn, indigestion, nausea, vomiting, epigastric pain. More severe symptoms can include gastrointestinal bleeding, convulsions, renal failure, and respiratory depression. Management involves symptomatic and supportive care; gastric lavage and activated charcoal may be considered in acute overdose.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Avoid in the third trimester due to potential premature closure of the fetal ductus arteriosus. Use with caution during breastfeeding; low levels are excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the manufacturing date, consult the product packaging for exact details.
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory bodies
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of naproxen sodium in various pain and inflammatory conditions. Ongoing post-marketing surveillance continues to monitor its long-term effects and safety profile.
Lab Monitoring
- Complete blood count (CBC) to monitor for anemia or other blood dyscrasias
- Liver function tests (LFTs) periodically
- Renal function tests (e.g., serum creatinine, BUN) periodically, especially in elderly or those with pre-existing renal impairment
- Blood pressure monitoring regularly, especially in hypertensive patients
Doctor Notes
- Prior to prescribing, assess patient's cardiovascular and gastrointestinal risk factors.
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor renal function, blood pressure, and complete blood count periodically, especially in patients on long-term therapy or with risk factors.
- Counsel patients on potential adverse effects, including GI bleeding symptoms and signs of cardiovascular events.
Patient Guidelines
- Take the medicine with food or milk to reduce stomach upset.
- Do not exceed the recommended dose or duration of treatment.
- Report any unusual bleeding, black/tarry stools, or severe abdominal pain to your doctor immediately.
- Avoid concomitant use with other NSAIDs or aspirin without consulting your doctor.
- Avoid alcohol consumption during treatment 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 continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Nax-N may cause dizziness, drowsiness, or visual disturbances. If you experience these effects, avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Quit smoking, as it can increase the risk of gastrointestinal bleeding with NSAIDs.
- Limit alcohol intake.
- Maintain a healthy and balanced diet.
- Engage in regular, moderate exercise suitable for your condition.
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