Nax-N
Generic Name
Naproxen
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nax n 500 mg tablet | ৳ 7.00 | N/A |
Description
Overview of the medicine
Nax-N 500 mg Tablet contains Naproxen, a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain, inflammation, and stiffness caused by various conditions such as arthritis, tendinitis, bursitis, and menstrual cramps. It works by reducing the production of prostaglandins, substances in the body that cause inflammation and pain.
Uses & Indications
Dosage
Adults
For rheumatoid arthritis, osteoarthritis, ankylosing spondylitis: 250-500 mg orally twice daily, or 500 mg once daily. Max initial dose 1250 mg/day, then 1000 mg/day. For acute gout: 750 mg orally, then 250 mg every 8 hours until attack subsides. For mild to moderate pain, dysmenorrhea: 500 mg orally once, then 250 mg every 6-8 hours as needed, not exceeding 1250 mg/day on the first day and 1000 mg/day thereafter.
Elderly
Lower doses are recommended, typically 250 mg once or twice daily, due to increased risk of adverse effects, especially gastrointestinal and renal.
Renal_impairment
Not recommended for patients with severe renal impairment (creatinine clearance <30 mL/min). Dose reduction may be necessary for moderate impairment; close monitoring of renal function is advised.
How to Take
Take Nax-N 500 mg Tablet orally, preferably with food or milk to minimize gastrointestinal upset. Swallow the tablet whole with a full glass of water. Do not crush, chew, or break it.
Mechanism of Action
Naproxen works by reversibly inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, which are responsible for the synthesis of prostaglandins from arachidonic acid. By inhibiting prostaglandin synthesis, Naproxen reduces inflammation, pain, and fever.
Pharmacokinetics
Onset
Approximately 1 hour for analgesic effect.
Excretion
Approximately 95% of the dose is excreted in the urine as naproxen, 6-O-desmethylnaproxen, or their conjugates; small amounts are excreted in feces.
Half life
12-17 hours, allowing for twice-daily dosing.
Absorption
Rapidly and completely absorbed from the gastrointestinal tract; peak plasma concentrations achieved within 2-4 hours.
Metabolism
Primarily metabolized in the liver by demethylation and hydroxylation, followed by glucuronide conjugation.
Side Effects
Contraindications
- Hypersensitivity to naproxen or any other NSAID
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
- Active gastrointestinal bleeding or peptic ulcer disease
- Severe heart failure
- Third trimester of pregnancy
- Severe renal impairment
- Severe hepatic impairment
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity.
Methotrexate
May increase plasma methotrexate levels, leading to toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration and bleeding.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
ACE Inhibitors, ARBs, Diuretics
May reduce antihypertensive and diuretic effects; increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Antiplatelet agents (e.g., Aspirin)
Increased risk of gastrointestinal bleeding; may reduce antiplatelet effect of aspirin.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of gastrointestinal bleeding.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, heartburn, nausea, vomiting, epigastric pain. More severe symptoms can include gastrointestinal bleeding, respiratory depression, coma, acute renal failure, and anaphylactoid reactions. Management involves symptomatic and supportive care, including gastric lavage or activated charcoal if ingestion is recent.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Use during the third trimester is contraindicated due to potential premature closure of the fetal ductus arteriosus. In the first and second trimesters, use only if the potential benefit justifies the potential risk to the fetus. Naproxen is excreted in breast milk in small amounts; use with caution in breastfeeding mothers. Consult your doctor before use.
Side Effects
Contraindications
- Hypersensitivity to naproxen or any other NSAID
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
- Active gastrointestinal bleeding or peptic ulcer disease
- Severe heart failure
- Third trimester of pregnancy
- Severe renal impairment
- Severe hepatic impairment
Drug Interactions
Lithium
May increase plasma lithium levels, leading to toxicity.
Methotrexate
May increase plasma methotrexate levels, leading to toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration and bleeding.
Cyclosporine, Tacrolimus
Increased risk of nephrotoxicity.
ACE Inhibitors, ARBs, Diuretics
May reduce antihypertensive and diuretic effects; increased risk of renal impairment.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Antiplatelet agents (e.g., Aspirin)
Increased risk of gastrointestinal bleeding; may reduce antiplatelet effect of aspirin.
SSRIs (Selective Serotonin Reuptake Inhibitors)
Increased risk of gastrointestinal bleeding.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, heartburn, nausea, vomiting, epigastric pain. More severe symptoms can include gastrointestinal bleeding, respiratory depression, coma, acute renal failure, and anaphylactoid reactions. Management involves symptomatic and supportive care, including gastric lavage or activated charcoal if ingestion is recent.
Pregnancy & Lactation
Pregnancy Category C (first and second trimesters), Category D (third trimester). Use during the third trimester is contraindicated due to potential premature closure of the fetal ductus arteriosus. In the first and second trimesters, use only if the potential benefit justifies the potential risk to the fetus. Naproxen is excreted in breast milk in small amounts; use with caution in breastfeeding mothers. Consult your doctor before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, specific expiry date mentioned on the pack.
Availability
Pharmacies, Hospitals
Approval Status
Approved (Generic widely available)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Naproxen has been extensively studied in numerous clinical trials for its efficacy and safety in various pain and inflammatory conditions. These trials have established its role as a widely used NSAID.
Lab Monitoring
- Monitor complete blood count (CBC) periodically during long-term therapy.
- Assess renal function (serum creatinine, BUN) before initiation and periodically during therapy, especially in elderly or renally impaired patients.
- Monitor liver function tests (ALT, AST) periodically, particularly during long-term treatment.
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Carefully monitor patients for signs and symptoms of cardiovascular, gastrointestinal, and renal adverse events, especially in elderly patients or those with pre-existing conditions.
- Consider co-administration of gastroprotective agents (e.g., PPIs) in patients at high risk of GI complications.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Always take with food or milk to reduce stomach upset.
- Do not exceed the recommended dose or duration of treatment.
- Report any signs of unusual bleeding, black/tarry stools, or severe abdominal pain immediately.
- Be aware of the increased risk of cardiovascular events and discuss with your doctor if you have heart conditions or risk factors.
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 500 mg Tablet may cause dizziness, drowsiness, or visual disturbances in some individuals. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid excessive alcohol consumption while taking naproxen, as it may increase the risk of stomach bleeding.
- Maintain adequate hydration to support kidney function.
- Inform your doctor about all other medications and supplements you are taking.
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