Ranoxen Plus
Generic Name
Naproxen + Esomeprazole
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ranoxen plus 375 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Ranoxen Plus 375 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 and inflammation while protecting the stomach lining from NSAID-induced ulcers.
Uses & Indications
Dosage
Adults
One tablet once or twice daily, or as directed by physician.
Elderly
Lower doses may be considered due to increased risk of side effects. Consult physician.
Renal_impairment
Use with caution; dosage adjustment may be necessary. Consult physician.
How to Take
Take the tablet whole with a glass of water, preferably at least 30-60 minutes before a meal. Do not chew or crush.
Mechanism of Action
Naproxen works by inhibiting cyclooxygenase (COX-1 and COX-2) enzymes, which are involved in the production of prostaglandins, mediators of pain and inflammation. Esomeprazole, a proton pump inhibitor, reduces gastric acid secretion by irreversibly binding to and inhibiting the H+/K+-ATPase enzyme system at the secretory surface of the gastric parietal cell.
Pharmacokinetics
Onset
Naproxen: ~1 hour for pain relief. Esomeprazole: 1 hour for acid suppression.
Excretion
Naproxen: Primarily via urine (95%), small amount in feces. Esomeprazole: Primarily via urine (80%), small amount in feces.
Half life
Naproxen: ~12-17 hours. Esomeprazole: ~1-1.5 hours.
Absorption
Naproxen is rapidly and completely absorbed from the GI tract. Esomeprazole is absorbed rapidly after oral administration.
Metabolism
Naproxen: Primarily hepatic via CYP450 and glucuronidation. Esomeprazole: Hepatic via CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to Naproxen, Esomeprazole, or other NSAIDs/PPIs
- Active gastrointestinal bleeding or ulcer
- Severe renal or hepatic impairment
- Severe heart failure
- Third trimester of pregnancy
- History of asthma, urticaria, or allergic reactions after taking aspirin or other NSAIDs
Drug Interactions
SSRIs
Increased risk of GI bleeding.
Digoxin
Increased digoxin levels.
Tacrolimus
Increased risk of nephrotoxicity.
Clopidogrel
Increased risk of bleeding.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of GI ulceration.
Atazanavir, Nelfinavir
Reduced plasma concentrations of these antivirals by Esomeprazole.
Warfarin, Anticoagulants
Increased risk of bleeding.
Diuretics, ACE Inhibitors, ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include drowsiness, nausea, vomiting, epigastric pain, GI bleeding, and renal dysfunction. Management involves symptomatic and supportive measures. Gastric lavage and activated charcoal may be considered if recent ingestion.
Pregnancy & Lactation
Naproxen is contraindicated in the third trimester of pregnancy due to risk of premature closure of ductus arteriosus. Use during other trimesters or lactation only if clearly needed and potential benefits outweigh risks. Esomeprazole is generally considered safe but consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to Naproxen, Esomeprazole, or other NSAIDs/PPIs
- Active gastrointestinal bleeding or ulcer
- Severe renal or hepatic impairment
- Severe heart failure
- Third trimester of pregnancy
- History of asthma, urticaria, or allergic reactions after taking aspirin or other NSAIDs
Drug Interactions
SSRIs
Increased risk of GI bleeding.
Digoxin
Increased digoxin levels.
Tacrolimus
Increased risk of nephrotoxicity.
Clopidogrel
Increased risk of bleeding.
Methotrexate
Increased methotrexate toxicity.
Corticosteroids
Increased risk of GI ulceration.
Atazanavir, Nelfinavir
Reduced plasma concentrations of these antivirals by Esomeprazole.
Warfarin, Anticoagulants
Increased risk of bleeding.
Diuretics, ACE Inhibitors, ARBs
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include drowsiness, nausea, vomiting, epigastric pain, GI bleeding, and renal dysfunction. Management involves symptomatic and supportive measures. Gastric lavage and activated charcoal may be considered if recent ingestion.
Pregnancy & Lactation
Naproxen is contraindicated in the third trimester of pregnancy due to risk of premature closure of ductus arteriosus. Use during other trimesters or lactation only if clearly needed and potential benefits outweigh risks. Esomeprazole is generally considered safe but consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies and hospitals
Approval Status
Approved by health authorities
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have demonstrated the efficacy of Naproxen for pain and inflammation, and Esomeprazole for gastric acid suppression and prevention of NSAID-induced ulcers.
Lab Monitoring
- Complete Blood Count (CBC)
- Renal function tests (Creatinine, BUN)
- Liver function tests (ALT, AST)
- Stool occult blood test (for long-term use)
Doctor Notes
- Consider lowest effective dose for shortest duration.
- Monitor renal and hepatic function, especially in elderly or patients with pre-existing conditions.
- Educate patients on symptoms of GI bleeding and cardiovascular risks.
- Review concomitant medications for potential interactions.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not exceed the recommended dose.
- Inform your doctor about any existing medical conditions or other medications you are taking.
- Report any signs of stomach bleeding (black stools, vomiting blood) immediately.
- Avoid alcohol consumption while taking this medicine.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the 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 in some individuals. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet and stay hydrated.
- Avoid smoking, as it can worsen GI issues.
- Regular exercise may help with musculoskeletal pain.
- Manage stress effectively.
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