Nalgesin

Nalgesin is an NSAID drug, a derivative of propanoic acid.

Indications Nalgesin

Indicated for the following disorders:

• headaches or toothaches;
• pain in the joints, muscles, and spine;
• to prevent the development of migraine or to ease its course;
• to relieve menstrual pain.

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Release form

Available in tablets, 10 pieces per blister. Each pack contains 1-2 blister strips.

Nalgesin forte is prescribed for:

• pain arising after injuries (bruises, sprains, and overloads);
• pain in the postoperative period (orthopedic, dental, gynecological, and trauma procedures);
• rheumatic pathologies (such as osteoarthritis, rheumatoid arthritis, Bechterew's disease, and gout).

Pharmacodynamics

Naproxen sodium is a NSAID. It has anti-inflammatory, analgesic and antipyretic properties. The effect of the drug on the body is due to the suppression of COX (an enzyme that participates in the processes of PG binding). Due to this, there is a decrease in PG indicators in various tissues and body fluids.

After oral administration of the drug, rapid hydrolysis of the substance occurs within the acidic environment of the gastric juice. The release of microelements of naproxen occurs, which subsequently dissolve quite quickly within the small intestine. This process promotes more complete and rapid absorption of the substance.

Pharmacokinetics

The active substance reaches peak plasma values 1-2 hours after taking the medicine. The drug values in the plasma increase in accordance with the dosage size (up to 500 mg). In the case of higher doses, the proportions of plasma values are not so pronounced. Approximately 99% of the substance is synthesized with plasma albumin (the concentration level reaches 50 mcg/ml).

About 70% of the active component is excreted unchanged, and another 30% is excreted as an inactive breakdown product (the substance 6-dimethyl-naproxen). Approximately 95% is excreted in the urine, and another 5% in the feces. The half-life of the substance is 12-15 hours and does not depend on its plasma values.

Dosing and administration

The tablets must be swallowed whole with water (1 glass). The course of therapy should be started with the minimum effective recommended doses.

For teenagers over 16 years old and adults.

For headaches/toothaches, as well as pain in the spine, joints and muscles: it is recommended to take 2 tablets (or 550 mg) 2 times a day. In this case, a maximum of 4 tablets (or 1100 mg) are allowed per day. The only exception is severe pain syndrome (except for pathologies affecting muscle tissue and bones), in the development of which it is allowed to increase the dosage to 1375 mg (or 5 tablets) per day.

In case of migraine (in case of development of the first symptoms of an attack) it is recommended to take 3 tablets of the medicine (825 mg). If it is necessary, you can take an additional 1 (275 mg) or 2 tablets, but it is allowed to do this at least 30 minutes after taking the first dose. The daily dosage is maximum (1375 mg).

When eliminating pain during menstruation, it is recommended to first take 550 mg of the medicine (2 tablets). You can also take 275 mg (1 tablet) every 6-8 hours. On the 1st day of the course, you are allowed to take no more than 1375 mg (5 tablets), and on subsequent days - a maximum of 1100 mg (or 4 tablets).

To relieve pain, the medicine should be used for 10 days. If there is no improvement, you should consult your doctor.

Use Nalgesin during pregnancy

The use of drugs in pregnant women is prohibited.

If it is necessary to use Nalgesin during lactation, it will be necessary to stop breastfeeding for this period.

Contraindications

Among the contraindications of the drug:

• individual hypersensitivity to naproxen sodium or additional components of the drug;
• intolerance to salicylates and other NSAIDs, which manifests itself in the form of urticaria, bronchial asthma, and nasal polyps;
• exacerbation or relapse of gastric ulcer/duodenal ulcer, as well as hemorrhage in the gastrointestinal tract;
• disorders in the functioning of the kidneys (CC is less than 30 ml/minute) or liver in severe form;
• presence of heart failure;
• children and adolescents under 16 years of age.

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Side effects Nalgesin

Taking pills can cause the development of the following side effects:

• lymphatic and hematopoietic systems: development of thrombocyto-, granulocyto- and leukopenia, as well as anemia (hemolytic or aplastic form) and agranulocytosis;
• organs of the immune system: occurrence of anaphylactic manifestations and hypersensitivity reactions;
• mental disorders: the appearance of abnormal dreams and seizures;
• nervous system organs: the appearance of dizziness, vertigo, headaches, as well as a state of depression, a feeling of drowsiness or weakness, sleep disorders, insomnia, problems with concentration, cognitive impairment and aseptic meningitis;
• visual organs: visual disturbances, the appearance of a cataract on the eye, the development of retrobulbar neuritis, ocular papillitis and swelling in the area of the optic nerve papilla;
• auditory organs: hearing disorders and problems with hearing, as well as tinnitus;
• cardiovascular system organs: congestive heart failure, palpitations and swelling, as well as the development of vasculitis;
• organs of the sternum with mediastinum, as well as the respiratory system: development of asthma, dyspnea, pulmonary edema, and eosinophilic pneumonia;
• metabolic processes: development of hypo- or hyperglycemia;
• Gastrointestinal organs: the appearance of abdominal pain, nausea, diarrhea or constipation, as well as stomatitis (or its ulcerative form), dyspeptic phenomena, bleeding in the gastrointestinal tract or gastric perforation. In addition, vomiting is possible (sometimes also with an admixture of blood), melena, the development of pancreatitis, colitis, ulcers in the intestines/stomach, as well as esophagitis;
• liver, as well as bile ducts: development of hepatitis or jaundice, and in addition, an increase in liver enzyme levels;
• connective tissues and bone and muscle structure: development of myasthenia or muscle pain;
• urinary system and kidneys: the appearance of hematuria, glomerular nephritis, tubulointerstitial nephritis, renal failure, nephrotic syndrome, as well as functional renal impairment and papillary necrosis;
• mammary glands and reproductive system: female infertility;
• subcutaneous layers and skin: rashes and itching, the appearance of purpura or bruises, the development of alopecia, erythema nodosum, SLE, photosensitive forms of dermatitis, as well as pustules, lichen planus, erythema multiforme, Lyell's syndrome or Stevens-Johnson syndrome, manifestations of photosensitivity (similar to the chronic form of hematoporphyria), urticaria and bullous epidermolysis;
• general disorders: feeling of thirst, hyperhidrosis, Quincke's edema, menstrual cycle disorders, development of hyperthermia (the appearance of fever with chills);
• changes in the values of instrumental and laboratory tests: an increase in creatinine levels, as well as the development of hyperkalemia.

There is information about the development of heart failure, swelling and increased blood pressure, which are associated with the use of NSAIDs.

Epidemiological data from clinical trials have shown that an increased risk of developing blood clots inside arteries (for example, developing a stroke or myocardial infarction) may be a consequence of using certain NSAIDs (especially with long-term use and high doses of the drug).

If the patient develops severe adverse reactions, the drug must be discontinued.

Overdose

In case of intentional or unintentional overdose of the drug, nausea, abdominal pain, vomiting, as well as ringing in the ears, dizziness and a feeling of irritability may develop. Cases of more severe intoxication manifest themselves in the form of melena, vomiting with blood, impaired consciousness, problems with respiratory function, as well as kidney failure and seizures.

In such situations, gastric lavage, the use of activated carbon, antacid drugs, inhibitors (proton pump or H2 receptors), and misoprostol are required. In addition, other methods aimed at eliminating the signs of the disorder are used.

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Interactions with other drugs

It is prohibited to combine Nalgesin with aspirin and other NSAID drugs, as this increases the likelihood of developing negative effects.

Combined use with cholestyramine or antacids can inhibit the absorption of naproxen, although this does not affect the amount of this substance.

The combination with cardiac glycosides can cause an exacerbation of heart failure, reduce the glomerular filtration rate, and also increase the CG levels in the blood.

After using mifepristone, it is recommended to delay taking naproxen for 8-12 days, since this drug can weaken the effect of the latter.

Caution is required when combining the drug with corticosteroids, because this combination can increase the likelihood of bleeding, as well as ulcers in the gastrointestinal tract.

The active substance of the drug may impair the process of platelet aggregation, resulting in an increase in bleeding time. This property must be taken into account when determining the duration of the bleeding period, as well as during combined use with anticoagulants.

It is prohibited to combine the drug with Naprosyn, since this drug contains the same active ingredient (naproxen).

Results of animal studies have shown that combining Nalgesin with quinolones increases the risk of developing seizures in humans.

Because naproxen is almost entirely synthesized with plasma protein, it must be combined with caution with sulfonylurea or hydantoin derivatives.

The drug is able to reduce the natriuretic properties of furosemide, and in addition, the antihypertensive effect of antihypertensive drugs.

The combined use of Nalgesin with lithium drugs increases the plasma values of the latter.

Like other drugs in the NSAID category, naproxen can reduce the antihypertensive properties of propranolol, as well as other beta-blockers. At the same time, it increases the likelihood of kidney failure in people who additionally use ACE inhibitors.

Combined use with the substance probenecid prolongs the half-life of the active component of Nalgesin, and in addition increases its plasma level in the body.

Combined use with the drug cyclosporine can increase the likelihood of developing functional problems with the kidneys.

In vitro tests showed that the combined use of the drug with zidovudine increases the plasma levels of the latter.

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Storage conditions

The medicine does not require special temperature conditions for storage. It is recommended to store the blister pack in the original package to protect it from sunlight. The storage place should be inaccessible to small children.

Shelf life

Nalgesin is permitted to be used for a period of 5 years from the date of release of the drug.