Nalgezin

Nalgezin is a drug of NSAID, a propanoic acid derivative.

[1]

Indications of the nalgezin

It is indicated for such violations:

• headaches or toothaches;
• pain in the joints, muscles, and spine;
• To prevent the development of migraine or weaken its course;
• for getting rid of pain during menstruation.

[2], [3]

Release form

Produced in tablets, 10 pieces on the 1st blister. Inside a single pack contains 1-2 blister plates.

Nalgezin forte is prescribed for:

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

Pharmacodynamics

Naproxen sodium is an 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 is a participant in the GH binding process). Because of this, there is a decrease in GHG indices in various tissues and body fluids.

After oral administration of the drug, a rapid hydrolysis of the substance takes place inside the acidic medium of the gastric juice. There is a release of naproxen microelements, which subsequently dissolve rather quickly within the small intestine. This process promotes a more complete and rapid absorption of the substance.

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Pharmacokinetics

Peak plasma values of the active substance reaches 1 to 2 hours after the drug is consumed. The parameters of drugs inside the plasma increase in accordance with the sizes of dosages (up to a size of 500 mg). In the case of higher doses, the proportions of the plasma values are not so pronounced. Approximately 99% of the substance is synthesized with plasma albumin (concentration level reaches 50 μg / ml).

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

Use of the nalgezin during pregnancy

Use of drugs in pregnant women is prohibited.

If you want to use Nalgezin during lactation, it will be necessary at this time to cancel breastfeeding.

Contraindications

Among the contraindications of drugs:

• individual hypersensitivity to naproxen sodium or additional elements of the drug;
• intolerance to salicylates and other NSAIDs, which manifests itself in the form of hives, bronchial asthma, and polyps in the nose;
• exacerbation or relapse of gastric ulcer / ulcer of the duodenum intestine, as well as hemorrhage in the gastrointestinal tract;
• disorders in the work of the kidneys (QC is less than 30 ml / minute) or liver in severe form;
• presence of heart failure;
• children and teenagers under 16 years of age.

[5], [6]

Side effects of the nalgezin

The use of tablets can lead to the development of such side effects:

• lymphatic and hematopoietic systems: development of thrombocyte, granulocyte and leukopenia, and in addition to anemia (hemolytic or aplastic form) and agranulocytosis;
• organs of the immune system: the occurrence of anaphylactic manifestations and reactions of hypersensitivity;
• mental disorders: the occurrence of abnormal dreams and seizures;
• organs of the National Assembly: the appearance of vertigo, vertigo, headaches, and in addition, a state of depression, a feeling of drowsiness or weakness, a sleep disorder, insomnia, trouble concentrating, cognitive impairment and an aseptic form of meningitis;
• visual organs: visual disturbances, the appearance of a thorn in the eye, the development of retrobulbar neuritis, ocular papillitis, and puffiness in the area of the nipple of the optic nerve;
• auditory organs: hearing disorders and hearing problems, as well as tinnitus;
• CAS organs: a congestive form of heart failure, palpitations and swelling, and the development of vasculitis;
• organs of the sternum with mediastinum, as well as respiratory system: development of asthma, dyspnoea, pulmonary edema, and eosinophilic pneumonia;
• metabolic processes: development of hypo- or hyperglycemia;
• Gastrointestinal organs: the appearance of abdominal pains, nausea, diarrhea or constipation, but also stomatitis (or ulcerative form), dyspeptic phenomena, bleeding in the gastrointestinal tract, or gastric perforation. In addition, vomiting (sometimes also with a trace of blood), melena, the development of pancreatitis, colitis, ulcers in the intestine / stomach, and also esophagitis is possible;
• liver, as well as bile ducts: the development of hepatitis or jaundice, and in addition an increase in liver enzymes;
• connective tissue and structure of bones and muscles: the development of myasthenia gravis or muscle pain;
• urinary system and kidneys: the appearance of hematuria, glomerular nephritis, tubulointerstitial nephritis, kidney failure, nephrotic syndrome, and in addition 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, nodosa erythema, SLE, photosensitive forms of dermatitis, and besides pustules, red flat lichen, erythema multiforme, Lyell syndrome or Stevens-Johnson, photosensitivity on the chronic form of hematoporphyria), hives and bullous epidermolysis;
• general disorders: thirst, hyperhidrosis, Quincke edema, menstrual cycle disorder, development of hyperthermia (fever with chills);
• changes in the values of instrumental, as well as laboratory tests: an increase in creatinine, as well as the development of hyperkalemia.

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

Epidemiological information with clinical trials has shown that increasing the likelihood of blood clots in the arteries (for example, the development of a stroke or myocardial infarction) may result from the use of individual NSAIDs (in particular, long-term use and high dosages of drugs).

If the patient develops severe negative reactions, it is required to cancel the medicine.

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Dosing and administration

Tablets should be swallowed completely, washed down with water (1 cup). The course of therapy should begin with the minimum effective recommended dosage.

For teenagers over 16 years of age and adults.

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

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

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

To relieve pain, the drug should be used within 10 days. If there is no improvement, consult your doctor.

Overdose

With deliberate or unintentional drug overdose, it is possible to develop nausea, abdominal pain, vomiting, and in addition ringing in the ears, dizziness and irritability. Cases of more severe intoxication are manifested in the form of melena, vomiting with blood, a disorder of consciousness, problems with respiratory function, and in addition, 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 are applied to eliminate signs of violation.

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Interactions with other drugs

It is forbidden to combine Nalgezin with aspirin and other NSAID medicines, as this increases the likelihood of developing negative effects.

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

Combination with cardiac glycosides can cause an exacerbation of heart failure, reduce the rate of glomerular filtration, and in addition increase the indices of SG inside the blood.

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

Caution is required when the drug is combined 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 can worsen the process of gluing together platelets, resulting in longer bleeding time. This property needs to be considered when determining the duration of the bleeding period, as well as during combined use with anticoagulants.

It is forbidden to combine the medicine with naprosin, since this drug contains the same active ingredient (naproxen).

The results of tests conducted on animals showed that when a combination of Nalgezin and quinolones in humans, the risk of developing seizures increases.

Because naproxen almost the whole is synthesized with plasma protein, it must be carefully combined with derivatives of sulfonylurea or hydantoin.

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

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

Like other drugs included in the category of NSAIDs, naproxen is able to reduce the antihypertensive properties of propranolol, as well as other β-blockers. Together with this, it increases the likelihood of developing kidney failure in people who additionally use ACE inhibitors.

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

Combined drug taking with a drug, cyclosporine can increase the likelihood of developing functional problems with the kidneys.

In vitro tests, it was possible to determine that the combined use of the drug with zidovudine increases the plasma indices of the latter.

[10], [11], [12]

Storage conditions

The medicine does not require special temperature conditions for maintenance. It is recommended to store the blister plate in the original pack to protect it from exposure to sunlight. Keep out of reach of small children.

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Shelf life

Nalgezin is allowed to be used in the period of 5 years from the date of release of the medicinal product.