Naproff

Naproff is a drug from the NSAID group.

Indications Naproffa

Shown in such cases:

• toothaches or headaches;
• migraine attacks;
• pain during menstruation;
• pain in the joints, muscles, and spine (problems with the functioning of the musculoskeletal system);
• pain that appears after injuries (due to overexertion, various bruises or sprains);
• pain after surgical operations (orthopedic, traumatological, dental, and gynecological procedures);
• rheumatic pathologies (rheumatoid arthritis, osteoarthritis, as well as gout and Bechterew's disease).

Release form

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

Pharmacodynamics

Naproxen is an NSAID, a derivative of methylacetic acid. The substance has strong analgesic, anti-inflammatory and antipyretic properties.

The active component acts by slowing down the processes of leukocyte movement, as well as weakening lysosomal activity and inflammatory conductors. The drug is a powerful lipoxygenase inhibitor, and in addition, a blocker of arachidonic acid binding processes. At the same time, it slows down the action of COX-1 elements, as well as COX-2, included in arachidonic acid, as a result of which the process of binding of intermediate PG products is inhibited. The substance also slows down platelet aggregation.

Naproxen sodium is a non-opioid analgesic and therefore does not affect the central nervous system.

Pharmacokinetics

When taken orally, the drug is quickly and almost completely absorbed from the gastrointestinal tract. The bioavailability level reaches 95%. The half-life of the active component is 12-17 hours.

Eating food does not affect the blood levels of the substance, with peak levels occurring after 1-2 hours.

The distribution volume is 0.16 l/kg. After administration in medicinal concentrations, naproxen is 99% synthesized with protein.

The active substance is metabolized in the liver, forming the element 6-O-desmethyl-naproxen. Both of these components then participate in conjugation processes.

The clearance rate of naproxen is 0.13 ml/min/kg. About 95% of the substance is excreted unchanged in the urine (and also as 6-O-desmethyl naproxen and conjugates of both components).

Dosing and administration

The tablets must be swallowed whole with water.

The course of treatment begins with the most effective dosages of the drug for the shortest possible period of time. Doses can be adjusted in accordance with the occurrence of negative manifestations and drug effects.

The standard dosage for pain relief is 550-1100 mg. At the initial stage, you need to take 1 tablet (550 mg), and then the portion can be increased in parts of 275 mg (with a maximum of 1100 mg per day). Then, during the therapy period, you need to take 275 mg of the medicine 3-4 times a day. The intervals between doses are usually approximately 6-8 hours.

Individuals who tolerate small doses of the drug well and who do not have a history of gastrointestinal pathologies are allowed to increase the daily dose to 1375 mg during periods of severe pain (severe forms of musculoskeletal disorders, pain due to migraine, acute gout attacks, and dysmenorrhea).

At the onset of the first symptoms of a migraine attack, it is necessary to drink 825 mg of the medicine (this is equal to 3 tablets of 275 mg size or 1 tablet of 550 mg and 1 tablet of 275 mg). Then, if necessary, it is allowed to drink an additional 275-550 mg, but this must be done at least 30 minutes after taking the initial portion. It is allowed to take no more than 5 tablets per day (or 1375 mg).

To relieve cramps and pain that occur during menstruation, as well as pain after the procedure of installing an IUD inside the uterus, you need to drink 550 mg of the drug. If necessary, you are allowed to drink another 275 mg. On the first day of the course, you can take up to 1375 mg of the drug, and then - no more than 1100 mg.

During an exacerbation of gout, you must first drink 825 mg of the drug, and then take it in parts of 275 mg at intervals of 8 hours until the attack stops. In this case, you cannot exceed the maximum daily dose, which is 1375 mg.

When eliminating rheumatic pathologies (osteoarthritis, Bechterew's disease or rheumatoid arthritis), the size of the first daily dose is 550-1100 mg (in two doses - morning and evening). For people with severe night pain or weak morning mobility, as well as those who switch from other NSAIDs (in high doses) to Naproff, and people with arthrosis (in which the main symptom is considered to be pain), the size of the initial daily dose will be 825-1375 mg. It is necessary to continue the therapeutic course in daily portions of 550-1100 mg, which are often divided into 2 doses. Morning and evening doses cannot be the same size - they need to be adjusted in relation to the prevailing manifestations of the disease (night pain / weak morning mobility). For some individuals, a single daily dose (in the morning or evening) may be sufficient.

The therapeutic course should be reviewed after equal time intervals. If there is no positive effect, the drug should be discontinued.

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Use Naproffa during pregnancy

The medicine should not be taken by pregnant women or during breastfeeding.

Contraindications

Among the contraindications:

• intolerance to naproxen or other components of the drug;
• the presence of urticaria or bronchial asthma and other allergic reactions that arise due to the use of salicylates and other NSAIDs;
• exacerbation of a duodenal ulcer or gastric ulcer (or their recurrence), as well as bleeding in the gastrointestinal tract;
• children under 16 years of age;
• kidney dysfunction (creatinine clearance level <30 ml/minute) or severe liver dysfunction, as well as heart failure.

Side effects Naproffa

As a result of using the drug (often in excessive doses), side effects may develop:

• Digestive system organs: most often constipation, nausea, abdominal pain, diarrhea, dyspeptic symptoms and stomatitis develop. In rare cases, bleeding in the gastrointestinal tract or gastric perforation occurs, as well as melena, hematemesis and vomiting;
• liver: occasionally liver enzyme levels increase or jaundice develops;
• nervous system organs: dizziness, vertigo, drowsiness and headaches often develop. Rarely, insomnia, muscle pain or weakness, sleep disorders, depression, nausea and problems with concentration occur;
• subcutaneous layers and skin: mainly rashes, itching, bruises appear, hyperhidrosis or purpura develops. Less often, alopecia begins or photosensitive dermatitis develops;
• auditory organs: mainly tinnitus occurs, and occasionally hearing disorders may develop;
• visual organs: visual function disorders often develop;
• cardiovascular system: mainly dyspnea, palpitations and swelling occur. Congestive heart failure is occasionally observed;
• systemic disorders: a feeling of thirst often occurs. In some cases, a fever develops, allergy symptoms appear, and the menstrual cycle is disrupted;
• urinary system organs: occasionally hematuria, renal failure, glomerulonephritis, tubulointerstitial nephritis develop, as well as nephrotic syndrome and necrotic papillitis;
• lymph and hematopoietic system: thrombocyto-, granulocyto- or leukopenia and eosinophilia occasionally occur;
• Respiratory system: in some cases, eosinophilic pneumonia is observed.

Side effects that could not be linked to the drug:

• lymph and hematopoietic system: development of anemia (hemolytic or aplastic form);
• nervous system organs: cognitive impairment or aseptic meningitis;
• skin and subcutaneous layers: erythema multiforme, Lyell's or Stevens-Johnson syndromes, manifestations of photophobia (similar to chronic hematoporphyria), urticaria, and hereditary pemphigus;
• digestive tract organs: development of ulcerative stomatitis;
• cardiovascular system organs: occurrence of vasculitis;
• systemic disorders: hypo- or hyperglycemia, Quincke's edema.

In case of development of severe negative reactions it is necessary to stop using the medicine.

Overdose

Intentional or unintentional overdose may cause vomiting, abdominal pain, nausea, ringing in the ears, dizziness, drowsiness or irritability. Severe intoxication may cause melena, vomiting of blood, respiratory or consciousness disorders, renal failure and convulsions.

To get rid of symptoms, gastric lavage, activated carbon (0.5 g/kg), and in addition misoprostol with antacid drugs and H2 inhibitors and proton pump inhibitors are required. Symptomatic therapy is also performed.

Interactions with other drugs

The component naproxen is capable of weakening platelet adhesion, which prolongs the bleeding period. This feature must be taken into account when determining the bleeding period, as well as in the case of combination with anticoagulants.

Since the drug is synthesized in large quantities with plasma protein, it is necessary to combine it with sulfonylurea derivatives, as well as hydantoin, with caution.

When used simultaneously with furosemide, its natriuretic effect decreases. When combined with antihypertensive drugs, their effectiveness decreases. The drug can also increase the plasma level of lithium.

Naproff reduces the tubular excretion of methotrexate, as a result of which the toxic properties of the latter may increase when these drugs are combined.

Combination with probenecid prolongs the biological half-life and increases plasma levels of naproxen.

When combined with cyclosporine, the likelihood of developing functional renal disorders may increase.

Like other NSAIDs, this medication may increase the risk of kidney problems when used in combination with ACE inhibitors.

In vitro tests have shown that the combination of the drug with zidovudine increases the plasma levels of the latter.

When combined with antacid drugs that contain aluminum and magnesium, as well as sodium bicarbonate, the absorption rate of the active substance of the drug decreases.

Combining Naproff with prednisolone may significantly increase the plasma level of the latter.

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Storage conditions

The tablets must be kept in a place where moisture does not penetrate and inaccessible to small children. Temperature level – 25°С.

Shelf life

Naproff can be used for a period of 3 years from the date of release of the drug.