Naprosyn (Naproxen). Dosage, Side Effects, Interactions
Naprosyn (Naproxen) is a prostaglandin synthesis inhibitor and is used to treat pain, reduce fever and reduce inflammation.
Naproxen belongs to the active substance group of non-steroidal anti-inflammatory drugs (NSAIDs) and is used as an analgesic, fever-reducing and anti-inflammatory drug. Particularly in the case of acute arthritis and gout attacks , chronic and rheumatoid arthritis as well as chronic polyarthritis, Bechterew’s disease and other inflammatory rheumatic diseases of the spine, irritation in arthroses and spondylarthroses, inflammatory soft-tissue rheumatic diseases, painful swelling and inflammation after injuries, cramp-like symptoms during menstrual bleeding and after insertion of a IUD is given for symptomatic treatment.
How Naprosyn (Naproxen) works
Various messenger substances are involved in the development of pain in the body. One of these messengers is prostaglandin, which is released when the body is damaged and makes the pain receptors more sensitive. As a result, they react faster and transmit the pain signal to the brain, where the actual pain originates. Naproxen inhibits the synthesis of the messenger substance prostaglandin by blocking cyclooxygenases 1 and 2. The transmission of pain to the brain, which results in the pain-relieving effect, is interrupted.
Orally given, naproxen is completely absorbed in the small intestine and partly in the stomach. 99% of the active substance is bound to proteins in the plasma. The bioavailability is 80 to 100%. The maximum plasma level is reached after two to four hours. The half-life is between 10 and 18 hours. It is broken down in the liver into two metabolites by glucuronidation and demethylation. The metabolites are then excreted exclusively via the kidneys. When given intravenously, about 10% is eliminated unchanged via the kidneys, the rest is metabolized in the liver and then eliminated via the kidneys.
Dosage of Naprosyn (Naproxen)
Naproxen is available as 220 mg, 250 mg, 500 mg and 750 mg tablets, 50 mg/ml suspension and 75 mg/2 ml injection.
The dosage depends on the type and severity of the disease. The recommended daily dose for adults is 500 to 1250 mg of naproxen in one to three divided doses. A single dose should not exceed 1000 mg. For an analgesic effect, 200 to 400 mg is administered two to three times a day.
Children and adolescents from the age of 11 receive between 10 and 15 mg per kilogram of body weight and day. The administration should be divided into two single doses. The maximum daily dose of 15 mg per kilogram of body weight must not be exceeded.
Side effects of Naprosyn (Naproxen)
In the following, side effects that can occur during therapy with naproxen are listed according to their frequency.
- Gastrointestinal complaints such as nausea, vomiting, heartburn, stomach pain, feeling of fullness, constipation (constipation) or diarrhea (diarrhea)
- Minor blood loss in the gastrointestinal tract => risk of anemia in exceptional cases.
- Hypersensitivity reactions with exanthema , itching (pruritis), purpura or ecchymoses
- visual disturbances
- hearing impairment
- Gastrointestinal ulcers => possible risk of bleeding and perforation
- peripheral edema.
- Asthma attacks => possibly with drop in blood pressure
- eosinophilic pneumonia
- Tar Stool (Melaena)
- bloody diarrhea
- discomfort in the lower abdomen
- esophageal lesions
- liver dysfunction
- increased sensitivity to light
- acute renal failure
- nephrotic syndrome
- interstitial nephritis.
- Worsening of infection-related inflammation
- Symptoms of aseptic meningitis including severe headache, nausea, vomiting, fever, stiff neck or decreased consciousness
- Disorders of the blood count => aplastic anemia, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis => the first signs can be fever, sore throat, superficial wounds in the mouth, flu-like symptoms, severe exhaustion, nosebleeds and skin bleeding
- hemolytic anemia
- severe hypersensitivity reactions such as B. the angio-neurotic syndrome => signs are swelling of the face, tongue and larynx, shortness of breath, tachycardia, severe circulatory disorders up to life-threatening shock
- heart failure
- Liver damage => especially with long-term therapies
- Stevens-Johnson Syndrome
- toxic epidermal necrolysis
- Kidney damage such as papillary necrosis => especially with long-term therapy
If several NSAIDs are given at the same time, the risk of gastrointestinal ulcers and bleeding increases.
Other possible interactions are listed below:
- digoxin , phenytoin , lithium => increase in serum levels; Serum lithium level checks necessary
- Diuretics , ACE inhibitors and angiotensin II antagonists => reduced effect of these drugs; fluid control necessary; Risk of hyperkalemia with potassium-sparing diuretics
- Glucocorticoids => increased risk of gastrointestinal ulcers and bleeding
- Platelet aggregation inhibitors and selective serotonin reuptake inhibitors => increased risk of gastrointestinal bleeding
- Acetylsalicylic acid => reduced effect on platelet aggregation for several days
- Methotrexate => increased concentration of methotrexate
- Ciclosporin => increased kidney toxicity
- Anticoagulants => increased effect of warfarins
- Probenicid and sulfinpyrazone => delayed elimination of naproxen
- Antacids => reduced absorption of naproxen.
Naproxen is contraindicated in:
- Hypersensitivity to the active substance
- known reactions of bronchospasm, asthma, rhinitis or urticaria after taking acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (NSAIDs)
- unexplained blood disorders
- Pre-existing or previous peptic ulcer or haemorrhage
- gastrointestinal bleeding or perforation with previous NSAID therapy
- cerebrovascular or other active bleeding
- severe liver or kidney dysfunction
- severe heart failure
- Pregnancy in the last trimester
- children under the age of five.
Naproxen affects prostaglandin synthesis. This can lead to an increased risk of birth defects and miscarriages. Therefore, naproxen should not be given during the first two trimesters of pregnancy unless absolutely necessary. In the third trimester, naproxen is contraindicated because of fetal harm.
Only small amounts of naproxen pass into breast milk during breastfeeding. However, a gift is not recommended.
Naproxen can also affect fertility. It should therefore be avoided when women are trying to conceive.
In higher doses, naproxen shows central nervous side effects. This can affect responsiveness.
Further information can be found in the respective technical information.
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