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Neproxen

 

1. Generic Name & Brand Names

  • Generic Name: Naproxen

  • Common Brand Names:

    • Prescription: Naprosyn®, EC-Naprosyn®, Anaprox® DS

    • OTC (Lower Dose): Aleve®, Naprelan® (ER), Flanax®

    • Generics: Store brands (e.g., "Naproxen Sodium," "Equate Pain Relief")

2. Dosage Forms

  • Oral:

    • Tablets (Immediate/Delayed-Release)

    • Extended-Release Tablets (e.g., Naprelan®)

    • Liquid Suspension (pediatric/Rx)

    • Capsules

  • Topical: Gel (limited availability)

  • Suppositories (rare, country-specific)

3. Drug Class

  • NSAID (Non-Steroidal Anti-Inflammatory Drug)

  • Analgesic (Pain Reliever)

  • Anti-inflammatory

  • Antipyretic (Fever Reducer)

4. Uses

  • Chronic Inflammatory Conditions:

    • Osteoarthritis, Rheumatoid Arthritis, Ankylosing Spondylitis

    • Gout, Tendonitis, Bursitis

  • Acute Pain:

    • Menstrual cramps (primary dysmenorrhea), migraines, dental pain

  • Fever Reduction (less common than other NSAIDs)

5. Side Effects

  • Common:

    • Heartburn, nausea, abdominal pain

    • Dizziness, headache

    • Mild fluid retention/swelling

  • Serious (Seek Immediate Help):

    • GI Bleeding/Ulcers: Black/tarry stools, vomiting blood

    • Kidney Damage: Reduced urine, swollen ankles, fatigue

    • Heart Attack/Stroke: Chest pain, sudden weakness/slurred speech

    • Severe Skin Reactions: SJS/TEN (blistering, peeling rash)

    • Liver Toxicity: Jaundice (yellow skin/eyes), dark urine

    • High Blood Pressure

6. Warnings Before Taking

  • Black Box Warning (USA): ↑ Risk of cardiovascular events (stroke/heart attack) and GI bleeding/ulcers.

  • Contraindications:

    • Allergy to NSAIDs/aspirin

    • History of asthma attacks after NSAIDs

    • CABG surgery recovery

    • 3rd trimester pregnancy

  • Use with Extreme Caution If:

    65 years old, history of ulcers/bleeding, heart/kidney/liver disease, hypertension, or on blood thinners (e.g., warfarin).

  • Drug Interactions:

    • Avoid with other NSAIDs, SSRIs (e.g., fluoxetine), diuretics, or lithium.

  • Pregnancy: Avoid in 3rd trimester; consult doctor in 1st/2nd trimesters.

7. How to Take It

  • With Food/Milk: Always take with food to reduce stomach irritation.

  • Swallow Whole: Do not crush, chew, or split extended-release tablets.

  • Dosing (Adults):

    • Arthritis/Chronic Pain: 250–500 mg twice daily (max 1,500 mg/day).

    • Acute Pain (OTC): 220 mg every 8–12 hours (max 660 mg/24h).

  • Minimum Effective Dose: Start low (e.g., 250 mg BID for arthritis).

8. Uses in Adults

  • Chronic Inflammatory Arthritis: Long-term management (lowest effective dose).

  • Short-Term Pain: ≤10 days for acute pain (unless directed otherwise).

9. Missed Dose

  • Chronic Use (Scheduled): Skip if close to next dose. Never double dose.

  • As-Needed (OTC): Take when symptoms recur (wait ≥8–12 hours).

10. Overdose

  • Symptoms:

    • Severe stomach pain, vomiting, drowsiness

    • Kidney failure, seizures, coma

  • Action: Call poison control (1-800-222-1222) or seek ER immediately.

    *Note: Symptoms may be delayed up to 24 hours due to long half-life.*

11. Avoid While Taking

  • Other NSAIDs: Aspirin, ibuprofen, diclofenac.

  • Alcohol: ↑ Risk of stomach ulcers/bleeding.

  • Blood Thinners: Warfarin, clopidogrel (↑ bleeding risk).

  • Before Surgery: Stop ≥7–10 days prior (consult surgeon).

12. Storage

  • Temperature: Room temperature (15–30°C / 59–86°F).

  • Moisture/Light: Keep in original container; avoid humidity/direct light.

  • Safety: Use child-resistant packaging; keep away from children/pets.

Critical Safety Notes:

⚠️ Long Half-Life: Effects last 8–12+ hours—do not redose too soon!
⚠️ GI Risk: Higher in elderly or prolonged use; consider stomach protection (e.g., PPI).
⚠️ OTC vs. Rx: OTC strength (220 mg = 200 mg naproxen) is not sufficient for arthritis; Rx doses required.
⚠️ Cardiovascular Risk: Avoid long-term use if history of heart disease.

Always consult your doctor before starting/changing doses, especially for chronic conditions. Use the lowest effective dose for the shortest duration needed.

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