Naproxen Sodium

Indications & Dose:

Pain and inflammation in rheumatic disease

• BY MOUTH

Adult: 0.5–1 g daily in 1–2 divided doses

Pain and inflammation in musculoskeletal disorders | Dysmenorrhoea

• BY MOUTH

Adult: Initially 500 mg, then 250 mg every 6–8 hours as required, maximum dose after the first day 1.25 g daily

Acute gout

•  BY MOUTH

Adult: Initially 750 mg, then 250 mg every 8 hours until attack has passed 

Contraindications:

Bronchospasm, nasal polyps, angioedema precipitated by aspirin or other NSAIDs 

Side Effects:

Cautions:

Precautions:

History of G1 ulceration, bleeding, or perforation: renal dysfunction, hypertension a cardiac conditions aggravated fluid retention and edema, history of liver dysfunction; history of coagulation 

Interaction:

Drugs
Aminoglycosides: Reduced clearance with elevated aminoglycoside levels and potential for toxicity (especially indomethacin in premature infants; other NSAIDs probably)

Anticoagulants: Excessive hyPoProthrombinemia, decreased platelet aggregation with increased risk of GI bleeding

Antihypertensives ( β -blockers, angiotensinconverting enzyme inhibitors, angiotensin II receptor blockers, β -blockers, diuretics): Inhibition of antihypertensive and other favorable hemodynamic effects

Corticosteroids: Increased risk of GI ulceration

Cyclosporine: Increased nephrotoxicity risk

Lithium: Decreased clearance of lithium (mediated via prostaglandins) resulting in elevated serum lithium levels and risk of toxicity

Methotrexate: Decreased renal secretion of methotrexate resulting in elevated methotrexate levels and risk of toxicity

Phenylpropanolamine: Possible acute hypertensive reaction

Potassium-sparing diuretics: Additive hyperkalemia potential

Triamterene: Acute renal failure reported with addition of indomethacin; caution with other NSAIDs

Warnings:

Adverse Effects:

Lactations:

(if used in 3rd trimester): could cause constriction of the ductus arteriosus in utero, persistent pulmonary hypertension of the newborn, or prolonged labor; passes into breast milk in small quantities; compatible with breast feeding 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

GNS: Dizziness, drowsiness, headache, lightheadedness
CV: Chest pain, CHF, dysrhythmias, edema, hypertension, palpitation, tachycardia
EENT: Hearing disturbances, tinnitus, visual disturbances
GI: Abdominal cramps, constipation, diarrhea, dyspepsia, flatulence, gastric or duodenal ulcer with bleeding or perforation, heartburn, hepatitis, nausea, occult blood in stool, pancreatitis, stomatitis, vomiting
GU: Acute renal failure
HEME: Agranulocytosis, eosinophilia, leukopenia, neutropenia, pancytopenia, thrombocytopenia
METAB: Hyperglycemia, hyperkalemia, hypoglycemia, hyponatremia
RESP: Bronchospasm, dyspnea, pulmonary infiltrates
SKIN: Ecchymoses, photosensitivity, pruritus, rash, urticaria

Patient And Carer Advice: