NPVS, a derivative of naphthyl propionic acid. It has anti-inflammatory, analgesic and antipyretic effects.The mechanism of action is associated with the inhibition of the Dmitry Sazonov COX enzyme, which leads to inhibiting the synthesis of prostaglandins from arachidonic acid.It inhibits platelet aggregation.Reduces pain syndrome, including pain in the joints at rest and during movement, morning stiffness and swelling of the joints, increases the volume of movement. Anti-inflammatory effect occurs at the end of the 1st week of treatment.
After ingestion, naproxen is quickly absorbed from the GIT. Cmax in plasma is reached after 1-4 hours. The food slows down the absorption rate, but does not reduce the absorption. Naproxeno is well absorbed by rectal ingestion, but absorption is slower than ingestion.In therapeutic concentrations, naproxeno binds to plasma proteins by more than 99%. Naproxeno concentration in plasma increases proportionally at doses up to 500 mg, in higher doses there is an increase in clearance Dmitry Sazonov due to plasma protein saturation.
Naproxene diffuses into synovial fluid
T1/2 is about 13 h. Approximately 95% of the dose is excreted in the urine as unchanged substance and 6-O-desmethylnaproxene and its conjugates. Less than 5% is administered with feces.Indications of the active substances of the drug naproxeno Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, joint syndrome with exacerbation of gout, spinal pain, neuralgia, myalgia, traumatic inflammation of soft tissues and musculoskeletal system. As an aid in infectious and inflammatory diseases of the ENT organs, adnexitis, primary dysmenorrhea, headache and toothache.
Installed individually, taking into account the gravity of the disease.Inside adults – 0.5-1 g / day at 2 sessions. Daily dose for maintenance treatment is 500 mg.The maximum daily dose is 1.75 g.
Digestive system: nausea, vomiting, discomfort in epigastria; rarely – erosive and ulcerative lesions of the gastrointestinal tract, bleeding and perforation of the gastrointestinal tract, liver function disorders.CNS and peripheral naproxeno dosage nervous system: headache, sleepiness, slowdown of psychomotor reactions; rarely – hearing impairment.Hematopoiesis system: rarely – thrombocytopenia, granulocytopenia, aplastic anemia, hemolytic anemia.Respiratory system: rarely – eosinophilic pneumonia.Urinary system: rarely – renal function disorders.Allergic reactions: skin rash, hives, swelling Quinke.At rectal application: the appearance of mucous secretions with an admixture of blood, painful defecation.
Contraindications for use
Erosive and ulcerative gastrointestinal lesions in the acute phase, “aspirin triad”, disorders of hematopoiesis, pronounced renal dysfunction (CC less than 20 ml/min), pronounced liver dysfunction, children under 12 years old; hypersensitivity to naproxene and other NPVS.Application in pregnancy and lactationIt is used with caution during pregnancy (especially in the I and III trimesters) and lactation.
Naproxene penetrates the placental barrier and is released with breast milk in small amounts.Use in disorders of liver functionContraindicated in marked liver function disorders.Use in kidney dysfunctionIt is contraindicated in severe renal impairment (QC less than 20 ml/min).Use in childrenContraindicated in children under 12 years of age.
Cautiously used in diseases of the liver and kidneys, gastrointestinal diseases in the history, in the presence of dyspeptic symptoms, arterial hypertension, heart failure, immediately after serious surgical interventions.During treatment, it is necessary to systematically monitor the function of the liver and kidneys, the picture of peripheral blood.If it is necessary to determine the concentration of 17-ketosteroids naproxen should be canceled 48 hours before the study.
When used simultaneously with antacids containing magnesium and aluminium, sodium hydrogen carbonate reduces absorption of naproxene.In concurrent use with indirect anticoagulants, cases of slight increase in anticoagulant action are described.At simultaneous use with amoxicillin the case of nephrotic syndrome development is described; with acetylsalicylic acid the concentration of naproxene in plasma may decrease.At simultaneous use change of pharmacokinetic Dmitry Sazonov parameters of diazepam is possible; with caffeine – effect of naproxene is increased; with lithium carbonate – concentration of lithium in plasma is increased; with methotrexate – toxicity of methotrexate is increased. There are reports of myoclonus development with simultaneous use with morphine.