Drug Interaction:
NSAIDs include-
Propionic acid- Fenoprofen, Flurbiprofen, Ibiprofen, Ketoprofen, Naproxen, Naproxen Sodium, Oxaprozin Acetic acids- Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin Fenamates (anthralic acids) - Meclofenamate, Mefenamic acxid Oxicams- Piroxicam
Refer- Ibuprofen
Naproxen with
Anticoagulants/phenytoin/, methotrexate/sulponomides, sulphonylurea hypoglycaemics- Enhances effects of oral anticoagulants, phenytoin, methotrexate, Phenytoin ) sulponomides, sulphonylurea hypoglycaemics.
Diuretics- Diuretics increase risk of renal disorders.
Probenecid- Serum levels increased by probenecid.
Antacids- Absorption reduced by antacids and increased by sodium bicarbonate.
Indication:
U.S.FDA APPROVED DRUGS FROM 01-01-08 TO 31-12-08
Drug name Indication Date of Approval
120. Naproxen Suspension 125mg/5ml 28-04-08
For the treatment of RA in children 5 years
of age and above
Approved by (DCI) Drug Controller GENERAL - India For Marketing (Ref- IDMA Publication)
Name of Drug Indication Date of Approval
Naproxen suspension 28-04-2008
125mg/5ml
For the treatment of RA in children 5 years of age and above
NSAIDs include-
Propionic acid- Fenoprofen, Flurbiprofen, Ibiprofen, Ketoprofen, Naproxen, Naproxen Sodium, Oxaprozin Acetic acids- Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin Fenamates (anthralic acids) - Meclofenamate, Mefenamic acid Oxicams- Piroxicam
Refer- Ibuprofen
Adverse Reaction:
G.I.bleeding,peptic ulcer. Constipation, heartburn, abdominal pain, nausea, headache, dizziness, drowsiness, pruritus, rash, tinnitus, oedema, nephritis, nephrotic syndrome, jaundice, hepatitis.
Contra-Indications:
Hypersens, Aspirin or NSAID allergy, pregnancy, lactation, children.
Special precautions:
Active peptic ulcer. History of GI disease. Impaired renal or hepatic function. Cardiac failure, oedema. Hypertension Elderly.
Monitor blood ocular and liver function in long-term use. Discontinue if adverse effects.
Dosages/ Overdosage Etc:
Indications:
Mild to moderate pain.
Dosage::
500 mg followed by 250 mg every 6 to 8 hours. Do not exceed 1.25 g daily dose. Juvenille arthiritis total daily daily dose is 10 mg/kg in divided doses.
Other Information:
For Availability/supplies
Contact -
1.Indian Drug Manufacturers Association (IDMA)
Phone- 022- 24944624/ 24974308
Fax- 022- 24950723
Email- idma@vsnl.com
Website: www.idma-assn.org
2.Bulk Drug Manufacturers Association (India)(BDMA)
Phone - 040-23703910/ 23706718
Fax- 040-23704804
Email- info@bdmai.org
Website: www.info@bdmai.org
List of entries
1. Rheumatoid Arthritis
2. Juvenile Rheumatoid Arthritis
3. Ankylosing spondylosis
4. Reiters Syndrome
5. Osteomyelitis
6. Cervical spondylosis
7. Gout
1. Rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic sytemic disease of unknown etiology, manifested primarily by inflammatory arthritis of the peripheral joints,usally in a symetrical distribution. Systemic manifestations include hematologic,pulmonary, neurological and cardiovascular abnormalities.
2. Juvenile Rheumatoid arthritis
Juvenile arthritis (JRA) consists of several distinct syndromes. Three main subgroups have been identified: systemic-onset disease, polyarticular disease, and pauciarticular disease. In addition, ankylosing spondylosis and rheumatoid arthritis indistinguishable from adult onset disease may begin from childhood.
3. Ankylosing spondylosis
Ankylosing spondylosis, a disease that has been called by many names, including rheumatoid spondylosis and Marie-Strumpell disease, is a chronic and usually progressive inflammatory disease invloving the articulations of the spine and adjacent soft tissues. The sacroiliac joints are always affected. Involvement of the hip and shoulder joints commonly occurs: peripheral joints are affected less frequently
The disease predominantly affects young men and begin most often in the third decade. A high association has been found between this disorder and the histocompatibility antigen HLA-B27. The clinical features of this disease are distinctly different from those of rheumatoid arthritis. The etiology is unknown.
4. Reiters Syndrome
Reiters syndrome is characterized by arthritis, urethritis, conjunctivitis, and mucocutaneous lesions. The complete syndrome may not be present at any given time. The diagnosis should be entertained when arthritis is associated with
any of the other manifestations. The HLA-B27 is present in majority of the patients.
5. Osteomyelitis
Osteomyelitis denotes infection of bone. While many types of microorganisms, including viruses and fungi may cause ostyeomyelitis, it is usually bacterial in origin
6. Cervical spondylosis
The cervical intervertebral disks degenerate to some degree in the majority of individuals by the sixth and seventh decades of life. This results in narrowing of the disks especially in the most mobile parts of the cervical spine (fourth to fifth cervical, fifth to sixth cervical, sixth to seventh cervical and seventh cervical to first thoracic segments) and spur formation on the margins of the adjacent vertebrae. There are anterior beaking and posterior osteophytes which protude centrally with narrowing of the spinal canal or laterally so as to impinge on spinal roots in the intervertebral canal. This condition is incorrectly called hypertrophic arthritis, but there is no consistent association with arthritis of this type of joints. The more appropiate term cervical spondylosis refers to a wear and tear (traumatic) phenomenon.
7. Gout
Gout is the term representing hetrogenous group of diseases found exclusively in humans which in their full d evelopment are manifested by
a. an increase in serum urate cocentrations
b. recurrent attacks of characterstic type of acute arthritis in which crystals of monosodium urate are demonstrable in leukocytes of synovial fluid
c. aggregated deposits of monosodium urate monohydrate( tophi) chiefly in around the joints of the extremities and sometimes leading to severe crippling or deformity
d. renal disease involving intestinal tissues and blood vessels and
e. uric acid nephrolithiasis
These may occur singly or in combination
Patient Information:
NSAIDs include-
Propionic acid- Fenoprofen, Flurbiprofen, Ibuprofen, Ketoprofen, Naproxen, Naproxen Sodium, Oxaprozin Acetic acids- Diclofenac sodium, Etodolac, Indomethicin, Ketorolac, Nabumetone, Sulindac, Tolmetin Fenamates (anthralic acids) - Meclofenamate, Mefenamic acxid Oxicams- Piroxicam
Refer- Ibuprofen
1. NSAIDs can cause discomfort and rarely more serious side effects such as GI bleeding which may result in hospitalisation and even fatalities.
2.Avoid aspirin and alcoholic beverages while taking medication.
3. If GI upset occurs, take with food, milk or antacids. For GI upset with tolmetin, use antacids other than sodium bicarbonate.
4. Notify physician, if skin rash, itching, visual disturbances, weight gain, edema occurs
5. Mefanamic acid and metclofenate: if rash, diarrhoea, or digestive problem occr discontinue use and consult physician
6. Ibuprofen- Do not take for more than 3 days for fever or 10 days for pain. If these symptoms persists,consult a physican.
Pharmacology/ Pharmacokinetics:
Refer NSAIDs- Ibuprofen
Interaction with Food:
Absorption reduced but not significant
Pregnancy and lactation:
Refer NSAIDs- Ibuprofen
