NAPROSYN Tablet Ref.[50769] Active ingredients: Naproxen

Posology

Undesirable effects may be minimised by using the lowest effective dose for the shortest duration necessary to control symptoms (see section 4.4).

Adults

Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis

500mg to 1g taken in 2 doses at 12-hour intervals or alternatively, as a single administration. In the following cases a loading dose of 750mg or 1g per day for the acute phase is recommended:

a) In patients reporting severe night-time pain/or morning stiffness.

b) In patients being switched to Naprosyn from a high dose of another anti-rheumatic compound.

c) In osteoarthrosis where pain is the predominant symptom.

Acute gout

750mg at once then 250mg every 8 hours until the attack has passed.

Acute musculoskeletal disorders and dysmenorrhoea

500mg initially followed by 250mg at 6-8 hour intervals as needed, with a maximum daily dose after the first day of 1250mg.

Older people

Studies indicate that although total plasma concentration of naproxen is unchanged, the unbound plasma fraction of naproxen is increased in older people. The implication of this finding for Naprosyn dosing is unknown. As with other drugs used in older people it is prudent to use the lowest effective dose and for the shortest duration possible as elderly patients are more prone to adverse events. The patient should be monitored regularly for GI bleeding during NSAID therapy. For the effect of reduced elimination in older people refer to Section 4.4.

Paediatric population (over 5 years)

For juvenile rheumatoid arthritis: 10mg/kg/day taken in 2 doses at 12-hour intervals. Naprosyn is not recommended for use in any other indication in children under 16 years of age.

Renal / hepatic impairment

A lower dose should be considered in patients with renal or hepatic impairment. Naprosyn is contraindicated in patients with baseline creatinine clearance less than 30 ml/minute because accumulation of naproxen metabolites has been seen in patients with severe renal failure or those on dialysis (see section 4.3).

Treatment should be reviewed at regular intervals and discontinued if no benefit is seen or intolerance occurs.

Method of administration

For oral administration.

To be taken preferably with or after food.

Symptoms

Symptoms include headache, heartburn, nausea, vomiting, epigastric pain, gastrointestinal bleeding, rarely diarrhoea, disorientation, excitation, drowsiness, dizziness, tinnitus, fainting. In cases of significant poisoning acute renal failure and liver damage are possible.

Respiratory depression and coma may occur after the ingestion of NSAIDs but are rare.

In one case of naproxen overdose, transient prolongation of the prothrombin time due to hypothrombinaemia may have been due to selective inhibition of the synthesis of vitamin-K dependent clotting factors.

A few patients have experienced seizures, but it is not known whether these were naproxen-related or not. It is not known what dose of the drug would be life-threatening.

Management

Patients should be treated symptomatically as required. Within one hour of ingestion of a potentially toxic amount activated charcoal should be considered. Alternatively in adults gastric lavage should be considered within one hour of ingestion of a potentially life-threatening overdose.

Good urine output should be ensured.

Renal and liver function should be closely monitored.

Patients should be observed for at least four hours after ingestion of potentially toxic amounts.

Frequent or prolonged convulsions should be treated with intravenous diazepam.

Other measures may be indicated by the patient’s clinical condition.

Haemodialysis does not decrease the plasma concentration of naproxen because of the high degree of protein binding. However, haemodialysis may still be appropriate in a patient with renal failure who has taken naproxen.

5 years.

Store below 30°C.

Keep blister in the outer carton in order to protect from light.

Clear or opaque PVC blister packaging with aluminium lidding in cartons, containing 56 tablets.

No special requirements for disposal.

Any unused medicinal product for waste material should be disposed of in accordance with local requirements.