Naprosyn Entero (Naproxen)

Naproxen is an NSAID that reduces inflammation and pain in several rheumatic and musculoskeletal disorders.

• Pain: provides symptomatic relief of mild to moderate acute pain.
• Rheumatoid arthritis: decreases joint swelling, stiffness and pain.
• Osteoarthritis: improves mobility and reduces chronic joint discomfort.
• Ankylosing spondylitis: alleviates spinal inflammation and stiffness.
• Gout flares: lessens acute inflammatory pain associated with gout attacks.

• Naproxen inhibits both cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes, which blocks the conversion of arachidonic acid to prostaglandins. By reducing prostaglandin synthesis, the drug diminishes the inflammatory response, lowers peripheral sensitisation of nociceptors, and consequently provides analgesic and anti‑inflammatory effects.

Adverse reactions may range from mild to severe and should be monitored during therapy.

Common Side Effects

• Dyspepsia: upset stomach or indigestion.
• Headache: mild to moderate head pain.
• Dizziness: sensation of light‑headedness.
• Nausea: feeling of queasiness.
• Diarrhoea: loose stools.
• Peripheral oedema: mild swelling of the lower limbs.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding.
• Renal impairment: reduced kidney function.
• Hepatotoxicity: liver enzyme elevation.
• Cardiovascular events: increased risk of heart attack or stroke.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Anaphylaxis: rare but potentially life‑threatening allergic response.

Before initiating therapy, consider patient‑specific risk factors and monitor appropriately.

• Cardiovascular risk: assess history of heart disease before use.
• Gastrointestinal history: avoid in patients with active ulcers or severe GI bleeding.
• Renal function: monitor creatinine in patients with pre‑existing kidney disease.
• Hepatic disease: use cautiously in liver impairment.
• Concomitant anticoagulants: increase bleeding risk; monitor coagulation parameters.
• Store at ambient temperature: keep below 25 °C, retain in original container, protect from moisture and direct sunlight.

Naproxen may interact with several drug classes, requiring vigilance.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): heightened bleeding risk.
• Selective serotonin reuptake inhibitors (SSRIs): increased gastrointestinal bleeding.
• Other NSAIDs or COX‑2 inhibitors: additive renal and GI toxicity.
• Methotrexate: reduced clearance leading to toxicity.
• Lithium: elevated serum lithium levels.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: possible reduction in renal function.
• Diuretics: risk of reduced kidney perfusion.
• Corticosteroids: synergistic GI ulcer risk.
• Antihypertensives: may blunt blood‑pressure‑lowering effect.
• Oral hypoglycemics: potential alteration of glucose control.