Naproxen Evolan (Naproxen)

Naproxen is an NSAID that reduces inflammation and pain in several musculoskeletal and gynecologic conditions.

• Pain relief: Provides effective analgesia for mild to moderate acute pain.
• Inflammation reduction: Decreases swelling and inflammatory response in affected tissues.
• Arthritis: Improves joint function and reduces stiffness in osteoarthritis and rheumatoid arthritis.
• Dysmenorrhea: Alleviates menstrual cramps and associated discomfort.
• Fever: Lowers elevated body temperature associated with inflammatory conditions.
• Post‑operative pain: Helps manage pain after minor surgical procedures.

• Naproxen exerts its anti‑inflammatory and analgesic actions by reversibly inhibiting cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes. This blockade reduces the conversion of arachidonic acid to prostaglandins and thromboxanes, key mediators of inflammation, pain, and fever. The decreased prostaglandin synthesis leads to diminished peripheral sensitisation and vascular permeability, providing symptomatic relief. The effect is dose‑dependent and persists for several hours after administration.

Naproxen may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia, or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Mild skin rash or itching.
• Elevated blood pressure in susceptible individuals.
• Edema: peripheral swelling due to fluid retention.
• Tinnitus: ringing in the ears.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding.
• Severe hypersensitivity reactions such as Stevens‑Johnson syndrome.
• Renal impairment or acute kidney injury.
• Hepatotoxicity with elevated liver enzymes.
• Cardiovascular events including myocardial infarction or stroke.
• Anaphylaxis: life‑threatening allergic reaction.

When prescribing or dispensing Naproxen, several precautions should be observed to minimise risk.

• Assess renal function: avoid use in patients with severe renal impairment.
• Evaluate gastrointestinal risk: use with caution in those with history of ulcers or bleeding.
• Monitor cardiovascular status: consider risk in patients with coronary artery disease.
• Review concomitant medications: avoid concurrent use with other NSAIDs or anticoagulants without supervision.
• Pregnancy and lactation: use only if clearly needed after risk‑benefit assessment.
• Store at ambient temperature: keep below 25 °C, in the original packaging, protected from moisture.

Naproxen can interact with several medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Selective COX‑2 inhibitors: additive gastrointestinal toxicity.
• High‑dose aspirin: enhanced renal adverse effects.
• Lithium: NSAIDs may raise lithium serum levels.
• Methotrexate: reduced clearance leading to toxicity.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: possible reduction in antihypertensive effect and renal function.
• Diuretics: may potentiate renal impairment.
• SSRIs or SNRIs: heightened bleeding risk.
• Corticosteroids: increased gastrointestinal ulcer risk.
• Antidiabetic drugs: NSAIDs may affect glycaemic control.