Generic Name

Naproxen 10% Topical

Precaution

Pre-existing CV risk factors or disease e.g. fluid retention, CHF, hypertension. History of GI disease (bleeding or ulcers). Other forms of asthma. Hepatic impairment; closely monitor patients with any abnormal LFT. Renal impairment. Elderly. Lactation.

Indication

Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis, Mild to moderate pain, Tendonitis, Acute musculoskeletal disorders, Bursitis

Contra Indication

Hypersensitivity. Aspirin or NSAID allergy. Perioperative pain in the setting of CABG surgery. Pregnancy (3rd trimester)

Dose

N/A

Side Effect

Oedema, palpitation, dizziness, drowsiness, headache, light headedness, vertigo, pruritus, skin eruption, ecchymosis, purpura, rash, fluid retention, abdominal pain, constipation, nausea, heartburn, diarrhoea, dyspepsia, stomatitis, flatulence, gross bleeding/perforation, indigestion, ulcers, vomiting, abnormal renal function, haemolysis, anaemia, increased bleeding time, elevated LFTs, visual disturbances, tinnitus, hearing disturbances, dyspnoea, diaphoresis, thirst. Potentially Fatal: Anaphylactic/anaphylactoid reactions. Exfoliative dermatitis, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN).

Pregnancy Category

Mode of Action

Naproxen, a propionic acid derivative, is a prototypical NSAID. It reversibly inhibits the cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, thus resulting in reduced synthesis of prostaglandin precursors. It can inhibit platelet aggregation, has anti-inflammatory, analgesic and antipyretic actions.

Interaction

May enhance methotrexate toxicity. Reduced BP response to ACE inhibitors or angiotensin II receptor antagonists. Increased risk of serious GI events (e.g. ulcer) w/ aspirin. Increased risk of GI bleeding w/ warfarin. May reduce the natriuretic effects of furosemide or thiazide diuretics. May increase serum lithium concentrations and reduce renal lithium clearance. Delayed absorption w/ antacids, colestyramine or sucralfate. May interfere w/ the antihypertensive effects of ?-blockers (e.g. propranolol). May increase serum levels w/ probenecid.

Pregnancy Category Note

Pregnancy category: C; D in 3rd trimester or near delivery.

Adult Dose

Topica Adult: Apply Naproxen gel 2-6 times a day as required.

Child Dose

N/A

Renal Dose

N/A

Administration

N/A