ALOE PLUS COMBINATION PRODUCT BROWN TABLETS

Indications

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Gout
• Acute pain
• Dysmenorrhea
• Tendonitis
• Bursitis

Dosage

Children: Refer to the BNF for Children for specific paediatric dosing information.

Adults: Refer to the BNF for specific dosing information.

Mechanism of action

Naproxen works by inhibiting the activity of cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2. This inhibition leads to a decrease in the synthesis of prostaglandins, which are compounds that mediate inflammation, pain, and fever. By lowering prostaglandin levels, naproxen effectively reduces pain and inflammation in the body.

Pharmacodynamics

Naproxen's anti-inflammatory effects are primarily due to its ability to inhibit COX enzymes, leading to reduced synthesis of inflammatory mediators. The analgesic effect arises from its ability to block the peripheral and central mechanisms of pain, while its antipyretic effect results from its action on the hypothalamic heat-regulating center. The onset of action typically occurs within 30 minutes to 1 hour after oral administration, with peak effects reached within 1 to 2 hours.

Pharmacokinetics

Naproxen is absorbed rapidly from the gastrointestinal tract, with peak plasma concentrations occurring about 2 to 4 hours after oral administration. It has a high protein binding capacity, primarily to albumin, which can affect its distribution in the body. The elimination half-life of naproxen is approximately 12 to 17 hours, allowing for twice-daily dosing in most cases. It is metabolized in the liver via cytochrome P450 enzymes and primarily excreted in the urine as metabolites.

Contra-indications

• Hypersensitivity to naproxen or any of its components
• Active gastrointestinal bleeding or ulceration
• Severe renal impairment
• Severe heart failure
• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs

Adverse effects

• Gastrointestinal disturbances such as nausea, vomiting, and abdominal pain
• Dyspepsia or indigestion
• Headache and dizziness
• Rash and other hypersensitivity reactions
• Increased risk of cardiovascular events
• Renal impairment

Interactions

• Increased risk of gastrointestinal bleeding with other NSAIDs, anticoagulants, or corticosteroids
• May reduce the antihypertensive effect of ACE inhibitors and diuretics
• May enhance the effects of anticoagulants
• Increased risk of nephrotoxicity when used with other nephrotoxic agents

Precautions

• Use with caution in patients with a history of gastrointestinal disease
• Monitor renal function, especially in long-term use or in patients with pre-existing renal conditions
• Caution in patients with cardiovascular disease or risk factors
• Avoid use in late pregnancy due to potential effects on fetal cardiovascular system

Pregnancy

Naproxen should be avoided, especially in the third trimester due to risks of fetal cardiovascular effects and complications during delivery.

Breast-feeding

Naproxen is excreted in breast milk, and caution is advised; consult a healthcare provider before use.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Tablets
• Suspension
• Enteric-coated formulations