Naproxen 10% Topical

Indications

Naproxen 10% Topical is used for: Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis, Mild to moderate pain, Tendonitis, Acute musculoskeletal disorders, Bursitis

Adult Dose

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

Child Dose

Renal Dose

Administration

Contra Indications

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

Precautions

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.

Pregnancy-Lactation

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

Interactions

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.

Adverse Effects

Side effects of Naproxen 10% Topical : 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).

Mechanism 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.