Naproxen

Reviewed by Dr Bipin B. 

Drug class:	NSAIDs
Generic name:	Naproxen
Brand name:	NAXID, NAPROSYN

Introduction

Naproxen is a NSAIDs, which is used commonly for menstrual pain and other inflammatory condition.
Since its inception, many other drugs with similar pharmacodynamic properties have been developed. Although they have similarities, there are notable differences in the potency and duration of action of these drugs.

Adverse effect

Compared to aspirin, naproxen and its progenitors provide better tolerability with less frequent mild side effects. Although some individuals may still experience gastric discomfort, nausea, and vomiting, these symptoms are less common than those typically associated with aspirin or indomethacin. Additionally, incidences of gastric erosion and occult blood loss are rare.
In terms of central nervous system (CNS) side effects, naproxen can cause headache, dizziness, blurred vision, tinnitus, and even depression. However, such side effects are relatively rare. Hypersensitivity reactions such as rash and itching are also uncommon, although these drugs may trigger aspirin-induced asthma. It is important to note that fluid retention is less pronounced than with phenylbutazone. However, pregnant women and individuals with peptic ulcers should avoid these medicines.

Pharmacokinetics and Interactions

All members of the naproxen family are well absorbed orally and exhibit high plasma protein binding ranging from 90% to 99%. However, these drugs generally do not interact significantly with other drugs in terms of displacement interactions. Therefore, there is no need to alter the dosage of oral anticoagulants or oral hypoglycemics while using naproxen. Nevertheless, caution should be exercised when using these drugs with anticoagulants because of their inhibitory effect on platelet function.
Similar to other nonsteroidal anti-inflammatory drugs (NSAIDs), naproxen and its congeners may reduce the diuretic and antihypertensive effects of thiazides, furosemide, and β-blockers. It is noteworthy that propionic acid derivatives, including naproxen, readily cross the blood-brain barrier, enter the synovial fluid, and can cross the placenta. These drugs are metabolized primarily in the liver via hydroxylation and glucuronide conjugation, and they are excreted in both urine and bile.

Use of Naproxen:

1. Simple analgesic and antipyretic: Naproxen acts as a simple analgesic and antipyretic similar to low doses of aspirin. It is particularly effective in treating dysmenorrhea, where its action is attributed to inhibition of prostaglandin synthesis. It is easily available as an over-the-counter medicine.
2. Musculoskeletal Disorders: Naproxen and its congeners have wide use in conditions such as rheumatoid arthritis, osteoarthritis and other musculoskeletal disorders, especially when pain is more prominent than inflammation.
3. Inflammation management: These drugs are indicated for a variety of conditions, including soft tissue injuries, fractures, vasectomy, tooth extraction, postpartum recovery, and postoperative care, as they help suppress inflammation and swelling .
   In addition, naproxen is rated as the safest conventional NSAID according to the Intuitive Adverse Drug Reaction Reporting System in the United Kingdom.

conclusion

In conclusion, naproxen provides a safer alternative to aspirin with better tolerability and fewer side effects. Although it may cause some gastrointestinal discomfort and rare CNS side effects, its adverse effects are generally milder than those of aspirin. These drugs are well absorbed orally and exhibit high protein binding, and their interactions with other drugs are usually not clinically significant. Naproxen is widely used as a simple analgesic, antipyretic and anti-inflammatory agent, especially in musculoskeletal disorders. Its effectiveness and safety have been recognized, making it a popular choice for pain relief and inflammation management.