Neso 500/20mg Tablet

Uses of

• Pain Relief

How does

Naproxen, as an anti-inflammatory and analgesic agent, works by inhibiting the action of the COX enzyme responsible for the production of prostaglandins that cause pain and inflammation. It effectively reduces mild to moderate pain, inflammation, and joint stiffness associated with various conditions such as injury, fibrositis, tenosynovitis, low back pain, strains, and sprains.

However, the use of NSAIDs like Naproxen can be associated with gastric discomfort, acidity, and an increased risk of stomach ulcers. To minimize these potential side effects, esomeprazole, a proton pump inhibitor, is combined with Naproxen in Neso 500/20mg Tablet. Esomeprazole works by reducing the production of gastric acid, thus protecting the stomach lining and decreasing the likelihood of gastric irritation and ulcer formation during long-term treatment. This combination helps to alleviate pain while minimizing the gastric irritation that can occur with Naproxen alone.

Side Effects of Neso 500/20mg Tablet

The common side effects that may occur with Neso 500/20mg Tablet include:

1. Heartburn and dyspepsia (indigestion)
2. Nausea
3. Sore mouth or mouth ulcers
4. Abdominal pain
5. Constipation
6. Headache and dizziness
7. Fits or seizures (uncommon)
8. Bruising, itching, sweating, increased sensitivity to the sun, or hair loss
9. Changes in eyesight, such as eye pain
10. Hearing loss and ringing in the ears
11. Fluttering feeling in the heart
12. Thirst, fever, feeling tired, or generally unwell
13. Swelling of the hands, feet, or legs
14. Difficulty breathing, including shortness of breath, wheezing, or coughing

Some uncommon side effects associated with Neso 500/20mg Tablet include:

1. Kidney problems
2. Vomiting
3. Skin rashes
4. Mental confusion and possibly hallucinations

Rare side effects that may occur with Neso 500/20mg Tablet include:

1. Depression
2. Fits or seizures (again)
3. Pneumonia or swelling of the lungs
4. Numbness in hands and feet
5. High levels of blood potassium, which can cause abnormal heart rhythm

It's important to promptly report any concerning or persistent side effects to your doctor or healthcare professional for further evaluation and advice. They will be able to assess the severity of the side effects and provide appropriate guidance.

Please note that this is not a complete list of side effects, and individual experiences may vary. It's always best to consult with a healthcare professional for personalized information and guidance regarding your specific situation.

Quick Suggestions:

• Engage in gentle activities like walking or swimming for 20-30 minutes to strengthen muscles and relieve joint stiffness.
• Regular low-strain exercises and a healthy diet can contribute to maintaining a healthy weight, which can reduce stress on the joints.
• Sufficient rest and sleep are important for muscle recovery and reducing inflammation and swelling.
• Applying a cold or hot compress to the joints for 15-20 minutes can provide relief. Cold therapy can help reduce swelling, while heat therapy can help relax muscles and improve circulation.
• Consider acupuncture, massage, and physical therapy as additional options for pain management.
• Anti-inflammatory foods: Include foods rich in flavonoids, such as soy, berries, broccoli, grapes, and green tea, in your diet to help reduce inflammation. High-fiber foods, berries, cherries, leafy green vegetables, and black peppers provide antioxidants, calcium, and vitamin B12 that can support overall health.
• Foods or drinks that can trigger acid reflux or heartburn, such as onions, peppermint, chocolate, citrus fruits or juices, tomatoes, and high-fat and spicy foods, should be avoided.
• Quit smoking and limit alcohol consumption as they can negatively impact overall health, including joint health.
• Inform your doctor if you have specific medical conditions or risk factors that may increase the risk of heart problems.
• Regular monitoring of liver and kidney function may be necessary during the long-term use of Neso 500/20mg Tablet.
• Be aware that esomeprazole in the tablet may interfere with certain laboratory tests, so it's important to inform healthcare providers about your medication use.
• Vitamin B12 levels should be regularly monitored during long-term use of Neso 500/20mg Tablet, as it can rarely lead to deficiency.

Indication of Neso 500/20mg Tablet

Neso 500/20mg Tablet is a non-steroidal anti-inflammatory drug. It works by reducing the hormones that cause pain and inflammation in the body and inhibits the H+/K+ ATPase channel. The tablet is helpful against conditions such as erosive esophagitis, gastroesophageal reflux disease (GERD), Helicobacter pylori infections, and Zollinger-Ellison syndrome.

Pharmacology

Neso 500/20mg Tablet is formulated with two distinct layers. The first layer contains an immediate-release formulation of esomeprazole magnesium, while the second layer consists of enteric-coated naproxen.

Esomeprazole is a proton pump inhibitor that primarily acts on proton pumps in the stomach's parietal cells. By specifically inhibiting the ATPase H+/K+ pump, esomeprazole effectively reduces gastric acid secretion. This mechanism leads to a decrease in the production of stomach acid, providing relief from conditions such as heartburn, indigestion, and gastric ulcers.

Naproxen, on the other hand, is a non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties. Its primary mode of action is the inhibition of prostaglandin synthesis. Prostaglandins are chemical substances involved in inflammation, pain, and fever. By inhibiting their production, naproxen helps alleviate pain, reduce inflammation, and lower body temperature.

In Neso 500/20mg Tablet, the immediate-release esomeprazole layer is designed to release the medication in the stomach, where it can quickly inhibit gastric acid secretion. The enteric-coated naproxen core remains intact until it reaches the small intestine. Once in the small intestine, the enteric coating dissolves, allowing the naproxen to be absorbed into the bloodstream and exert its anti-inflammatory and analgesic effects.

By combining these two medications in a single tablet with this formulation, Neso 500/20mg Tablet provides the benefits of both esomeprazole and naproxen while reducing the risk of gastric irritation associated with NSAID use.

Dosage & Administration of Neso 500/20mg Tablet

For adults with conditions such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis:

• The recommended dose is one capsule of Neso 500/20mg Tablet twice daily.
• Each capsule contains 375 mg of naproxen and 20 mg of esomeprazole, or alternatively, 500 mg of naproxen and 20 mg of esomeprazole.

For adolescent patients aged 12 years and older with juvenile idiopathic arthritis, weighing more than 50 kg:

• The recommended dose is either 375 mg of naproxen and 20 mg of esomeprazole or 500 mg of naproxen and 20 mg of esomeprazole.

For adolescent patients aged 12 years and older with juvenile idiopathic arthritis, weighing between 38 kg and less than 50 kg:

• The recommended dose is 375 mg of naproxen and 20 mg of esomeprazole tablets, taken twice daily.

It's important not to split, chew, crush, or dissolve the tablet. Neso 500/20mg Tablet should be taken at least 30 minutes before meals.

Please note that the dosing and administration instructions provided here are for informational purposes only. Individual dosage and treatment regimens may vary based on the patient's condition, medical history, and healthcare provider's instructions. It's essential to consult with your doctor or pharmacist to obtain accurate and personalized dosing recommendations for Neso 500/20mg Tablet.

Interaction

Aspirin: There may be an increased risk of stomach bleeding when taking Neso 500/20mg Tablet with aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).

Ibuprofen: Similar to aspirin, there may be an increased risk of stomach bleeding when taking Neso 500/20mg Tablet with ibuprofen or other NSAIDs.

Warfarin: Neso 500/20mg Tablet may interact with warfarin, a blood thinner, potentially increasing the risk of bleeding. Regular monitoring of blood clotting parameters may be necessary.

Rivaroxaban: Neso 500/20mg Tablet may interact with rivaroxaban, an anticoagulant, potentially increasing the risk of bleeding. Close monitoring is advised.

Prednisolone: There may be an increased risk of stomach ulcers and bleeding when taking Neso 500/20mg Tablet with prednisolone or other corticosteroids.

Furosemide: Neso 500/20mg Tablet may decrease the diuretic effect of furosemide, a medication used to treat fluid retention. Close monitoring of fluid balance and renal function is recommended.

Propranolol, Enalapril, Losartan, and Candesartan: Neso 500/20mg Tablet may interact with these medications used to treat heart problems and high blood pressure, potentially reducing their effectiveness. Blood pressure should be closely monitored.

Citalopram: There may be an increased risk of bleeding when taking Neso 500/20mg Tablet with citalopram, an antidepressant. Caution is advised, and any unusual bleeding should be reported to a healthcare professional.

Methotrexate: Neso 500/20mg Tablet may interact with methotrexate, a medication used to treat rheumatoid arthritis, potentially increasing the risk of methotrexate toxicity. Close monitoring is necessary.

It's essential to consult with a healthcare professional or pharmacist about potential interactions between Neso 500/20mg tablet and any other medications you are taking. They can provide personalized advice based on your specific situation.

Regarding drug-food interactions, it's advised to avoid alcohol intake while taking Neso 500/20mg Tablet due to the increased risk of stomach bleeding, drowsiness, and dizziness.

For individuals with specific medical conditions, such as diabetes, stomach ulcer, gastrointestinal bleeding, asthma, kidney, liver, or heart problems, or autoimmune conditions like systemic lupus erythematosus, colitis, or Crohn's disease, it is important to consult with a doctor before taking Neso 500/20mg Tablet, as there may be specific considerations or precautions to be taken.

Contraindications

If you have a known allergy to any component of Neso 500/20mg Tablet or to substituted benzimidazole medications, you should avoid taking this medication. Allergies can manifest as various symptoms, including rash, itching, swelling, or difficulty breathing. It's important to inform your healthcare provider about any known allergies before starting any new medication.

Additionally, if you have a history of asthmatic urticaria (hives) or other allergic reactions after taking aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), it's advisable to exercise caution when considering the use of Neso 500/20mg Tablet. NSAIDs, including naproxen, can potentially trigger allergic reactions in individuals with a history of sensitivity.

Regarding the perioperative period of coronary artery bypass graft (CABG) surgery, it's worth noting that the use of NSAIDs, including naproxen, may not be recommended during this time. The decision to use any medication in the perioperative period should be made by the healthcare team involved in the surgical procedure, taking into consideration the individual patient's condition, risks, and benefits.

It's crucial to discuss your specific medical history and any concerns with your doctor or healthcare provider before initiating Neso 500/20mg Tablet or any other medication. They will be able to evaluate your individual circumstances and provide appropriate recommendations or alternative treatment options if necessary.

Pregnancy & Lactation

Pregnancy category: Neso 500/20mg Tablet is classified as pregnancy category C. This means that it may have the potential to cause harm to the fetus if used during pregnancy. It is generally recommended to avoid using this medication, especially in the third trimester, as it can cause premature closure of the ductus arteriosus in the fetus. The closure of the ductus arteriosus is an important step in the transition of blood circulation after birth. Therefore, it's important to consult with a healthcare provider or doctor for a thorough evaluation of the risks and benefits before using Neso 500/20mg Tablet during pregnancy.

Breastfeeding: Due to the naproxen content in Neso 500/20mg Tablet it is generally advised to avoid using this medication while breastfeeding. Naproxen can be excreted in breast milk and may potentially have adverse effects on the nursing infant. It is recommended to discuss alternative pain management options with your healthcare provider if you are breastfeeding.

Precautions & Warnings

Allergy: It is important not to take Neso 500/20mg Tablet if you are allergic to it or any of its components. Allergic reactions can range from mild to severe and may include symptoms such as rash, itching, swelling, or difficulty breathing.

Long-term use of NSAIDs: Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), including naproxen in Neso 500/20mg Tablet, may increase the risk of heart attack, stroke, and stomach ulcers. The risk of developing ulcers is higher in individuals with a history of ulcers, bleeding disorders, advanced age, alcoholism, or multiple diseases. It's important to discuss the risks and benefits of long-term NSAID use with your doctor.

Elderly patients: Elderly patients are at a higher risk of gastrointestinal bleeding problems associated with NSAID use. The doctor may need to limit the dose for elderly patients to minimize this risk.

Recent or upcoming heart bypass surgery: Neso 500/20mg Tablet should not be used by patients who have recently undergone heart bypass surgery or are scheduled to have it. This is because NSAIDs, including naproxen, may interfere with the healing process.

Pregnancy and breast-feeding: Neso 500/20mg Tablet is not recommended for pregnant women, especially in the third trimester, as it may harm the baby. Pregnant or breastfeeding women should consult a doctor before taking Neso 500/20mg Tablet to evaluate the potential risks and benefits.

Children: Neso 500/20mg Tablet should not be given to children unless prescribed by a doctor. The safety and appropriate dosage for children should be determined by a healthcare professional.

Concomitant use of other NSAIDs: It is important not to take any other NSAIDs for pain relief along with Neso 500/20mg Tablet unless specifically prescribed by a doctor. Taking multiple NSAIDs simultaneously can increase the risk of side effects.

Bone health: Prolonged use of proton pump inhibitors like esomeprazole (present in Neso 500/20mg Tablet) may be associated with an increased risk of brittle bones. In some cases, the doctor may recommend taking Vitamin D and calcium supplements to support bone health while using Neso 500/20mg Tablet.

Alcohol consumption: It is advised not to consume alcohol while taking Neso 500/20mg Tablet as it may increase the risk of stomach bleeding or ulcer formation.

Storage Conditions

This tablet should be stored at room temperature, away from heat and direct light. Keep it away from the reach of children and pets.