Napexa 375mg+20mg Tablet

✔️ Uses of naproxen and esomeprazole

The combination of naproxen and esomeprazole is used to manage the signs and symptoms of:

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis

It is also prescribed to reduce the risk of NSAID-induced gastric ulcers in patients who require long-term anti-inflammatory therapy.

✔️ Side Effects:

• Indigestion and gastritis
• Diarrhea
• Gastric ulcer
• Upper abdominal pain
• Nausea

✔️ This formulation consists of a rapid-release layer of esomeprazole magnesium and an enteric-coated core of naproxen.

• Esomeprazole is released first in the stomach, reducing acid secretion by inhibiting the proton pump (H+/K+ ATPase) in gastric parietal cells. This lowers stomach acidity.
• Naproxen, a non-steroidal anti-inflammatory drug (NSAID), is released later in the small intestine and works by inhibiting prostaglandin synthesis, thereby reducing pain, inflammation, and fever.

✔️ Interaction

• NSAIDs may reduce the effectiveness of ACE inhibitors, diuretics, and beta-blockers
• Increased risk of bleeding when used with warfarin
• Esomeprazole may alter the absorption of drugs affected by gastric pH

✔️ Dosage & Administration

Use the lowest effective dose for the shortest duration based on individual treatment goals.

Adults (Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis):

• One tablet twice daily of either:
  • 375 mg naproxen / 20 mg esomeprazole
  • 500 mg naproxen / 20 mg esomeprazole

Adolescents (≥12 years):

• >50 kg: Same as adult dose
• 38–50 kg: One tablet (375 mg/20 mg) twice daily

If a lower dose of esomeprazole (below 40 mg daily) is required, alternative therapy should be considered.

✔️ Pregnancy & Lactation

• Classified as pregnancy category C
• Should be avoided in late pregnancy due to the risk of premature closure of the fetal ductus arteriosus
• Not recommended for use during breastfeeding due to the naproxen component

✔️ Contraindications:

• Patients with hypersensitivity to naproxen, esomeprazole, or other similar drugs
• Individuals with a history of allergic reactions to NSAIDs (e.g., asthma, urticaria)
• Patients undergoing coronary artery bypass graft (CABG) surgery

✔️ Precautions & Warnings

• Use cautiously in patients with cardiovascular disease or risk factors
• Monitor patients with fluid retention or heart failure
• Long-term use should be carefully evaluated due to potential risks

✔️ Storage:

• Store below 30°C
• Protect from light and moisture
• Keep out of reach of children