Universal reference book for medicines
Name of the drug: NAPROXEN-ACRI® (NAPROXEN-AKRI®)

Active substance: naproxen

Type: NSAIDs

Manufacturer: Chemical-Pharmaceutical Plant Akrihin (Russia)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
NSAID, a derivative of naphthylpropionic acid.
Has anti-inflammatory, analgesic and antipyretic effect.
The mechanism of action is associated with inhibition of the enzyme COX, which leads to inhibition of the synthesis of prostaglandins from arachidonic acid.

Suppresses the aggregation of platelets.

Reduces pain syndrome, incl.
pain in the joints at rest and during movement, morning stiffness and swelling of the joints, contributes to an increase in the volume of movements. The anti-inflammatory effect comes to the end of the 1st week of treatment.
PHARMACOKINETICS
After ingestion naproxen is rapidly absorbed from the digestive tract.
C max in plasma is achieved after 1-4 hours. The food slows the rate of absorption, but does not reduce the degree of absorption. Naproxen is well absorbed by rectal administration, but absorption is slower than when ingested.
In therapeutic concentrations, naproxen binds to plasma proteins by more than 99%.
The concentration of naproxen in the plasma increases proportionally at doses up to 500 mg, at higher doses an increase in clearance due to saturation of plasma proteins is observed.
Naproxen diffuses into the synovial fluid.

T 1/2 is about 13 hours. Approximately 95% of the dose is excreted in the urine as unchanged substance and 6-O-desmethylnaproxen and its conjugates.
Less than 5% is administered with feces.
INDICATIONS
Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, articular syndrome with exacerbation of gout;
pain in the spine, neuralgia, myalgia, traumatic inflammation of soft tissues and the musculoskeletal system. As an auxiliary agent for infectious and inflammatory diseases of ENT organs, adnexitis, primary dysmenorrhea, headache and toothache.
DOSING MODE
Established individually taking into account the severity of the course of the disease.

Inside adults - 0.5-1 g / day in 2 divided doses.
The daily dose for maintenance treatment is 500 mg.
The maximum daily dose is 1.75 g.

Children aged 1 to 5 years - 2.5-5 mg / kg / day in 1-3 divided doses, the maximum course of treatment is 14 days.
With juvenile arthritis in children older than 5 years, the daily dose is 10 mg / kg.
SIDE EFFECT
On the part of the digestive system: nausea, vomiting, a feeling of discomfort in the epigastrium;
rarely - erosive and ulcerative lesions of the gastrointestinal tract, bleeding and perforation of the gastrointestinal tract, impaired liver function.
From the side of the central nervous system and peripheral nervous system: headache, drowsiness, slowing of the speed of psychomotor reactions;
rarely - hearing impairment.
From the hemopoietic system: rarely - thrombocytopenia, granulocytopenia, aplastic anemia, hemolytic anemia.

From the respiratory system: rarely - eosinophilic pneumonia.

From the urinary system: rarely - renal dysfunction.

Allergic reactions: skin rash, urticaria, angioedema.

With rectal administration: the appearance of mucous discharge with an admixture of blood, a painful defecation.

CONTRAINDICATIONS
Erosive-ulcerative lesions of the gastrointestinal tract in the phase of exacerbation, "aspirin triad", hematopoietic disorders, expressed renal dysfunction (CC less than 20 ml / min), severe liver function disorders, children under 1 year;
hypersensitivity to naproxen and other NSAIDs.
PREGNANCY AND LACTATION
Use with caution in pregnancy (especially in I and III trimesters) and during lactation.

Naproxen penetrates through the placental barrier, excreted in breast milk in small amounts.

APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in severe renal dysfunction (KK less than 20 ml / min).

APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Contraindicated in severe violations of liver function.

APPLICATION FOR CHILDREN
Contraindicated in children under 1 year.

SPECIAL INSTRUCTIONS
With caution apply for liver and kidney disease, gastrointestinal diseases in history, with dyspeptic symptoms, with arterial hypertension, heart failure, immediately after serious surgical interventions.

In the process of treatment, systematic monitoring of liver and kidney function, a picture of peripheral blood is necessary.

If it is necessary to determine the concentration of 17-ketosteroids, naproxen should be discontinued 48 hours before the study.

Impact on the ability to drive vehicles and manage mechanisms

During the period of application, it is necessary to refrain from potentially dangerous activities related to the need for concentration of attention and increased speed of psychomotor reactions.

DRUG INTERACTION
With simultaneous application with antacids containing magnesium and aluminum, sodium bicarbonate, absorption of naproxen decreases.

With simultaneous use with indirect anticoagulants, cases of slight enhancement of the effect of anticoagulants are described.

With simultaneous use with amoxicillin, a case of developing a nephrotic syndrome is described;
with acetylsalicylic acid - it is possible to reduce the concentration of naproxen in the blood plasma.
With simultaneous application, it is possible to change the pharmacokinetic parameters of diazepam;
with caffeine - the effect of naproxen is enhanced; with lithium carbonate - it is possible to increase the concentration of lithium in blood plasma; with methotrexate - may increase the toxicity of methotrexate.
There are reports of the development of myoclonus when used simultaneously with morphine.

With simultaneous use with prednisolone, a significant increase in the concentration of prednisolone in the blood plasma is possible;
with probenecid - a decrease in the concentration of naproxen in the blood plasma; with salicylamide - increases the effect of salicylamide.
With simultaneous application with furosemide, a decrease in the diuretic effect of furosemide is possible.

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