Sonap 250

Indications

Sonap serves to alleviate the signs and symptoms associated with various conditions, including:

• Rheumatoid arthritis
• Osteoarthritis
• Ankylosing spondylitis
• Juvenile arthritis
• Tendonitis
• Bursitis
• Acute gout Additionally, it is effective in managing primary dysmenorrhea and pain.

Pharmacology

Similar to other non-selective NSAIDs, naproxen operates by inhibiting COX-1 and COX-2 enzymes, thereby reducing prostaglandin synthesis. While both enzymes contribute to prostaglandin production, they function differently. COX-1 is consistently active and present in normal tissues like the stomach lining, while COX-2 is inducible and produces prostaglandins responsible for pain, fever, and inflammation. Naproxen’s desirable antipyretic, analgesic, and anti-inflammatory properties stem from its inhibition of the COX-2 enzyme, while unwanted effects like gastrointestinal upset and renal issues are associated with COX-1 inhibition.

Dosage & Administration

Naproxen oral formulations should be ingested with water, preferably after meals.

Naproxen Enteric Coated Tablet:

• Adults: For rheumatoid arthritis, osteoarthritis, ankylosing spondylitis: 500-1000 mg per day in two divided doses at 12-hour intervals. The maintenance dose is typically 500 mg per day in two divided doses at 12-hour intervals, not exceeding 1000 mg daily.
• For acute gout: Initially 750 mg, followed by 250 mg every 8 hours until the attack subsides. Not recommended for children under 16.
• For dysmenorrhea: Initially 500 mg, followed by 250 mg every 6-8 hours for up to 5 days if necessary.
• For other indications like analgesia and acute musculoskeletal disorders: Initially 500 mg, followed by 250 mg every 6-8 hours if necessary. Naproxen Enteric Coated Tablet for Children: Not recommended for children under 16.

Naproxen Suspension for Children:

• For juvenile rheumatoid arthritis: The usual dose for children over 2 years is 10 mg/kg/day in two divided doses at 12-hour intervals. Therapy in children under 2 years is not recommended. Dosage guide:
  • 13 kg (29 lb): 2.5 mL b.i.d.
  • 25 kg (55 lb): 5 mL b.i.d.
  • 38 kg (84 lb): 7.5 mL b.i.d.

Naproxen Gel: Apply 2-6 times daily as needed, not recommended for children.

Interactions

• ACE inhibitors: Diminish antihypertensive effect.
• Antacids & Sucralfate: Delay Sonap absorption.
• Aspirin: Increase adverse effects.
• Diuretics: Reduce natriuretic effect.
• Methotrexate: Enhance toxicity.
• Warfarin: Increase GI bleeding risk.
• Selective Serotonin Reuptake Inhibitors (SSRI): Increase GI bleeding risk.

Contraindications

Naproxen is contraindicated in patients with known hypersensitivity to it. Avoid in patients with asthma, urticaria, or allergic-type reactions to aspirin or other NSAIDs. Contraindicated for perioperative pain in coronary artery bypass graft (CABG) surgery.

Side Effects

Common side effects may include:

• Gastrointestinal: Heartburn, abdominal pain, nausea, diarrhea, dyspepsia.
• Central Nervous System: Headache, vertigo, drowsiness.
• Dermatological: Pruritus, purpura.
• Cardiovascular: Edema, palpitation.
• Others: Visual disturbances, hearing disturbances.

Pregnancy & Lactation

Naproxen may adversely affect the fetus and should be cautiously used in pregnancy. It’s excreted in breast milk but considered safe in small amounts.

Precautions & Warnings

Renal effects: Long-term use may lead to renal issues. Caution in patients with impaired renal function. Monitor serum creatinine and/or creatinine clearance.

Hepatic effects: Few cases of jaundice reported.

Therapeutic Class

Osteoarthritis and rheumatoid arthritis drugs, Non-steroidal Anti-inflammatory Drugs (NSAIDs).

Storage Conditions

Store below 30°C, protected from light and moisture, and out of children’s reach.