Tab. Napro A Plus 500 mg

Ingredients:
Each tablet contains:
Naproxen Sodium – A nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation.
Esomeprazole Magnesium – A proton pump inhibitor (PPI) that reduces stomach acid, helping to prevent gastric irritation caused by NSAIDs.

Direction of Use:
Take the tablet with a full glass of water.
Swallow whole; do not crush, chew, or break the tablet.
It is best taken before meals to reduce the risk of stomach upset.
Follow your doctor’s instructions for the best results.

Indication:
Relief of pain and inflammation in conditions such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.
Prevention of NSAID-induced gastric ulcers in patients at risk of gastrointestinal complications.

Pharmacology:
Naproxen Sodium: A non-selective NSAID that inhibits cyclooxygenase (COX-1 and COX-2), reducing pain, inflammation, and fever.
Esomeprazole Magnesium: A PPI that suppresses stomach acid production by blocking the H⁺/K⁺ ATPase enzyme in the gastric parietal cells, protecting against NSAID-induced ulcers.

Dosage & Administration:
Adults: 1 tablet twice daily (morning and evening) or as prescribed by a doctor.
Use in children: Not recommended unless directed by a physician.
Duration: Use for the shortest duration necessary to manage symptoms.

Interaction:
With anticoagulants (e.g., warfarin): May increase the risk of bleeding.
With corticosteroids or other NSAIDs: Increases the risk of stomach ulcers and bleeding.
With proton pump inhibitors (e.g., omeprazole): May reduce the absorption of naproxen.
With diuretics, ACE inhibitors, or beta-blockers: NSAIDs may reduce their effectiveness.
With digoxin or methotrexate: Can increase their levels in the blood, leading to toxicity.

Contraindications:
Hypersensitivity to naproxen, esomeprazole, or other NSAIDs/PPI drugs.
History of asthma, urticaria, or allergic reactions after taking aspirin or NSAIDs.
Active gastrointestinal bleeding, peptic ulcers, or severe liver/kidney disease.
Pregnancy (especially third trimester) unless advised by a doctor.

Side Effects:
Common: Nausea, headache, dizziness, heartburn, bloating, and constipation.
Serious but rare: Stomach ulcers, gastrointestinal bleeding, kidney problems, and severe allergic reactions.

Pregnancy & Lactation:
Pregnancy: Not recommended, especially in the third trimester due to potential harm to the fetus.
Lactation: May pass into breast milk; consult a doctor before use.

Precautions & Warnings:
Avoid alcohol and smoking, as they increase the risk of stomach ulcers.
Patients with cardiovascular disease should use with caution, as NSAIDs can increase the risk of heart attack and stroke.
Long-term use may require monitoring of kidney, liver, and gastrointestinal health.

Overdose Effects:
Symptoms include severe stomach pain, vomiting (possibly with blood), confusion, drowsiness, and difficulty breathing.
Seek immediate medical attention in case of overdose.

Therapeutic Class:
NSAID + Proton Pump Inhibitor Combination

Storage Conditions:
Store below 30°C, in a dry place, away from direct sunlight and moisture.
Keep out of reach of children.