Indications

Anaflex (Naproxen) is a non-steroidal anti-inflammatory drug (NSAID) used to relieve the signs and symptoms of:

• Arthritis: Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and juvenile arthritis.
• Inflammatory Conditions: Tendonitis, bursitis, and acute gout. It is also indicated for the management of primary dysmenorrhea and pain.

Pharmacology

Naproxen is a non-selective NSAID that works by blocking both COX-1 and COX-2 enzymes. This action reduces the synthesis of prostaglandins, which are responsible for pain, fever, and inflammation. The inhibition of COX-2 provides the desired therapeutic effects, while the inhibition of COX-1 is linked to potential gastrointestinal and renal side effects.

Dosage & Administration

• Oral Preparations: Should be taken with water, preferably after meals.
• Adults (Enteric Coated Tablet):
  • Arthritis: 500-1000 mg per day in two divided doses at 12-hour intervals. Maximum daily dose is 1000 mg.
  • Acute Gout: Initial dose of 750 mg, followed by 250 mg every 8 hours until the attack subsides.
  • Dysmenorrhea & other pain: Initial dose of 500 mg, followed by 250 mg every 6-8 hours as needed, for up to 5 days.
• Children (Suspension):
  • Juvenile Rheumatoid Arthritis: 10 mg/kg/day in two divided doses for children over 2 years old.
• Naproxen Gel: Apply 2-6 times a day as needed. Not for use in children under 12 years.

Interaction

• ACE Inhibitors: May diminish their antihypertensive effect.
• Antacids & Sucralfate: May delay the absorption of Anaflex.
• Warfarin & SSRIs: Increase the risk of gastrointestinal bleeding.
• Diuretics: May reduce the diuretic effect of Furosemide and Thiazides.
• Methotrexate: May enhance its toxicity.

Contraindications

Anaflex is contraindicated in patients with hypersensitivity to Naproxen or who have experienced asthma, urticaria, or allergic reactions to aspirin or other NSAIDs. It should not be used for perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.

Side Effects

The most common side effects are gastrointestinal, including heartburn, abdominal pain, nausea, and diarrhea. Other side effects may include headache, drowsiness, dizziness, edema, and visual or hearing disturbances.

Pregnancy & Lactation

The use of Anaflex in the first and third trimesters of pregnancy requires careful consideration of the benefits versus risks. It may cause premature closure of the ductus arteriosus in infants. Small amounts are excreted in breast milk; however, some manufacturers recommend avoiding breastfeeding.

Precautions & Warnings

• Renal effects: Use with caution in patients with impaired renal function, as it can cause renal damage with long-term use.
• Hepatic effects: There have been rare reports of moderate to severe jaundice.
• GI effects: Use with caution in patients with a history of gastrointestinal disease due to the risk of ulceration and bleeding.

Therapeutic Class

Anaflex belongs to the class of Non-steroidal Anti-inflammatory Drugs (NSAIDs), and is also used for Osteoarthritis and Rheumatoid Arthritis.

Storage Conditions

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