Molecular structure of Naproxen
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Anaprox

Naproxen (trade names: Aleve, Anaprox, Naprogesic, Naprosyn, Naprelan) is a non-steroidal anti-inflammatory drug (NSAID) commonly used for the reduction of mild to moderate pain, fever, inflammation and stiffness caused by conditions such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis, injury, menstrual cramps, tendinitis, bursitis, and the treatment of primary dysmenorrhea. It works by reducing hormones that cause inflammation and pain in the body. more...

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Although naproxen typically requires a higher dosage than other NSAIDs — a minimal dose is about 200 mg — it binds very well to albumin and thus achieves a longer half-life in the blood than other drugs, lasting up to 12 hours per dose.

Naproxen is also available as a sodium salt, naproxen sodium, which is more rapidly absorbed from the gastrointestinal tract.

Naproxen was first sold as the prescription drug Naprosyn in 1976; naproxen sodium was first sold under the trade name Anaprox in 1980. The Food and Drug Administration (FDA) approved naproxen sodium's use as an over-the-counter drug in 1991 , and it is sold in the United States as Aleve. Naproxen is still a prescription drug in much of the world, including Canada.

Structure and details

Naproxen is a member of the arylacetic acid family of NSAIDs. It is an odorless, white to off-white crystalline substance with a molecular weight of 230.2628. It is lipid-soluble, practically insoluble in water with a low pH (below pH 4), while freely soluble in water at 6 pH and above. Naproxen has a melting point of 153 °C.

Side effects and warnings

Like other NSAIDs, naproxen is capable of producing disturbances in the gastrointestinal tract. Taking the medication with food may help to alleviate this most commonly reported side-effect.

Also like other NSAIDs, naproxen can inhibit the excretion of sodium and lithium. Extreme care must be taken by those who use this drug along with lithium supplements.

Naproxen is also not recommended for use with NSAIDs of the salicylate family (drugs may reduce each other's effects), nor with anticoagulants (may increase risk of bleeding).

In December 2004, the FDA issued a press release following the decision by the National Institutes of Health to halt a five-year study, called the Alzheimer's Disease Anti-Inflammatory Prevention Trial. That study aimed to test both Aleve and Celebrex as preventatives for Alzheimer's disease. Preliminary information from the study showed naproxen elevated the risk of heart attack and stroke by 50%. The FDA advised patients taking over-the-counter naproxen products to:

  • carefully follow the instructions on the label,
  • avoid exceeding the recommended doses for naproxen (220 milligrams twice daily), and
  • take naproxen for no longer than ten days unless a physician directs otherwise.

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Cirrhosis—A Liver Problem
From American Family Physician, 11/15/01

What is cirrhosis?

If the liver is damaged, scars can form. When the liver has a lot of scar tissue, blood will not easily flow through it. Cirrhosis is the name for a scarred liver. (Say this: sir-oh-sis.) Cirrhosis keeps the liver from working the way it should. A liver with cirrhosis can't make enough of some proteins your body needs. It can't remove enough harmful toxins (poisons) from your blood. It can't help your blood to clot normally.

What causes cirrhosis?

Cirrhosis is most often caused by heavy use of alcohol or by an infection (usually with the hepatitis B or hepatitis C virus). Some medicines and chemicals can hurt the liver. Diseases that weaken the immune system and some inherited diseases can damage the liver.

What problems can cirrhosis cause?

* People with cirrhosis bruise easily because their blood does not clot the right way. When these people have a cut, it may bleed for a long time.

* Blood vessels around the esophagus (in the throat) and the intestines can stretch and become thin. If these blood vessels burst open, the result is a dangerous amount of bleeding.

* Because the liver is not working right, toxins build up in the blood. They can hurt your brain. People with cirrhosis are also more likely to get liver cancer.

* If the cirrhosis is so bad that the liver stops working, the only treatment is a liver transplant.

* Cirrhosis can cause death. According to the American Liver Foundation, cirrhosis is the 8th leading cause of death in the United States.

Can any of these problems be prevented?

If you have cirrhosis, it may be possible to avoid, or at least slow down, many of the problems caused by cirrhosis. Here are some things you can do to feel better for a longer time:

* Don't drink any amount of alcohol of any kind.

* Ask your doctor about getting important vaccines, like hepatitis A vaccine, hepatitis B vaccine, pneumococcal vaccine (to help prevent pneumonia) and influenza vaccine (to help prevent the flu). Hepatitis A infection is very dangerous for people with liver damage.

* Tell your doctor about every medicine, vitamin and herbal remedy you are taking. Many medicines and herbal remedies are dangerous to people with cirrhosis (see the list in the box on the next page).

* Follow a low-fat, "heart-smart" diet. Foods that are low in fat, oil, and salt are good for your liver and your heart.

* Work with your doctor to set up a health care routine. In addition to your regular doctor visits, you will need tests at least once a year to check your liver and your risk for bleeding problems.

Where can I get more information about chronic liver disease and cirrhosis?

For more information, you can contact the following groups:

COPYRIGHT 2001 American Academy of Family Physicians
COPYRIGHT 2001 Gale Group

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