Loxoprofen Anhydrous Sodium

Indications & Dose:

Musculoskeletal disorders, rheumatic arthritis, (including juvenile arthritis) osteoarthritis, ankylosing spondylitis, acute gout, chronic juvenile arthritis. Mild to moderate pain including dysmenorrhoea; postoperative analgesia, fever and dental pain.)
Adult

• BY MOUTH

60 mg three times daily.

Child

Not recommended. 

Contraindications:

Patients with a his-tory of hypersensitivity to aspirin or any other NSAID— which includes those in  whom attacks of asthma, angio-edema, urticaria or rhinitis, nasal polyps, bronchospasm and other symptoms of aller-gic or anaphylactoid reactions. Active  peptic ulceration have been precipitated by aspirin or any other NSAID)
Pregnancy: Use is not recommended.&
breast feeding: Contraindicated. 

Side Effects:

Gastro-intestinal discomfort: nausea, diarrhoea, and occasionally bleeding and ulceration occur; dyspepsia may be minimised by taking these drugs with food or milk. Hypersensitivity reactions (particularly angioedema, bronchospasm,and rashes), headache, dizziness, vertigo, hearing disturbances such as tinnitus, and haematuria. Blood disorders, fluid retention may occur (rarely precipitating congestive heart failure in elderly patients). Reversible acute renal failure may be provoked by NSAIDs especially in patients with preexisting renal impairment . Rarely, papillary necrosis or interstitial fibrosis associated with NSAIDs may lead to renal failure. Aseptic meningitis has been reported rarely with NSAIDs; patients with connective tissue disorders such as systemic lupus erythematosus may be especially suscep-tible. Hepatic damage is another rare side-effect inhibition of uterine motility.

SIDE EFFECTS SHARED BY NSAIDS: Gastrointestinal ulceration and intolerance (lesser with non acetylated salicylates or paminophenol derivatives),  inhibition of prostaglandin mediated renal function, blockade of plate-let aggregation, hypersensitivity reactions (most pronounced with aspirin than with non acetylated salicylates). 

Cautions:

In patients with renal, cardiac, or hepatic impairment caution is required since the use of NSAIDs may result in deterioration of renal function, the dose  should be kept as low as possible and renal function should be monitored. While it is preferable to avoid them in patients with current or previous gastro-intestinal ulceration, and to withdraw them if gastro-intestinal lesions develop, nevertheless patients with serious rheumatic diseases (e.g. rheumatoid arthritis) are usually dependent on NSAIDs for effective relief of pain and stiffness. Administration of histamine H2-receptor blocking drugs  or misoprostol may permit recommencement of a NSAID without further gastrointes-tinal problems. 

Precautions:

Monitor the pt. on long term treatment, G.I. bleeding, renal, hepatic or cardiac insufficiency, pregnancy, lactation, porphyria, haematological abnormalities, elderly.NSAIDs should be used with caution in the elderly, in allergic disorders (they are 
OLD AGE: Use with caution

Interaction:

Drug

Anticoagulants: May prolong prothrombin time. Instruct patients to watch for signs and symptoms of bleed-ing.

ACE inhibitors: Antihypertensive effects of captopril may be blunted or completely abolished by Indomethacin.

ß-Blockers: Antihypertensive effect may be blunted.

Cyclosporine: Nephrotoxicity of both agents may be increased.

Digoxin: Serum digoxin levels may be increased by ibuprofen and indomethacin.

Hydantoins: Serum hydantoin levels increased resulting in increased pharmacological and toxic effects.

Lithium: Serum lithium levels may be increased.

Loop diuretics: Decreased effects.

Methotrexate: Risk of methotrexate toxi-city (bone marrow suppression, nephrotoxicity, stomatitis) may be increased.

Salicylates: Displaces NSAIDs from serum binding sites resulting in decreased plasma concentrations of NSAIDs and increased incidence of GI effects.

Sympathomimetics: Indomethacin coadministration may result in increased blood pressure.

Thiazide diuretics: Naproxen and indomethacin may cause decreased antihypertensive and diuretic action.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: