Nasopain Tablet (Delayed Release) 500 mg + 20 mg

Nasopain Tablet (Delayed Release) combines Naproxen Sodium + Esomeprazole Magnesium (500 mg+20 mg) to address inflammation and reduce gastric risks. Manufactured by Jenphar Bangladesh Ltd, this delayed-release tablet offers dual-action therapy for arthritis and chronic pain management.

Priced at ৳15.00 per unit (90.00/strip), Nasopain is prescribed for osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Its unique formulation releases esomeprazole first to protect the stomach lining before naproxen acts as an NSAID to reduce pain and inflammation.

Key pharmacological benefits:

• Naproxen inhibits prostaglandin synthesis for pain relief
• Esomeprazole blocks gastric acid production via H⁺/K⁺ ATPase inhibition
• Proven 67% reduction in NSAID-induced ulcers compared to monotherapy

Dosage varies by condition and patient weight, typically 1 tablet twice daily. For adolescents (12+ years), weight-based dosing applies. Avoid combining with blood thinners or antihypertensives due to interaction risks.

Common side effects include mild gastrointestinal discomfort, though significantly reduced compared to standard NSAIDs. Contraindicated in third-trimester pregnancy and breastfeeding. Store below 30°C in original packaging to maintain stability.

Adults: 500 mg naproxen +20 mg esomeprazole twice daily. Contraindicated in severe renal impairment (creatinine clearance <30 ml/min). Hepatic impairment requires dose adjustment. Administer with/without food, but high-fat meals delay absorption. Continue as directed by physician based on treatment response.

Immediate release esomeprazole has been included in the tablet formulation to decrease the incidence of gastrointestinal side effects from Naproxen. Naproxen and Esomeprazole tablet has been shown to significantly decrease the occurrence of gastric ulcers and NSAID associated upper gastrointestinal adverse events compared to Naproxen alone. Naproxen: Clinical trial and epidemiological data suggest that use of coxibs and some NSAIDs (particularly at high doses and in long-term treatment) may be associated with a small increased risk of arterial thrombotic events (for example myocardial infarction or stroke). Although data suggest that the use of Naproxen (1000 mg daily) may be associated with a lower risk, some risk cannot be excluded. Oedema, hypertension and cardiac failure have been reported in association with NSAID treatment. The most commonly observed adverse events are gastrointestinal in nature. Peptic ulcers, perforation or GI bleeding, sometimes fatal, particularly in older people, may occur. Nausea, vomiting, diarrhoea, flatulence, constipation, dyspepsia, abdominal pain, melaena, haematemesis, ulcerative stomatitis, exacerbation of colitis and Crohn’s disease have been reported following administration. Less frequently, gastritis has been observed.

Contraindicated in third trimester. Naproxen excreted in breast milk – avoid during lactation. NSAIDs may impair female fertility when attempting conception.

Monitor BP, renal function in elderly (>65 years). Test/treat H. pylori infection if present. Check vitamin B₁₂ levels during prolonged use. NSAID therapy >1 year requires GI surveillance.

Pediatrics (12+ years): 375 mg naproxen for 38-50 kg weight. Use lowest effective dose in elderly. Maximum 20 mg esomeprazole/day in severe hepatic impairment.

Symptoms: Related to Naproxen overdose- Significant Naproxen overdosage may be characterized by lethargy, dizziness, drowsiness, epigastric pain, abdominal discomfort, heartburn, indigestion, nausea, transient alterations in liver function, hypoprothrombinemia, renal dysfunction, metabolic acidosis, apnea, disorientation or vomiting. Gastrointestinal bleeding can occur. Hypertension, acute renal failure, respiratory depression, and coma may occur, but are rare. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following an overdose. It is not known what dose of the drug would be life-threatening.

Related to esomeprazole overdose- The symptoms described in connection with deliberate esomeprazole overdose (limited experience of doses in excess of 240 mg/day) are transient. Single doses of 80 mg esomeprazole were uneventful.

Management: Related to Naproxen- Patients should be managed by symptomatic and supportive care following a NSAID overdose, particularly with respect to GI effects and renal damage. There are no specific antidotes. Hemodialysis does not decrease the plasma concentration of Naproxen because of the high degree of its protein binding. Emesis and/or activated charcoal (60 to 100 g in adults, 1 to 2 g/kg in children) and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose. Forced diuresis, alkalinization of urine or hemoperfusion may not be useful due to high protein binding.

Related to Esomeprazole- No specific antidote is known. Esomeprazole is extensively plasma protein bound and is therefore not readily dialyzable. As in any case of overdose, treatment should be symptomatic and general supportive measures should be utilised.