► Anapran (naproxen (naproxen sodium)) - Practical Medicine

Anapran (naproxen (naproxen sodium)) - coated tablets

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Anapran coated tablets; 275 mg; 20 tables Polfa Pabianice S.A. 9.76 6.94
Anapran coated tablets; 275 mg; 60 tables Polfa Pabianice S.A. 21.55 13.10
Anapran coated tablets; 550 mg; 20 tables Polfa Pabianice S.A. 19.18 13.54
Anapran coated tablets; 550 mg; 60 tables Polfa Pabianice S.A. 41.36 24.45

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:naproxen (naproxen sodium)

The drug is available on prescription

What is Anapran?

It is a preparation with general action containing a non-steroidal anti-inflammatory drug.

What does Anapran contain and how does it work?

The active substance is Naproxen , a non-steroidal anti-inflammatory drug (NSAID) from the group of propionic acid derivatives (a naphthalene derivative). It has strong anti-inflammatory, analgesic and antipyretic effects. Naproxen counteracts the synthesis of prostaglandins, substances that play a significant role in the development of inflammation. The effect of naproxen is to inhibit the activity of cyclooxygenases (both COX-1 and COX-2). These enzymes take part in the reactions leading to the formation of prostaglandins from the lipids of cell membranes. Naproxen reduces the symptoms of inflammatory response (swelling, increased body temperature, pain, stiffness of the joints). The product is used in the treatment of inflammatory and pain conditions of rheumatic and non-rheumatic origin. It does not have antimicrobial activity. It also has an anti-platelet aggregation effect. The product contains naproxen in the form of sodium salt, which ensures faster absorption of the active substance and a faster start of analgesia. The analgesic effect occurs after 20 minutes, and the maximum concentration in the blood is usually obtained within 1 hour after administration. Naproxen sodium is almost completely absorbed from the gastrointestinal tract. The naproxen penetrates slowly into the joint cavities (stationary naproxen concentration in the synovial fluid is obtained after about 7 days of application). Naproxen passes through the placenta and into the breast milk of women.

When should I use Anapran?

The preparation is indicated for symptomatic treatment:
· Rheumatoid arthritis
· Juvenile rheumatoid arthritis
· Osteoarthritis
· Ankylosing spondylitis
· Osteoarthritis
· Acute inflammation of the musculoskeletal system (inflammation of synovial bursules, tenosynovitis)
· Acute attack of gout
· Pain of various origins of weak or moderate intensity, including post-traumatic, postoperative, bone and muscle pains, headache, MIG raine pain, toothache, neuralgia
· Painful menstruation
· In a fever of various origins.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients.
Contraindication to the preparation is allergic to Acetylsalicylic acid (colloquially called sometimes Aspirin ) or other non-steroidal anti-inflammatory drugs. Allergy to these drugs may be manifested as an attack of asthma, urticaria or acute rhinitis.
The use of the preparation is contraindicated in people:
with active or past peptic ulcer of the stomach and / or duodenum, bleeding or perforation, including NSAIDs
with severe kidney, liver or heart failure
with an increased risk of bleeding (haemorrhagic diathesis)
in women in the third trimester of pregnancy.
Do not use in breast-feeding women.
Do not use in children and adolescents up to 16 years of age, except for use in juvenile rheumatoid arthritis.

Take special care with Anapran?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Use of the product at the lowest effective dose over the shortest possible period reduces the risk of side effects.
In the case of long-term treatment, regular monitoring of renal and hepatic function as well as blood counts is recommended. Special care and close medical supervision is required when using the preparation in elderly patients who are at increased risk of serious side effects.
It must not be used in conjunction with other naproxen-containing medicines, including naproxen sodium. Do not use the preparation with other NSAIDs, including selective COX-2 inhibitors (increased risk of serious side effects). Do not use in combination with corticosteroid s.
The use of non-steroidal anti-inflammatory drugs is associated with the risk of gastrointestinal haemorrhage, ulceration or perforation, which may be the cause of death and may not be preceded by warning signs. These symptoms can occur at any time during treatment, also in people without previous gastrointestinal disorders. These complications are particularly dangerous in the elderly. Always tell your doctor immediately if you have any unusual symptoms on the part of the digestive tract (especially bleeding). If there is bleeding from the gastrointestinal tract, immediate discontinuation of the preparation is necessary.
In patients with previous gastrointestinal diseases, the use of the preparation is possible only under strict medical supervision. In these patients, it is necessary to use the lowest effective doses. High doses and advanced age increase the risk of Gastrointestinal bleeding in these patients. Take care and consult a doctor if you are taking other medicines at the same time increasing the risk of gastrointestinal side effects, including peptic ulceration or bleeding (eg corticosteroids with a general effect, anticoagulants, eg Warfarin , platelet aggregation inhibitors, including even small doses of acetylsalicylic acid [colloquially called aspirin], drugs from the group of selective serotonin reuptake inhibitors). In the above cases, the doctor may sometimes recommend the use of protective drugs (eg misoprostol, proton pump inhibitors).
The preparation may mask the symptoms of infection. If you suspect an infection, consult your doctor, as appropriate treatment may be necessary. The preparation does not have an antimicrobial effect.
Special care should be taken in people:
· With a history of a digestive tract, including chronic inflammatory bowel diseases such as ulcerative colitis, Leśniowski's disease and Crohn's disease (risk of exacerbation)
· With active or past bronchial asthma, with allergic seasonal rhinitis, with polyps or chronic respiratory infections and in people allergic to any allergens (risk of developing bronchoconstriction causing difficulty in breathing and / or angioneurotic edema that may impede breathing and be a threat life, it is necessary to provide the possibility of quick access to medical help)
· With blood clotting disorders or using anticoagulants (increased risk of bleeding, naproxen inhibits platelet aggregation and prolongs bleeding time)
· Hypertensive arterial, congestive heart failure, fluid retention, edema (use of NSAIDs may cause fluid retention and edema)
· With hepatic impairment, liver cirrhosis (the lowest effective dose should be used)
· With impaired renal function (risk of further deterioration of their activities, regular monitoring of renal function is recommended)
· With systemic lupus erythematosus and mixed connective tissue disease (increased risk of developing sterile meningitis)
· In the elderly (increased risk of side effects, be especially careful and use the lowest effective dose for the shortest possible time, long-term use only under strict medical supervision).
If you suspect or have been diagnosed with any of the above conditions, consult a physician before using the preparation.
Special care and close medical supervision is required when using the product in hypertensive patients with congestive heart failure, fluid retention and edema, ischemic heart disease, peripheral artery disease or cerebrovascular disease, and in patients with risk factors for systemic diseases cardiovascular (diabetes, smoking, hyperlipidemia). If you belong to any of the above groups, consult a physician before using the preparation.
Prolonged use of naproxen at high doses may increase the risk of heart attack or stroke.
Occasionally, severe liver side effects may occur after taking naproxen, some of which may lead to death.
In some patients, monitoring of renal function is necessary before and during the use of the preparation. If necessary, your doctor will advise you to use a lower daily dose. This group includes people:
· With impaired renal flow
· Liver cirrhosis
· With limited sodium supply
· With congestive heart failure
· After kidney disease
· Using diuretics
· In the elderly with known or suspected renal dysfunction.
The preparation, like other non-steroidal anti-inflammatory drugs, may cause severe skin reactions, sometimes leading to death, such as Stevens and Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis. These reactions are very rare and most often appear in the first month of application. In the event of the first symptoms of skin lesions (rash, mucosal lesions) or any symptoms of hypersensitivity, the preparation should be discontinued immediately and a physician should be consulted.
The preparation, like other non-steroidal anti-inflammatory drugs, can rarely cause hypersensitivity reactions, including angioedema, severe Anaphylactic reactions that can be life-threatening.
The preparation may cause visual disturbances or other eye discomfort, the occurrence of which requires consultation with an ophthalmologist.
If your doctor advises you to reduce the dose of steroids you are using or when you stop using naproxen, follow your doctor's instructions carefully. The reduction in the dose of oral steroids may only take place under strict medical supervision. Do not suddenly stop taking steroids, but reducing their dose must be done gradually. Restoration of normal adrenal function may take time and symptoms of adrenal insufficiency and exacerbation of arthritis symptoms may occur.
The use of the preparation may cause fertility problems in women and is not recommended in women who are planning to become pregnant.
Additional information about the other ingredients of the preparation:
the preparation contains lactose; people with galactose intolerance, lactase deficiency or malabsorption of Glucose -galactose should not use this preparation.

Does this preparation affect the ability to drive vehicles?
In some people, the preparation may cause side effects affecting psychophysical fitness, such as blurred vision, drowsiness, dizziness, depression or other central nervous system disorders, which may impair the speed of reaction and the ability to drive vehicles and operate machinery / equipment. Be careful.

Dosage of Anapran

The preparation is in the form of coated tablets. It is intended for oral use. Use the product as directed by your doctor. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, osteoarthritis: usually 550-1100 mg per day in 2 divided doses (every 12 hours); sometimes the doctor may recommend taking a daily dose once a day; in exacerbations, a loading dose of 825-1100 mg per day is sometimes administered.
Acute inflammation of the musculoskeletal system, pains of various origins, dysmenorrhea, fever of various origins: initially 550 mg, then 275 mg every 6-8 hours, not exceeding the dose of 1375 mg on the first day and 110 mg on the following days of use.
The maximum dose is 1375 mg a day.
Acute attack of gout: initially 825 mg, then 275 mg every 8 hours, until the pain subsides.
Migraine headaches: 825 mg at the first signs of impending migraine; if necessary, additionally 275-550 mg, not earlier than 30 min after the first dose.
Do not use in children and adolescents up to 16 years of age, except for use in juvenile rheumatoid arthritis.
Children after 5 years of age:
Juvenile rheumatoid arthritis: 10 mg / kg body weight per day in 2 divided doses (5 mg / kg body weight twice daily).
In people with impaired kidney or liver function, the doctor will adjust the dosage accordingly. The use of the preparation is contraindicated if the creatinine clearance is less than 20 ml / min.
Application method:
The preparation in the form of coated tablets is intended for oral use. The tablets should be taken during or after a meal, swallowed whole (do not chew or break). The doctor will determine the duration of treatment. In case of rheumatoid arthritis, long-term treatment may be necessary.

Can I use Anapran during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or planning to become pregnant, please inform the doctor prescribing the prescription for this medicine (see the warnings in the section "When should you take extra care with the preparation?").
The use of the preparation is contraindicated in women in the third trimester of pregnancy due to the risk of premature closure of the ductus arteriosus and suppression of uterine contraction. Do not use the preparation in the first and second trimester of pregnancy. The use of the preparation in the I and II trimesters of pregnancy is allowed only at the express request of the doctor and under his supervision, in cases when, after considering the ratio of expected benefits for the mother to possible risk to the fetus, he considers the use of the preparation absolutely necessary. Only a doctor can assess the benefit / risk ratio in your case.
Do not use in breast-feeding women.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
The use of antacids or cholestyramine may delay the absorption of naproxen.
Caution should be exercised when using naproxen with:
anticoagulants (eg warfarin, acenocoumarol, Heparin ) and drugs that inhibit platelet aggregation (possible increase in their effect, increase the risk of haemorrhage, the patient should remain under close medical supervision)
diuretics, e.g. Furosemide (possible reduction of their effectiveness)
potassium-sparing diuretics (the risk of hyperkalemia)
antihypertensive agents, including angiotensin-converting enzyme inhibitors or angiotensin-blockers and beta-blockers (possible reduction in their efficacy, increased risk of renal damaging effects)
methotrexate and lithium (possible increase in plasma concentrations of both lithium and Methotrexate and intensification of their toxic effects)
probenecid (severity and prolonged naproxen time)
cardiac glycosides, e.g. Digoxin (the risk of increasing heart failure and increasing the concentration of cardiac glycosides in the blood)
cyclosporine and tacrolimus (increased risk of kidney damage)
zidovudine (prolonged bleeding time)
Hydantoin derivatives or sulphonamides (risk of increased activity)
acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (increased risk of side effects, especially gastrointestinal bleeding; acetylsalicylic acid reduces the effect of naproxen)
quinolone antibiotics (increased risk of seizures)
corticosteroids or serotonin reuptake inhibitors (increased risk of side effects, especially gastrointestinal bleeding)
sulphonylurea derivatives.
Impact on the results of laboratory tests:
It is recommended to stop taking naproxen for 48 hours before assessing adrenal function.

What side effects can occur?

Like all medicines, Anapran can also cause side effects, although it will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
Common or uncommon: indigestion, heartburn, abdominal pain, nausea, diarrhea, constipation, vomiting, headache and dizziness, drowsiness, insomnia, drowsiness, rash, urticaria, pruritus. Other side effects are rare or very rare and include: bleeding from the gastrointestinal tract, tar-like stools, bloody vomiting, gastric ulcer and / or duodenal ulcers with perforation, colitis, exacerbation of colitis, exacerbation of Leśniowski and Crohn's disease, inflammation of the mucous membrane of the cavity oral, esophagitis, acute pancreatitis, liver dysfunction, hepatitis (also fatal cases), jaundice, renal dysfunction, renal failure, renal papillary necrosis, haematuria , proteinuria, interstitial nephritis, nephrotic syndrome, hyperkalemia, increase in creatinine in the blood, edema, hypertension, heart failure, palpitations, hematological disorders (haemolytic and aplastic anemia, agranulocytosis, leukopenia, thrombocytopenia, prolonged bleeding time if symptoms such as: sore throat, flu-like symptoms, superficial mouth ulcers, fatigue, nosebleeds, bruising, ecchymosis or purpura should be consulted doctor immediately, because they may be the first symptoms of hematological disorders), vasculitis, asthma, pulmonary edema , eosinophilic pneumonia, nervous system disorders (seizures, disturbances in the ability to concentrate, aseptic meningitis , depression, paresthesia), visual disturbances, Corn eal opacity, optic neuritis, optic nerve edema, tinnitus, impaired hearing. Hypersensitivity reactions (rash, urticaria, pruritus, photosensitivity) and anaphylactic reactions, including life-threatening anaphylactic shock (sudden decrease in blood pressure, arrhythmia), angioneurotic edema (swelling of the face, larynx, tongue, throat that may impede breathing), exacerbation of asthma, bronchospasm and severe skin reactions: toxic epidermal necrolysis, Stevens and Johnson syndrome, exfoliative dermatitis, erythema multiforme, purpura, haemorrhagic diathesis, porphyria. Prolonged use of naproxen at high doses may increase the risk of heart attack or stroke.

Other preparations on the Polish market containing naproxen (naproxen sodium)

Aleve (coated tablets)
Anapran neo (coated tablets)
Nalgesin (coated tablets)
Nalgesin Forte (coated tablets)
Nalgesin Mini (coated tablets)
Naxii (coated tablets)