Naproxen

Several types of naproxen preparations are available on the pharmaceutical market, including tablets, capsules, oral suspensions, suppositories and gels for topical use.

Naproxen Hasco is formulated as a 10% gel for topical use only. This gel contains 100 mg of naproxen per gram of product and is packaged in easy-to-use tubes. The levomenthol and chloral hydrate in the composition contribute to a soothing effect and increased skin permeability.

Naproxen is indicated for the local symptomatic treatment of pain and inflammation associated with:

• Osteoarthritis – a degenerative joint disease characterised by pain, stiffness and limited mobility;
• Soft tissue injuries – including sprains, bruises or muscle strains;
• Joint and tendon injuries – especially those of a sporting or post-traumatic nature.

The use of the gel helps to reduce inflammation, pain and improve local mobility without the risk of systemic side effects associated with oral administration.

Naproxen should be applied locally, 4 to 5 times a day, to the affected area. It is recommended to apply a strip of gel approximately 1 cm wide over an area of 7 x 7 cm, followed by gentle massage until completely absorbed. After application, hands should be washed, unless they are the area being treated.

Treatment should not be prolonged longer than necessary, and the appearance of skin symptoms requires discontinuation of administration and consultation with a doctor.

Naproxen is contraindicated in the following situations:

• Known allergy to naproxen or any of the excipients
• Hypersensitivity to other NSAIDs (e.g. acetylsalicylic acid)
• Pregnancy in the third trimester
• Children under 3 years of age
• Application to damaged skin, open wounds or inflamed skin
• Contact with the eyes or mucous membranes

Caution is required when administering Naproxen in the following cases:

• Patients with gastric or duodenal ulcers or haemorrhagic diathesis – even if administered topically, minimal systemic absorption is possible;
• Patients with renal and/or hepatic impairment – due to the risk of systemic absorption;
• Application to large areas of skin or for prolonged periods – may lead to undesirable systemic reactions;
• Avoid exposure to sunlight or sunlamps during treatment and for the following two weeks.

Like any medicine, Naproxen can cause side effects, although not everybody gets them:

• Local skin reactions – erythema, pruritus, burning, irritation, photosensitivity;
• Rare systemic reactions – nausea, diarrhoea, headache, drowsiness, allergic reactions;
• Severe reactions – difficulty breathing, extensive rashes or oedema – require immediate discontinuation of treatment and emergency medical attention.

To date, no significant interactions of topical naproxen with other medicines have been reported. However, prolonged use on large areas of skin does not exclude the possibility of systemic interactions similar to those occurring with oral administration:

• Ethanol potentiates the effect of naproxen;
• Potentiation of the effects of oral anticoagulants (coumarins), phenytoin, hydantoin and methotrexate;
• Decreased effectiveness of diuretics (e.g. furosemide);
• Probenecid and sodium bicarbonate increase the serum concentration of naproxen.

No cases of overdose have been reported with the correct use of Naproxen gel. However, excessive use, application to large areas of skin or accidental ingestion (e.g. in children) may lead to systemic symptoms of NSAID intoxication:

• Nausea, vomiting, abdominal pain;
• Drowsiness, confusion;
• In severe cases – kidney or liver damage.

In such cases, immediate medical attention or emergency medical care should be sought.

Naproxen should be stored at temperatures below 25°C, in the original packaging, away from direct light and moisture. Keep out of the reach and sight of children. Do not use the medicine after the expiry date stated on the packaging.

• NIH, Naproxen
• Journal of Clinical and Diagnostic Research (JCDR), Efficacy and safety of naproxen gel in the management of musculoskeletal pain: A prospective cohort study
• PubMed, Clinical pharmacology and cardiovascular safety of naproxen
• MDPI, Recent advances in the synthesis of ibuprofen and naproxen