Can I take ibuprofen800mg with naproxen 500mg

Analgesics: Naproxen - effective for a long time for moderately severe pain

In Germany, the five active ingredients acetylsalicylic acid, ibuprofen, paracetamol, propyphenazone and phenazone were previously available for self-medication of mild to moderate pain. Now comes naproxen sodium, which has been on the US market as a non-prescription analgesic since 1994. Naproxen sodium was introduced in Germany in April 1999 and has been subject to prescription since then.

For short-term painful conditions, naproxen sodium is just as effective as comparative substances, for example ibuprofen and paracetamol. In the case of prolonged pain, naproxen sodium has advantages due to its longer duration of action, as it has to be taken less often.

Enantiomerically pure preparation

The 2-arylpropionic acid naproxen [(+) - (6-methoxy-2-naphthyl) propionic acid] is a non-steroidal anti-inflammatory drug with antipyretic, analgesic and anti-inflammatory properties. Naproxen has an asymmetric carbon atom and is therefore optically active. The formulations available on the market contain only the active S-enantiomer. The R enantiomer is largely inactive.

Enantiomerically pure preparations have several advantages: The organism is not unnecessarily burdened and the pharmacokinetics are predictable. In the case of ibuprofen, which is used as a racemate, the elimination half-life is extended by the R-enantiomer of the racemate, because about 50 to 90 percent of R-ibuprofen is produced in the organism, while that from the plasma has a half-life of about two Hours is eliminated. In contrast to the racemate ibuprofen, S-naproxen is neither inverted nor stored in adipose tissue.

Inhibition of cyclooxygenase

Like other nonsteroidal anti-inflammatory drugs, naproxen works by blocking the enzyme cyclooxygenase. In an oxidative biotransformation, the cyclooxygenase converts the endogenous arachidonic acid into the eicosanoids, of which the prostaglandins increase the sensitivity of peripheral pain receptors. If the conversion of arachidonic acid to prostaglandins is prevented, the sensitivity to pain can be reduced. Two isoforms of cyclooxygenase are known, COX-1 and COX-2. Naproxen inhibits both isoforms.

Good solubility

Naproxen sodium is more soluble in gastric juice than naproxen acid and is therefore absorbed more quickly: Significant, analgesic plasma concentrations can be registered within 20 to 30 minutes and maximum values ​​within one hour after oral administration. The elimination half-life is 12 to 15 hours and the analgesic effect lasts up to 12 hours. Because of its long duration of action, naproxen sodium is particularly suitable for treating long-lasting pain.

Favorable risk-benefit ratio

The benefit-risk balance of naproxen sodium is just as favorable as that of ibuprofen and more favorable than that of acetylsalicylic acid and paracetamol. In the meantime, over 200 million patients worldwide have taken Aleve® as self-medication and around 8000 patients in clinical studies. The type and frequency of side effects that occurred were comparable to those of ibuprofen. Compared to ASA, the measurable risk of bleeding is lower. Common adverse effects are gastrointestinal complaints such as nausea, heartburn and stomach pain, as well as central nervous disorders such as headaches and dizziness. Gastrointestinal ulcers are among the rare side effects. Naproxen sodium has no potential for abuse and is safe even in the event of an overdose - in contrast to ASA and paracetamol.

In principle, the contraindications of all NSAIDs apply to naproxen sodium: known hypersensitivity to the active ingredient, unexplained blood formation disorders, stomach and intestinal ulcers and pregnancy in the third trimester (risk of premature closure of the ductus ateriosus botalli and reduced labor). In the case of gastrointestinal complaints, hypertension, heart failure, kidney and liver damage and after major surgical interventions, particularly careful medical supervision of the intake is required. Because the active ingredient content is too high, children under the age of twelve are allowed to use Aleve do not take.

Clinical effectiveness

In a clinical pain model, naproxen sodium 220 mg was compared with ibuprofen 200 mg in a placebo-controlled manner. In terms of pain relief, both analgesics were clearly superior to the placebo; naproxen sodium showed superiority over ibuprofen, which was statistically significant after 12 hours. In a similarly designed study with twice the analgesic dose in each case, naproxen sodium was superior to ibuprofen in its analgesic effect after just 8 hours until the end of the measurements.

A comparison of the analgesic effectiveness of 440 mg naproxen sodium with 1000 mg paracetamol showed an advantage of naproxen sodium in terms of analgesic potency and also in terms of the longer duration of action. A recent study comparing 440 mg of naproxen sodium with 1300 mg of a sustained release formulation of paracetamol demonstrated superiority of naproxen sodium for both the extent of pain relief and the time to require remedication.

Box text: Naproxen Sodium - Tips for taking

Aleve& reg is indicated for the short-term treatment of mild to moderate pain and fever. One tablet contains 220 mg naproxen sodium, which corresponds to 200 mg naproxen. If the tablet is taken 30 minutes before a meal, the active ingredient can build up more quickly; if taken with food, it is better tolerated. Adults and adolescents from 12 years of age usually take one tablet as a single dose and, if necessary, another single dose after eight to twelve hours. The maximum daily dose is three tablets. Elderly patients should not take more than two tablets per day, divided into two divided doses. Patients should not use the preparation for more than four days without medical advice.

source

Prof. Dr. Kay Brune, Erlangen; Prof. Dr. Gerd Dannhardt, Mainz; Priv.-Doz. Dr. Burkhard Hinz, Erlangen; Prof. Dr. Petra Högger, Würzburg; Dr. med. M. Ribbat, Itzehoe; Dr. Anja Langeneckert, Kaiseraugst; Colloquium "Pharmacology and Clinical Use of Naproxen Sodium 220 mg (Aleve®) as an OTC analgesic ", Kronberg / Taunus, May 1, 2002, organized by Roche Consumer Health, Eppstein-Bremthal.