Oxaprozin

A to Z Drug Facts

 Action Decreases inflammation, pain and fever, probably through inhibition of cyclooxygenase activity and prostaglandin synthesis.

 Indications Relief of symptoms of rheumatoid arthritis and osteoarthritis.

 Contraindications Hypersensitivity to aspirin, iodides, or any other NSAID.

 Route/Dosage

ADULTS: PO 1200 mg once a day (maximum 1800 mg/day or 26 mg/kg, whichever is lower).

 Interactions

Beta-blockers: Antihypertensive effects may be decreased. Lithium: May increase lithium levels. Loop diuretics: Diuretic effects may be decreased. Methotrexate: May increase methotrexate levels. Warfarin: May increase risk of gastric erosion and bleeding.

 Lab Test Interferences False-positive urine immunoassay screening tests for benzodiazepines have been reported in patients taking oxaprozin.

 Adverse Reactions

CV: Edema; blood pressure changes; worsening or precipitation of CHF. CNS: Depression; sedation; somnolence; confusion; disturbed sleep. DERM: Rash; pruritus; erythema; photosensitivity; ecchymosis. EENT: Visual disturbances; tinnitus. GI: Gastric distress; peptic ulcers; occult blood loss; diarrhea; constipation; vomiting; nausea; dyspepsia; flatulence; anorexia; abdominal distress/cramps/pain; stomatitis. GU: Difficult or painful urination; urinary frequency; decreased menstrual flow. HEMA: Anemia; neutropenia; thrombocytopenia; leukopenia. HEPA: Hepatitis.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. GI effects: Serious GI toxicity (eg, bleeding, ulceration, perforation) can occur at any time, with or without warning symptoms. Elderly: Increased risk of adverse reactions. Hepatic function impairment: Exercise caution when administering to patients with impaired hepatic function or history of liver disease. Platelet aggregation: Can inhibit platelet aggregation; use with caution in patients with intrinsic coagulation defects or those on anticoagulant therapy. Renal impairment: May need to reduce dose.

 Administration/Storage

• Food may reduce the rate of absorption but not the extent. Antacids have no effect on rate or extent of absorption.
• Not recommended for patients with renal or hepatic disease, low body weight, advanced age, a known ulcer susceptibility or known sensitivity to other NSAIDs.
• Store < 86°F in a tight, light-resistant container.

 Assessment/Interventions

• Obtain patient history.
• Closely monitor patients at risk for peptic ulcer disease such as those with a history of serious GI problems, alcoholism, smoking or other ulcer-associated factors.
• Determine if patient is taking aspirin, oral anticoagulants, H₂-receptor antagonists, beta-blockers, iodides, or other NSAIDs as drug interactions can occur and discontinuation or adjustment in therapy would be indicated.
• Assess for adverse reactions. Notify physician if the following adverse reactions occur: Abdominal pain, anorexia, dyspepsia, flatulence, nausea, vomiting, depression, sedation, somnolence, confusion, sleep disturbances, rash, tinnitus and dysuria, frequency of urination.
• Ensure dosage is individualized to the lowest effective dose to minimize adverse effects.
• Anticipate a greater risk of reactions from patients on higher dosages or elderly patients.
• Monitor renal function tests (eg, creatinine, BUN).
• Monitor CBC, especially hemoglobin, hematocrit and platelets.
• If patient is taking beta-blockers, monitor blood pressure when starting therapy for increases in sitting and standing blood pressure.

 Patient/Family Education

• Instruct patient to take medication as prescribed and not to make up missed doses.
• Inform patient that analgesic effects are usually achieved after a single dose, but that it requires several days of dosing to reach the maximum effect.
• Inform patient concerning the expected therapeutic effects of the medication, which include analgesic, antipyretic and anti-inflammatory benefits.
• Instruct patient to inform the health care provider of symptom relief so that the dosage is individualized to the lowest effective dose to minimize adverse effects.
• Instruct patient to take the dose exactly as prescribed about the same time each day with a full glass of water.
• Caution patient to avoid taking other NSAIDs, aspirin, alcohol, or other otc medications unless advised to do so by the health care provider.
• Instruct patient concerning drug/drug interactions as applicable to their situation.
• Advise patient to discontinue drug and notify health care provider if any of the following occurs: Persistent GI upset or headache, skin rash, itching, visual disturbances, black stools, weight gain or edema, changes in urine pattern, joint pain, fever, or blood in urine.
• Caution patient regarding the serious GI, renal, hepatic, hematologic and dermatologic adverse effects that can occur at any time, with or without warning symptoms.
• Advise patient on long-term therapy that lab tests may be required and to keep appointments.
• Caution patient to inform their dentist or surgeon prior to any procedure that they are taking oxaprozin.
• Advise elderly or debilitated patients regarding their increased risk of adverse reactions.
• Caution patient regarding possibility of photosensitivity and to use protective measures until tolerance is determined.
• Advise patient that medication may cause drowsiness, and to use caution while driving or performing other tasks requiring mental alertness.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts