OXAPROZIN
| OXAPROZIN (ox-a-pro'zin) Daypro Classifications: analgesic, nonsteroidal antiinflammatory drug (nsaid); antipyretic; Therapeutic: nsaid, analgesic; antirheumatic; antipyretic Prototype: Ibuprofen Pregnancy Category: C |
Availability
600 mg tablet
Action
Long-acting NSAID agent, which is an effective prostaglandin synthetase inhibitor. It inhibits COX-1 and COX-2 enzymes needed for prostaglandin synthesis at the site of inflammation.
Therapeutic Effect
Has antiinflammatory, antipyretic, and analgesic properties.
Uses
Treatment of osteoarthritis and rheumatoid arthritis.
Unlabeled Uses
Ankylosing spondylitis, chronic pain, gout, oral surgery pain, temporal arteritis, tendinitis.
Contraindications
Hypersensitivity to oxaprozin or any other NSAID; complete or partial syndrome of nasal polyps; angioedema; CABG perioperative pain; pregnancy (category C) in first and second trimesters, and pregnancy (category D) in third trimester; lactation.
Cautious Use
History of GI bleeding, alcoholism, smoking; history of severe hepatic dysfunction, renal insufficiency; cardiac disease; coagulopathy; photosensitivity; older adults. Safety and effectiveness in children <6 y are not established.
Route & Dosage
| Osteoarthritis, Rheumatoid Arthritis Adult: PO 600–1200 mg q.d. (max: 1800 mg/d or 25 mg/kg, whichever is lower) |
Administration
Oral- Give with meals or milk to decrease GI distress.
- Divide doses in those unable to tolerate once-daily dosing.
- Use lower starting doses for those with renal or hepatic dysfunction, advanced age, low body weight, or a predisposition to GI ulceration.
Adverse Effects (≥1%)
CNS: Tinnitus, headache, insomnia, somnolence. GI: Diarrhea, abdominal pain, nausea, dyspepsia, flatulence, melena, ulcers, constipation, dry mouth, gastritis. Skin: Rash, pruritus. Urogenital: Dysuria, urinary frequency.Diagnostic Test Interference
May cause false-positive reactions for benzodiazepines with urine drug-screening tests.
Interactions
Drug: May attenuate the antihypertensive response to diuretics. nsaids increase the risk of methotrexate or lithium toxicity. May increase aspirin toxicity. Herbal: Feverfew, garlic, ginger, ginkgo may increase risk of bleeding.Pharmacokinetics
Absorption: Readily from GI tract. Peak: 125 min. Onset: 1–6 wk for maximum therapeutic effect. Distribution: 99% protein bound. Distributes into synovial fluid, crosses placenta. Distributed into breast milk. Metabolism: In the liver. Elimination: 60% in urine, 30–35% in feces. Half-Life: 40 h.Nursing Implications
Assessment & Drug Effects
- Monitor for S&S of GI bleeding, especially in patients with a history of inflammation or ulceration of upper GI tract, or those treated chronically with NSAIDs.
- Monitor patients with CHF for increased fluid retention and edema. Report rapid weight increases accompanied by edema.
- Lab tests: Perform baseline and periodic evaluation of Hgb, kidney and liver function. Auditory and ophthalmologic exams are recommended with prolonged or high-dose therapy.
Patient & Family Education
- Be aware that alcoholism and smoking increase risk of GI ulceration.
- Report immediately dark tarry stools, "coffee ground" or bloody emesis, or other GI distress.
- Avoid aspirin or other NSAIDs without explicit permission of physician.
- Be aware of the possibility of photosensitivity, which results in a rash on sun-exposed skin.
- Report immediately to physician ringing in ears, decreased hearing, or blurred vision.
- Do not exceed ordered dose. The goal of therapy is lowest effective dose.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug