Aponia - Tablet Nabumetone - 500mg 10 Tablet(s) / Box One Pharma Ltd. Introduction: Aponia is a pain relieving medicine. It effectively alleviates pain and inflammation in conditions like rheumatoid arthritis and osteoarthritis. Aponia should be taken in the dose and duration as advised by your doctor. It should be taken with food or milk to prevent stomach upset. Inform your doctor if you have any history of heart disease or stroke. Vomiting, stomach pain, nausea and indigestion are some of the common side effects that might be observed on taking this medicine. It may also cause dizziness, drowsiness or visual disturbances. Your doctor may regularly monitor your kidney function, liver function and levels... Uses of Aponia: Pain relief Side effects of Aponia: VomitingStomach pain/epigastric painNauseaIndigestionLoss of appetiteDiarrheaHeartburn How to use Aponia: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Aponia is to be taken with food. How Aponia works: Aponia is a non-steroidal anti-inflammatory drugs (NSAID). It works by blocking the release of certain chemical messengers that cause pain and inflammation (redness and swelling). Indication: Pain and inflammation associated with musculoskeletal and joint disorders, Osteoarthritis, Rheumatoid Arthritis Administration: Should taken with food. Adult Dose: Oral Adult Osteoarthritis 1g PO once daily initially; maintenance: 1-2 g/day PO in single daily dose or divided q12hr; not to exceed 2 g/day Rheumatoid Arthritis 1 g PO once daily initially; maintenance: 1-2 g/day PO in single daily dose or divided q12hr; not to exceed 2 g/day Elderly: 500 mg daily may be adequate in certain patients. Max: 1 g daily. Child Dose: Not recommended Renal Dose: Renal impairment: CrCl (ml/min) Dosage Recommendation 30-49 Max initial dose: 750 mg once daily. Increase if needed to a max dose of 1.5 g daily. <30 Max initial dose: 500 mg once daily. Increase if needed to a max dose of 1 g daily. Contraindication: Absolute: Aspirin allergy, severe renal impairment; perioperative pain in setting of coronary artery bypass graft (CABG) surgery Relative: Duodenal/gastric/peptic ulcer, stomatitis, systemic lupus erythematosus, ulcerative colitis, late pregnancy (may cause premature closure of ductus arteriosus) Mode of Action: Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclooxygenase (COX) isoenzymes, COX-1 and COX-2 May inhibit chemotaxis, alter lymphocyte activity, decrease proinflammatory cytokine activity, and inhibit neutrophil aggregation; these effects may contribute to anti-inflammatory activity Precaution: Pre-existing CV risk factors or disease; fluid retention, CHF, hypertension. History of GI disease (bleeding or ulcers). Elderly or debilitated patients. Other forms of asthma. Hepatic impairment; closely monitor patients with any abnormal LFT. Renal impairment; rehydrate patient prior to therapy and closely monitor renal function. Withhold for at least 4-6 half-lives prior to surgical or dental procedures. Side Effect: >10% Diarrhea (14%),Dyspepsia (13%),Abdominal pain (12%) 1-10% Constipation (3-9%),Dizziness (3-9%),Edema (3-9%),Flatulence (3-9%),Headache (3-9%),Nausea (3-9%),Positive stool guaiac (3-9%),Pruritus (3-9%),Rash (3-9%),Tinnitus (3-9%),Dry mouth (1-3%),Fatigue (1-3%),Gastritis (1-3%),Increased sweating (1-3%),Insomnia (1-3%),Nervousness (1-3%),Somnolence (1-3%),Stomatitis (1-3%),Vomiting (1-3%) Pregnancy Category Note: Pregnancy category: C; D if used for prolonged periods or near term (premature closure of ductus arteriosus) Interaction: Antihypertensive effects of hypotensive agents may be reduced. May increase ciclosporin levels. Increased risk of seizures with fluoroquinolones. May reduce efficacy of diuretics. May diminish the cardioprotective effect of acetylated salicylates. Alcohol may enhance gastric mucosal irritation. Potentially Fatal: Increased risk of bleeding with anticoagulants (e.g. warfarin, heparin, LMWHs) and antiplatelet agents (e.g. ticlopidine, clopidogrel, aspirin, abciximab, dipyridamole, eptifibatide, tirofiban). Increased risk of GI ulceration with corticosteroids. Severe bone marrow suppression, aplastic anaemia and GI toxicity may occur with methotrexate.