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Nobfen Dosage |
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For general use, 60 mg of Nobfen sodium (as anhydrous) is orally administered to adults 3 times a day.
For a single administration, 60-120 mg is orally given.
The dosages should be adjusted according to age and symptoms.
Coumarin-Type Anticoagulants: Several short-term controlled studies failed to wshow that Nobfen significantly affected prothrombin times or a variety of other clotting factors when administered to individuals on coumarin-type anticoagulants. However, because bleeding has been reported when Nobfen and other nonsteroidal anti-inflammatory agents have been administered to patients on coumarin-type anticoagulants, the physician should be cautious when administering Nobfen to patients on anticoagulants.
Aspirin: Animal studies wshow that aspirin given with nonsteroidal anti-inflammatory agents, including Nobfen, yields a net decrease in anti-inflammatory activity with lowered blood levels of the non-aspirin drug. Single dose bioavailability studies in normal volunteers have failed to wshow an effect of aspirin on Nobfen blood levels. Correlative clinical studies have not been performed.
Methotrexate: Nobfen, as well as other nonsteroidal anti-inflammatory drugs, probably reduces the tubular secretion of methotrexate based on in vitro studies in rabbit kidney slices. This may indicate that Nobfen could enhance the toxicity of methotrexate. Caution should be used if Nobfen is administered concomitantly with methotrexate.
H-2 Antagonists: In studies with human volunteers, co-administration of cimetidine or ranitidine with Nobfen had no substantive effect on Nobfen serum concentrations.
Furosemide: Clinical studies, as well as random observations, have shown that Nobfen can reduce the natriuretic effect of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis. During concomitant therapy with Nobfen, the patient should be observed closely for signs of renal failure, as well as to assure diuretic efficacy.
Lithium: Nobfen produced an elevation of plasma lithium levels and a reduction in renal lithium clearance in a study of eleven normal volunteers. The mean minimum lithium concentration increased 15% and the renal clearance of lithium was decreased by 19% during this period of concomitant drug administration.
This effect has been attributed to inhibition of renal prostaglandin synthesis by Nobfen. Thus, when Nobfen and lithium are administered concurrently, subjects should be observed carefully for signs of lithium toxicity. (Read circulars for lithium preparation before use of such concurrent therapy).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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