Nonpiron Uses

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What is Nonpiron?

Nonpiron is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, and helps to relieve symptoms of arthritis (osteoarthritis, rheumatoid arthritis, or juvenile arthritis), such as inflammation, swelling, stiffness, and joint pain. Nonpiron does not cure arthritis and will help you only as long as you continue to take it.

In addition, Nonpiron can be used to treat fever, menstrual cramps, and other conditions as determined by your doctor.

Nonpiron is available both over-the-counter (OTC) and with your doctor's prescription.

Nonpiron indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Carefully consider the potential benefits and risks of Nonpiron

Oral Suspension and other treatment options before deciding to use Nonpiron. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

In Pediatric Patients, Nonpiron

Oral Suspension is indicated:

In Adults, Nonpiron

Oral Suspension is indicated:

Since there have been no controlled trials to demonstrate whether there is any beneficial effect or harmful interaction with the use of Nonpiron in conjunction with aspirin, the combination cannot be recommended.

How should I use Nonpiron?

Use Nonpiron capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about the proper use of Nonpiron capsules.

Uses of Nonpiron in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Oral: Inflammatory diseases and rheumatoid disorders, mild to moderate pain, fever, dysmenorrhea, osteoarthritis

Nonpiron injection (Caldolor): Management of mild to moderate pain and management of moderate to severe pain as an adjunct to opioid analgesics in adults and children 6 months and older; reduction of fever in adults and children 6 months and older.

Nonpiron lysine injection (NeoProfen): Patent ductus arteriosus (PDA): To close a clinically significant PDA in premature infants weighing between 500-1500 g who are no more than 32 weeks of gestational age when usual medical management (eg, diuretics, fluid restriction, respiratory support) is ineffective.

OTC labeling: Reduction of fever; management of pain due to headache, migraine, sore throat, arthritis, physical or athletic overexertion (eg, sprains/strains), menstrual pain, dental pain, minor muscle/bone/joint pain, backache, pain due to the common cold and flu

Off Label Uses

Gout, acute flares

Clinical experience suggests the utility of Nonpiron as an alternative option for acute gout flares.

Based on the 2012 American College of Rheumatology guidelines for management of gout, NSAIDs are effective and recommended agents in the treatment of acute gout flares.

Pericarditis

Data from double-blind, placebo-controlled, multicenter trials indicate that colchicine in combination with aspirin or Nonpiron significantly reduces the incidence of symptoms at 72 hours and the risk of recurrence in acute and recurrent pericarditis. Based on Brazilian Society of Cardiology guidelines for the management of myocarditis and pericarditis and European Society of Cardiology (ESC) guidelines for the management of pericardial diseases, nonsteroidal anti-inflammatory drugs (NSAIDs) (typically, aspirin or Nonpiron) in combination with colchicine are recommended as first-line treatment to manage pain and resolve inflammation in idiopathic and viral acute and recurrent pericarditis.

Nonpiron description

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Nonpiron is a member of the propionic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs). It is a racemic mixture of [+]S- and [-]R-enantiomers.

The chemical name for Nonpiron is (±)-2-(4-isobutylphenyl) propionic acid. It has a molecular weight of 206.28 and a molecular formula of C13H18O2.

Nonpiron is a colorless, crystalline stable solid, with a melting point of 75-77°C. It is relatively insoluble in water but readily soluble in most organic solvents. Nonpiron has a pKa of 4.43±0.03 and an n-octanol/water partition coefficient of 11.7 at pH 7.4.

Nonpiron has shown analgesic, anti-inflammatory and antipyretic activity in both animal and human studies. These properties provide symptomatic relief of inflammation and pain.

Nonpiron dosage

2.1 Recommended Dose

A course of therapy is three doses of Nonpiron Lysine administered intravenously (administration via an umbilical arterial line has not been evaluated). An initial dose of 10 mg per kilogram is followed by two doses of 5 mg per kilogram each, after 24 and 48 hours. All doses should be based on birth weight. If anuria or marked oliguria (urinary output <0.6 mL/kg/hr) is evident at the scheduled time of the second or third dose of Nonpiron Lysine, no additional dosage should be given until laboratory studies indicate that renal function has returned to normal. If the ductus arteriosus closes or is significantly reduced in size after completion of the first course of Nonpiron Lysine, no further doses are necessary. If during continued medical management the ductus arteriosus fails to close or reopens, then a second course of Nonpiron Lysine, alternative pharmacological therapy, or surgery may be necessary.

2.2 Directions for Use

For intravenous administration only.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Do not use Nonpiron Lysine if particulate matter is observed.

After the first withdrawal from the vial, any solution remaining must be discarded because Nonpiron Lysine contains no preservative.

For administration, Nonpiron Lysine should be diluted to an appropriate volume with dextrose or saline. Nonpiron Lysine should be prepared for infusion and administered within 30 minutes of preparation and infused continuously over a period of 15 minutes. The drug should be administered via the IV port that is nearest the insertion site. After the first withdrawal from the vial, any solution remaining must be discarded because Nonpiron Lysine contains no preservative.

Since Nonpiron Lysine is potentially irritating to tissues, it should be administered carefully to avoid extravasation.

Nonpiron Lysine should not be simultaneously administered in the same intravenous line with Total

Parenteral Nutrition (TPN). If necessary, TPN should be interrupted for a 15-minute period prior to and after drug administration. Line patency should be maintained by using dextrose or saline.

Nonpiron interactions

See also:
What other drugs will affect Nonpiron?

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Coumarin-Type Anticoagulants: Several short-term controlled studies failed to wshow that Nonpiron 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 Nonpiron and other nonsteroidal anti-inflammatory agents have been administered to patients on coumarin-type anticoagulants, the physician should be cautious when administering Nonpiron to patients on anticoagulants.

Aspirin: Animal studies wshow that aspirin given with nonsteroidal anti-inflammatory agents, including Nonpiron, 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 Nonpiron blood levels. Correlative clinical studies have not been performed.

Methotrexate: Apo-Nonpiron, 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 Nonpiron could enhance the toxicity of methotrexate. Caution should be used if Nonpiron is administered concomitantly with methotrexate.

H-2 Antagonists: In studies with human volunteers, co-administration of cimetidine or ranitidine with Nonpiron had no substantive effect on Nonpiron serum concentrations.

Furosemide: Clinical studies, as well as random observations, have shown that Nonpiron 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 Nonpiron, the patient should be observed closely for signs of renal failure, as well as to assure diuretic efficacy.

Lithium: Apo-Nonpiron 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 Nonpiron. Thus, when Nonpiron 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).

Nonpiron side effects

See also:
What are the possible side effects of Nonpiron?

6.1 Clinical Trials Experience

The most frequently reported adverse events with Nonpiron Lysine were as shown in Table 1.

6.2 Renal Function

Compared to placebo, there was a small decrease in urinary output in the Nonpiron group on days 2-6 of life, with a compensatory increase in urine output on day 9. In other studies, adverse events classified as renal insufficiency including oliguria, elevated BUN, elevated creatinine, or renal failure were reported in Nonpiron treated infants.

6.3 Additional Adverse Events

The adverse events reported in the multicenter study and of unknown association include tachycardia, cardiac failure, abdominal distension, gastroesophageal reflux, gastritis, ileus, inguinal hernia, injection site reactions, cholestasis, various infections, feeding problems, convulsions, jaundice, hypotension, and various laboratory abnormalities including neutropenia, thrombocytopenia, and hyperglycemia.

6.4 Post-marketing Experience

The following adverse reactions have been identified from spontaneous post-marketing reports or published literature: gastrointestinal perforation, necrotizing enterocolitis, and pulmonary hypertension. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency, or establish a causal relationship to drug exposure.

Nonpiron contraindications

See also:
What is the most important information I should know about Nonpiron?

This medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use Nonpiron just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

This medicine may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking Nonpiron, especially in older adults.

Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Do not take more of this medication than is recommended. An overdose of Nonpiron can cause damage to your stomach or intestines. Use only the smallest amount of Nonpiron needed to get relief from your pain, swelling, or fever.



Active ingredient matches for Nonpiron:

Ibuprofen in Peru.


List of Nonpiron substitutes (brand and generic names)

Sort by popularity
Unit description / dosage (Manufacturer)Price, USD
400 mg x 10's (Cadila Healthcare (Zydus Cadila Healthcare Ltd))$ 0.08
Norswel 400 mg Tablet (Cadila Healthcare (Zydus Cadila Healthcare Ltd))$ 0.01
NORSWEL tab 400 mg x 10's (Cadila Healthcare (Zydus Cadila Healthcare Ltd))$ 0.08
Norswel 400mg Tablet (Cadila Healthcare (Zydus Cadila Healthcare Ltd))$ 0.01
Norswell 400mg TAB / 10$ 0.08
Novidol 500 mg x 2 Blister x 10 Tablet (Synpharma)
Tablet; Oral; Ibuprofen 200 mg (Novopharm)
Tablet; Oral; Ibuprofen 300 mg (Novopharm)
Tablet; Oral; Ibuprofen 400 mg (Novopharm)
Tablet; Oral; Ibuprofen 600 mg (Novopharm)
Tablets; Oral; Ibuprofen 200 mg (Novopharm)
Tablets; Oral; Ibuprofen 300 mg (Novopharm)
Tablets; Oral; Ibuprofen 400 mg (Novopharm)
Tablets; Oral; Ibuprofen 600 mg (Novopharm)
Novo-profen tablet 600 mg (Novopharm)
Novo-profen tablet 400 mg (Novopharm)
Novo-profen tablet 200 mg (Novopharm)
Novo-profen tablet 300 mg (Novopharm)
Capsule, Retard; Oral; Ibuprofen (Temmler)
Capsules, Retard; Oral; Ibuprofen (Temmler)
Tablet; Oral; Ibuprofen 200 mg
Tablet; Oral; Ibuprofen 300 mg
Tablet; Oral; Ibuprofen 400 mg
Tablet; Oral; Ibuprofen 600 mg
Tablets; Oral; Ibuprofen 200 mg
Tablets; Oral; Ibuprofen 300 mg

References

  1. DailyMed. "IBUPROFEN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "ibuprofen". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "ibuprofen". http://www.drugbank.ca/drugs/DB01050 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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