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Pranex

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Indications:

• Inflammatory disease of the joints (rheumatoid arthritis) • Lower back pain • Osteoarthritis • Pain and inflammation following surgery

Contraindications:

• Active peptic ulcer • Bleeding from the stomach or intestines • Breastfeeding • History of peptic ulcers • Nasal polyps associated with swelling of the lips, eyes and mouth (angioneurotic oedema) • People in whom aspirin or other medicines in this class (NSAIDs), cause attacks of asthma, itchy rash (urticaria) or nasal inflammation (rhinitis). • Pregnancy This medicine should not be used if you are allergic to one or any of its ingredients.

Adverse reactions:

• Headache • Rash • Blurred vision • Difficulty in sleeping (insomnia) • Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain • Indigestion (dyspepsia) • Ulceration of the stomach or intestine • Balance problems involving the inner ear (vertigo) • Dizziness • Kidney damage • Sensation of ringing, or other noise in the ears (tinnitus) • Flushing of the skin due to widening of the small blood vessels (erythema) • Loss of appetite • Hair loss (alopecia) • Itching (pruritis) • Bleeding from the stomach or intestine • Severe swelling of lips, face or tongue (angioedema) • Chest pain • Itchy rash (urticaria) • Blood disorders

Interactions:

This medicine is highly protein bound and it may therefore be necessary to modify the dosage of other highly protein bound drugs e.g. anti-coagulants. As there is a possibility of either a pharmacokinetic or pharmacodynamic interaction with aspirin or other salicylates, diflusinal, probenecid, lithium, triamterene, ACE inhibitors, haloperidol and methotrexate, patients receiving such combinations should be carefully monitored and dosages adjusted as necessary. Non-steroidal anti-inflammatory drugs may reduce the anti-hypertensive effects of beta-blockers, although clinical studies showed no propensity for This medicine to antagonise the effects of propranolol. Likewise the reduction of diuretic effects of thiazides and frusemide may occur with non-steroidal anti-inflammatory drugs and this should be borne in mind when treating patients with compromised cardiac function or hypertension.

Warnings:

• Decreased kidney function • Decreased liver function • Elderly people • Epilepsy • Heart failure • History of diseases of the stomach or intestines • Imbalance of water and salt concentrations in the blood (fluid and electrolyte imbalance) • Infection of the blood or body tissues with pus-forming or other pathogenic organisms (sepsis) • Parkinson’s disease • Psychotic illness

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Consultants Corner

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery

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Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

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