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oxaprozin (Rx)Brand and Other Names:Daypro

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 600mg
more...

Osteoarthritis

Initial in mild to moderate disease: 600mg PO qDay

Usual in moderate to severe disease: 1200mg PO qDay

Maximum 1,800 mg/day or 26 mg/kg/day, whichever is lower, divided PO q12hr 

Rheumatoid Arthritis

1200mg PO qDay (individualize)

Maximum 1,800 mg/day or 26 mg/kg/day, whichever is lower, divided PO q12hr 

Renal Impairment

Severe renal impairment or on dialysis: 600 mg PO qDay; may increase to 1200 mg/day; monitor closely

Hepatic Impairment

Caution in patients with severe liver impairment

Administration

Take with food or 8-12 oz water to avoid GI effects

Other Information

Renal Impairment: 600 mg PO qDay

Dosage Forms & Strengths

tablet

  • 600mg
more...

Juvenile Rheumatoid Arthritis

<6 years

  • Safety and efficacy not established

>6 years

  • 22-31 kg: 600 mg PO qDay
  • 32-54 kg: 900 mg PO qDay
  • >55 kg: 1200 mg PO qDay

Osteoarthritis

Initial in mild to moderate disease: 600mg PO qDay

Usual in moderate to severe disease: 1200mg PO qDay

Maximum 1,800 mg/day or 26 mg/kg/day, whichever is lower, divided PO q12hr 

Rheumatoid Arthritis

1200mg PO qDay (individualize)

Maximum 1,800 mg/day or 26 mg/kg/day, whichever is lower, divided PO q12hr

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Interactions

Interaction Checker

oxaprozin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Common

            Edema

            Rash

            Abdominal pain

            Anorexia

            Constipation

            Diarrhea

            Indigestion

            Nausea/Vomiting

            GI ulcer

            Gross bleeding with perforation

            Heartburn

            Anemia

            LFT's increased

            Tinnitus

            Dysuria, Increased frequency of urination

            Myocardial infarction (<2%)

            <1%

            Hypertension (<1%)

            Palpitations (<1%)

            Thrombotic tendency observations

            Erythema multiforme (rare)

            Scaling eczema

            Stevens-Johnson syndrome (rare)

            Toxic epidermal necrolysis (rare)

            Cerebrovascular accident

            Gastrointestinal hemorrhage (<1%)

            Agranulocytosis (rare)

            Leukopenia (<1%)

            Thrombocytopenia (<1%)

            Hepatitis (rare),

            Jaundice, Liver failure

            Anaphylactoid reaction (<1%)

            Amblyopia (<1%)

            Hearing loss (<1%)

            Acute renal failure (rare)

            Hematuria (rare)

            Interstitial nephritis (rare)

            Bronchospasm

            Serum sickness due to drug (rare)

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            Warnings

            Black Box Warnings

            Cardiovascular Risk

            • NSAIDs may increase risk of serious cardiovascular thrombotic events, myocardial infarction (MI), & stroke, which can be fatal
            • Risk may increase with duration of use
            • Patients with risk factors for or existing cardiovascular disease may be at greater risk
            • NSAIDs are contraindicated for perioperative pain in the setting of coronary artery bypass graft (CABG) surgery (increased risk of MI & stroke)

            Gastrointestinal Risk

            • NSAIDs increase risk of serious GI adverse events including bleeding, ulceration, & perforation of the stomach or intestines, which can be fatal
            • GI adverse events may occur at any time during use & without warning symptoms
            • Elderly patients are at greater risk for serious GI events

            Contraindications

            Absolute: ASA allergy, CABG

            Relative: bleeding disorder, duodenal/gastric/peptic ulcer, stomatitis, SLE, ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of ductus arteriosus)

            Cautions

            Asthma (bronchial), CHF, fluid retention, cardiac disease, HTN, severe hepatic impairment, hypertension, renal impairment

            Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs

            Risk of HTN

            Risk of renal damage on long-term use

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            Pregnancy & Lactation

            Pregnancy Category: C; avoid in late pregnancy, may cause premature closure of the ductus arteriosus

            The Quebec Pregnancy Registry identified 4705 women who had spontaneous abortions by 20 weeks' gestation; each case was matched to 10 control subjects (n=47,050) who had not had spontaneous abortions; exposure to nonaspirin NSAIDs during pregnancy was documented in approximately 7.5% of cases of spontaneous abortions and in approximately 2.6% of controls. (CMAJ, September 6, 2011; DOI:10.1503/cmaj.110454)

            Lactation: not known whether excreted in breast milk; effect on infant unknown

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclooxygenase isoenzymes, cyclooxygenase-1 (COX-1) and -2 (COX-2)

            May inhibit chemotaxis, may alter lymphocyte activity, decrease proinflammatory cytokine activity, and may inhibit neutrophil aggregation. These effects may contribute to its anti-inflammatory activity

            Pharmacokinetics

            Half-Life: 44-50 hr

            Protein Bound: 99%

            Vd: 11-17 L/70 kg

            Time to peak: 2-4hr

            Metabolism: Liver (microsomal oxidation (65%); glucuronic acid conjugation (35%)

            Metabolites: Ester, ether glucuronide

            Excretion: Urine (65%); feces (35%)

            Enzymes inhibited: Cyclooxygenase

            Absorption: 95% (PO)

            Dialyzable: Yes, but inefficient

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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