Oxaprozin (Oral)

Overview

Oxaprozin is a potent anti-inflammatory drug that is a part of the NSAID family of anti-inflammatories and is marketed under the brand name Daypro. It is prescribed to patients who are suffering from the severe inflammation, stiffness, and painful joints associated with arthritic disorders. It works on a patient at a hormonal level and reduces the levels of hormones that are responsible for inflammation and pain for patients afflicted with arthritis. Although it is normally used by older adults, it is sometimes prescribed to children over the age of 6 who have rheumatoid arthritis. The medication is taken orally as a tablet and is only available with a doctor's prescription.

Although oxaprozin is very effective for its intended purpose there are some health concerns that loom large for patients who are taking this medication. It is known to increase the risk of fatal heart attacks or strokes, and this risk is magnified if the medication is taken for a long period of time or in large doses. It is not recommended if a patient has a history of heart disease. Taking oxaprozin may cause internal bleeding in some patients and this can be potentially fatal. Certain surgeries also present a risk factor, especially any kind of heart surgery such as a coronary bypass. A number of potential side effects and a chance of severe drug interactions also may be taken into account by a physician before deciding to prescribe oxaprozin for arthritis.

Conditions Treated

  • Osteoarthritis
  • Rheumatoid arthritis
  • Juvenile rheumatoid arthritis

Type Of Medicine

  • Nonsteroidal Anti-Inflammatory Drug (NSAID)

Side Effects

Like many anti-inflammatory medications, oxaprozin has a significant chance of side effects along with the effects which were intended when it was prescribed. Some of the side effects that have been recorded are very serious and may require medical attention when they occur. If any of the following side effects occur while taking oxaprozin seek immediate medical care:

  • Bloating
  • Bloody or black, tarry stools
  • Burning upper abdominal or stomach pain
  • Burning while urinating
  • Cloudy urineConstipation
  • Decrease in urine output or decrease in urine-concentrating ability?Diarrhea
  • Difficult or painful urination
  • Frequent urination
  • Headache
  • Heartburn
  • Indigestion
  • Itching skin
  • Loss of appetite
  • Nausea or vomiting
  • Pale skin
  • ?Severe abdominal or stomach pain, cramping, or burning
  • Severe and continuing nausea
  • Swelling
  • Troubled breathing with exertion
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Vomiting of blood or material that looks like coffee grounds
  • Weight loss
  • Agitation
  • Bleeding gums
  • Blistering, peeling, or loosening of the skin
  • Blurred vision
  • Body aches or pain
  • Burning feeling in chest or stomach
  • Changes in blood pressure
  • Chest pain
  • Clay-colored stools
  • Coma
  • Confusion
  • Cough or hoarseness
  • Cracks in the skin
  • Dark urine
  • Depression
  • Difficult or labored breathing
  • Difficulty swallowing
  • Dilated neck veins
  • Dizziness
  • Ear congestion
  • Extreme fatigue
  • FaintingFeeling of discomfort
  • Fever or chills
  • Fluid-filled skin blisters
  • High fever
  • Hives or welts
  • Hostility
  • Increased sensitivity of the skin to sunlight
  • Increased thirst
  • Increased volume of pale, dilute urine
  • Inflammation of the joints
  • Irregular, fast or slow, or shallow breathing
  • Joint or muscle pain
  • Large, flat, blue or purplish patches in the skin
  • Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • Lethargy
  • Light-colored stools
  • Lightheadedness
  • Loss of heat from the body
  • Loss of voice
  • Lower back or side pain
  • Muscle aches
  • Muscle twitching
  • Noisy breathing
  • Pain or burning in the throat
  • Pain or tenderness around the eyes and cheekbones
  • Pale or blue lips, fingernails, or skin
  • Pinpoint red or purple spots on the skin
  • Pounding in the ears
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Rapid weight gain
  • Red skin lesions, often with a purple center
  • Red, irritated eyes
  • Redness or other discoloration of the skin
  • Redness, swelling, or soreness of tongue
  • Scaly skin
  • Seizures
  • Severe sunburn
  • Skin rash
  • kin thinness
  • Slow, fast, irregular, pounding, or racing heartbeat or pulse
  • ?Sneezing
  • Sore throat
  • Sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • Stuffy or runny nose
  • Stupor
  • Swelling of the face, fingers, feet, or lower legs
  • Swelling or inflammation of the mouth
  • Swollen lymph glands
  • Tenderness in the stomach area
  • Tightness in the chest
  • Unpleasant breath odor
  • Upper right abdominal or stomach pain
  • Yellow eyes or skin

Some of the side effects observed in patients who are taking oxaprozin are not considered serious and are a result of the body getting used to having the medication in the system. The side effects normally will subside as the patient gets used to the medication. However, if the symptoms are more intense or if they do not go away than this may indicate that there is a more serious medical problem. A patient taking this medication should check with a doctor if any of the following the side effects last more than a week:

  • Acid or sour stomach
  • Belching
  • Stomach discomfort
  • Continuing ringing or buzzing or other unexplained noise in the ears
  • Excess air or gas in the stomach or intestines
  • Hearing loss
  • Passing gas
  • Unusually relaxed and calm
  • Sleepiness or unusual drowsiness
  • Trouble sleeping
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • Burning, dry, or itching eyes
  • Change in taste
  • Decreased hearing
  • Discharge, excessive tearing
  • Dry mouth
  • Feeling of constant movement of self or surroundings
  • General feeling of discomfort or illness
  • Lack or loss of strength
  • Redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
  • Sensation of spinning
  • Shakiness in the legs, arms, hands, feet
  • Trembling or shaking of the hands or feet
  • While these are the most notable side effects that can happen while taking oxaprozin, this is not a complete list of the possible ways that this medication will affect a patient's system. If any additional side effects arise while taking this anti-inflammatory the patient should bring them to the attention of the prescribing physician.

Dosage

Oxaprozin is a potentially dangerous medication to take if it is not used as directed. Using more of it than prescribed or more often may be tempting to relieve inflammation, aches, and pains but this may increase the chance of potentially fatal conditions associated with overuse of this medication. Dosage instructions will be included with the prescription and should be followed even if they do not match the information provided by the manufacturer. The amount of the prescription received will take into account a number of factors including age, weight, and the severity of the condition being treated. Using more than this amount can increase the chance of drug interactions, side effects, and other unwanted conditions. This is especially true when oxaprozin is prescribed to elderly patients, who may incur additional risks from taking too much of this medication or taking it over a long period of time.

When taking oxaprozin for the treatment of inflammation the tablet is to be swallowed whole, not crushed or broken open for its contents or chewed before swallowing. It must be taken on a regular schedule that will be determined by the prescribing physician and this schedule will be determined by the general health of the patient. It generally will show results within a week of being taken for the first time but in some cases of more severe pain, it may take two weeks or longer to significantly reduce the inflammation. Oxaprozin tablets are taken for osteoarthritis and rheumatoid arthritis by adults and will usually consist of two daily doses of 600mg tablets. While this dose can be increased to treat more severe cases of these conditions the dose is not recommended to exceed 1800mg per day and may need to be divided into smaller doses throughout the day.

Children who are treated for juvenile rheumatoid arthritis with this medication are normally treated between the ages of 6 and 16 years of age but their dose needs to be determined by their pediatric specialist based on their age and body weight as well as their general health. In rare cases, it may be prescribed to children younger than 6 years of age but this must be done under very close supervision by a doctor.

If a patient misses a dose of oxaprozin the dose should be taken as quickly as possible. If too much time has passed and it is too close to the time of the next scheduled dose then the patient should skip to the next dose rather than take a risk of double dosing this medication.

Interactions

Certain medications should not be taken at the same time as a patient is taking oxaprozin. Some medications may interfere with its anti-inflammatory properties or it could negate the effects that those medications are supposed to have on the body. Taking some medications in tandem with oxaprozin may increase the risk of side effects of one or both medications. However, in some cases, it may be medically necessary to use both medications if one or both represent the best possible way to treat the condition in question. For example, Ketorolac is a medication that is not recommended and a doctor may decide not to treat a patient because of the severity of the drug interaction. The drugs on the following list are not usually recommended but may be prescribed with caution if they represent the best treatment option:

  • Abciximab
  • Aceclofenac
  • Acemetacin
  • Acenocoumarol
  • Amiloride
  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Amtolmetin Guacil
  • Anagrelide
  • Apixaban
  • Ardeparin
  • Argatroban
  • Aspirin
  • Balsalazide
  • Bemiparin
  • Bendroflumethiazide
  • Benzthiazide
  • Beta Glucan
  • Betamethasone
  • Bismuth Subsalicylate
  • Bivalirudin
  • Bromfenac
  • Budesonide
  • Bufexamac
  • Bumetanide
  • Cangrelor
  • Celecoxib
  • Certoparin
  • Chlorothiazide
  • Chlorthalidone
  • Choline Magnesium Trisalicylate
  • Choline Salicylate
  • Cilostazol
  • Citalopram
  • Clomipramine
  • Clonixin
  • Clopamide
  • Clopidogrel
  • Cortisone
  • Cyclopenthiazide
  • Cyclosporine
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Deflazacort
  • Desipramine
  • Desirudin
  • Desvenlafaxine
  • Dexamethasone
  • Dexibuprofen
  • Dexketoprofen
  • Diazoxide
  • Dibenzepin
  • Diclofenac
  • Diflunisal
  • Digoxin
  • Dipyridamole
  • Dipyrone
  • Dothiepin
  • Doxepin
  • Droxicam
  • Duloxetine
  • Edoxaban
  • Enoxaparin
  • Eplerenone
  • Epoprostenol
  • Eptifibatide
  • Escitalopram
  • Ethacrynic Acid
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Feverfew
  • Floctafenine
  • Flufenamic Acid
  • Fluocortolone
  • Fluoxetine
  • Flurbiprofen
  • Fluvoxamine
  • Fondaparinux
  • Furosemide
  • Ginkgo
  • Gossypol
  • Heparin
  • Hydrochlorothiazide
  • Hydrocortisone
  • Hydroflumethiazide
  • Ibuprofen
  • Iloprost
  • Imipramine
  • Indapamide
  • Indomethacin
  • Ketoprofen
  • Lepirudin
  • Levomilnacipran
  • Lithium
  • Lofepramine
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Magnesium Salicylate
  • Meadowsweet
  • Meclofenamate
  • Mefenamic Acid
  • Melitracen
  • Meloxicam
  • Mesalamine
  • Methotrexate
  • Methyclothiazide
  • Methylprednisolone
  • Metolazone
  • Milnacipran
  • Morniflumate
  • Nabumetone
  • Nadroparin
  • Naproxen
  • Nefazodone
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nortriptyline
  • Olsalazine
  • Opipramol
  • Oxaprozin
  • Oxyphenbutazone
  • Paramethasone
  • Parecoxib
  • Parnaparin
  • Paroxetine
  • Pemetrexed
  • Pentosan Polysulfate Sodium
  • Pentoxifylline
  • Phenindione
  • Phenprocoumon
  • Phenylbutazone
  • Phenyl Salicylate
  • Piketoprofen
  • Piroxicam
  • Polythiazide
  • Pralatrexate
  • Prasugrel
  • Prednisolone
  • Prednisone
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Protein C
  • Protriptyline
  • Reboxetine
  • Reviparin
  • Rivaroxaban
  • Rofecoxib
  • Salicylamide
  • Salicylic Acid
  • Salsalate
  • Sertraline
  • Sibutramine
  • Sodium Salicylate
  • Spironolactone
  • Sulfasalazine
  • Sulindac
  • Tacrolimus
  • Tenoxicam
  • Tianeptine
  • Tiaprofenic Acid
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tolfenamic Acid
  • Tolmetin
  • Torsemide
  • Treprostinil
  • Triamterene
  • Trichlormethiazide
  • Trimipramine
  • Trolamine Salicylate
  • Valdecoxib
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin
  • Xipamide

The following drugs are known to increase risks associated with the medications including the risk of side effects, but this risk may be mitigated by changing doses of one or both drugs. If these drugs are prescribed at the same time as oxaprozin the prescribing physician may also change the times at which the medications are taken to reduce the risk posed by potential drug interactions. These medications include:

  • Alacepril
  • Atenolol
  • Azilsartan
  • Azilsartan Medoxomil
  • Benazepril
  • etaxolol
  • Bisoprolol
  • Candesartan
  • Captopril
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Cilazapril
  • Delapril
  • Enalapril
  • Enalaprilat
  • Eprosartan
  • Esmolol
  • Fosinopril
  • Imidapril
  • Irbesartan
  • Labetalol
  • Levobunolol
  • Lisinopril
  • Losartan
  • Metipranolol
  • Metoprolol
  • Moexipril
  • Nadolol
  • Nebivolol
  • Olmesartan
  • Oxprenolol
  • enbutolol
  • Pentopril
  • Perindopril
  • Pindolol
  • Practolol
  • Propranolol
  • Quinapril
  • Ramipril
  • Sotalol
  • Spirapril
  • Telmisartan
  • Temocapril
  • Timolol
  • Trandolapril
  • Valsartan
  • Zofenopril

In addition to drug interactions, there is a chance that certain supplements, vitamins, or herbal remedies may interact with oxaprozin the patient should ensure that their doctor is aware of everything that they are taking to include over-the-counter medication. Smoking and drinking is not reccommended while taking oxaprozin.

Some medical conditions that a patient currently has or has a history of may affect the decision of the doctor to prescribe oxaprozin. The prescribing physician should be informed if the patient has had any of the following conditions:

  • Anemia
  • Bleeding problems
  • Congestive heart failure
  • Edema
  • Heart attack
  • Heart or blood vessel diseaseHyperkalemia
  • Hypertension
  • Kidney disease
  • Liver disease
  • Stomach or intestinal ulcers or bleeding?Stroke
  • Aspirin-sensitive asthma
  • Aspirin sensitivity
  • Heart surgery
  • Warnings

There are a number of reasons to be cautious when using oxaprozin to treat inflammation and arthritis. This is especially true if a child is treated with the medication, and a child's progress needs to be carefully monitored while they are taking this drug. Regular examinations, blood, and urine tests will be necessary to determine if a child should continue to take this medication or if any unwanted effects are being caused by using it to treat arthritis.

There is a significant risk of having a heart attack or stroke while taking oxaprozin, and this risk is much higher for those with a history of heart disease. This risk is higher if the medication is taken for a long period of time, and if a child has any chest pain while taking this medication it should immediately be reported to a doctor. This pain may spread to other areas of the body such as the extremities, jaw, back, or neck. Difficulty breathing or speaking accompanied by a headache, nausea, heavy sweating or feelings of faintness are also indicators that the patient requires emergency medical attention. If a child taking this medication has any symptoms of liver problems (such as yellow skin or eyes, dark-colored urine, pale stools, pain in the upper stomach, nausea, vomiting, or loss of appetite) a doctor should be told immediately.

One of the most troubling risks associated with taking oxaprozin is that it may cause internal bleeding including bleeding of the stomach or gastrointestinal tract. There may not be any warning before this occurs but it is more likely if there is a history of internal bleeding or stomach ulcers. Smoking or drinking may increase this risk as well, as can certain medications such as steroids or blood thinners. The most common contributor to this potentially fatal condition is prescribing this medication to patients who are over 60 years of age or are in very poor health. Some patients experience serious skin reactions to taking this medication and if a child taking the medication has any signs of blistering, loose skin, lesions, peeling, rashes, ulcers, or sores on the skin this is indicative of a rare and severe reaction that requires immediate medical care.

There are some warning signs that this medication is causing very serious side effects that will require medical care, and the patient should be checked into a hospital if they demonstrate any of these warning signs: swelling of the face, fingers, feet, or lower legs, severe stomach pain, black, tarry stools, or vomiting of blood or material that looks like coffee grounds, unusual weight gain, yellow skin or eyes, decreased urination, unusual bleeding or bruising, or skin rash. Also, signs of serious heart problems could occur such as chest pain, tightness in chest, fast or irregular heartbeat, unusual flushing or warmth of skin, weakness, or slurring of speech.

Some patients who take oxaprozin have an allergy to the medication and this rare allergy can lead to a serious condition called anaphylaxis. This is most common in patients who have an allergy to aspirin and patients with a known history of allergy to aspirin or other nonsteroidal anti-inflammatory drugs should not take this medication. If any symptoms of anaphylaxis occur while taking oxaprozin emergency medical care is called for. These symptoms include very fast or irregular breathing, gasping for breath, or fainting. Patients in this state may change color dramatically, have an erratic pulse, have hives or swelling of the skin, or quickly swell around the eyelids.

This medication is not recommended for use by pregnant women during later parts of a pregnancy because it can harm an unborn baby. Women who are pregnant or think they may become pregnant need to confer with their doctor regarding these risks. Taking oxaprozin may make a patient more sensitive to sunlight, so precautions such as sunscreen should be taken when going outdoors. Suntanning, especially with tanning beds, is not recommended. This medication may lead to complications during certain surgeries, so the patient should inform doctors and dentists that they are taking oxaprozin before any surgical procedure. For necessary surgery, it may be required that the oxaprozin be ceased for a specific interval before the procedure is performed.

Storage

Oxaprozin needs to be stored at room temperature in an area that is away from unfavorable environmental conditions such as high heat, freezing cold, and moisture. It should not be refrigerated or stored in an outdoor area such as an automobile as it may lose its effectiveness if it is allowed to freeze or melt. It can be potentially dangerous to children, pets, and those who it is not prescribed for. It should be maintained in its original container and kept in a secure location. When the medication is no longer needed or has expired, it should be disposed of in keeping with the guidelines for disposing of medical waste in the local area.

Summary

Oxaprozin works very well for its intended purpose as an anti-inflammatory, changing hormone levels so that those who are suffering from the pain and inflammation caused by arthritis can have relief and regain function. However, it is important to note that it is not a treatment for arthritis itself and will not cure the condition or repair the damage it has caused. It has several troubling side effects and drug interactions associated with it, and there are many vulnerable groups for which it should not be prescribed at all because it can be fatal. If there is sufficient communication between the doctor and the patient regarding these risk factors and the medication is used as directed it still may represent a patient's best hope for relief for their painful symptoms.