Tiaprofenic acid

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Introduction

Generic Name: Tiaprofenic Acid
Brand Names: Surgam®,

Chemical Formula: C14H12O3S

Tiaprofenic acid is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the arylpropionic acid derivative class. It is mainly used to treat conditions which are associated with pain and inflammation. This drug is also prescribed for treating various musculoskeletal disorders, because of its ability to decrease the inflammation and provide relief from pain.

Mechanism of Action

Like most of the NSAIDs, Tiaprofenic acid works by inhibiting the cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2, which play a pivotal role in the synthesis of prostaglandins. These prostaglandins are responsible for promoting inflammation, pain, and fever during injury or disease. By decreasing the prostaglandin production, Tiaprofenic acid helps control the symptoms associated with inflammation and pain. However, like other non-selective NSAIDs, this mechanism can also result in gastrointestinal and renal side effects due to the inhibition of protective prostaglandins (through the COX inhibition) in the stomach lining and kidneys.

Uses

  1. Osteoarthritis
    Tiaprofenic acid is prescribed for the management of pain and stiffness associated with osteoarthritis, a condition which is characterized by the degeneration of joint cartilage and the underlying bone.
  2. Rheumatoid Arthritis
    In addition to osteoarthritis, Tiaprofenic acid is also used in treating rheumatoid arthritis, an autoimmune disorder that causes chronic inflammation of the joints. This drug helps reduce the swelling and improve mobility which is hampered by this painful condition.
  3. Postoperative Pain
    Tiaprofenic acid is effective in managing pain after surgeries.
  4. Ankylosing Spondylitis
    For patients with ankylosing spondylitis, which is a form of arthritis that primarily affects the spine, Tiaprofenic acid provides relief from inflammation and stiffness, improving flexibility and mobility in the patients.
  5. Other Musculoskeletal Pain
    Tiaprofenic acid can also be used for other types of musculoskeletal pain, including tendinitis and soft tissue injuries. Its potent anti-inflammatory effects make it suitable for both acute and chronic conditions.

Dosage

The recommended dosage of Tiaprofenic acid varies depending on the condition being treated and the patient’s overall health status.

  • Adults: The usual dose for adults is 200 mg twice daily, typically advised to be taken after meals to minimize the risk of gastrointestinal irritation.
  • This drug is not recommended for children.

Side Effects

Tiaprofenic acid, like other NSAIDs, can lead to side effects, which may range from mild to severe depending on the patient’s medical history and the duration of use.

Common Side Effects:

  • Gastrointestinal discomfort
  • Nausea and indigestion
  • Dizziness
  • Headaches

Serious Side Effects:

  • Gastrointestinal ulcers and bleeding: Long-term or high-dose use of Tiaprofenic acid can cause serious gastrointestinal complications, including ulcers and bleeding in the GIT.
  • Kidney damage: Prolonged use of this drug may impair renal function, especially in individuals with pre-existing kidney issues or disorders.
  • Increased cardiovascular risk: Tiaprofenic acid may increase the risk of cardiovascular events, such as heart attacks or strokes, particularly in patients who have a history of heart disease.
  • Tiaprofenic acid-induced cystitis: This drug may cause severe cystitis characterized by change in urine frequency, painful and burning urination and sometimes haematuria.

Contraindications

Tiaprofenic acid is contraindicated in certain populations, particularly those at higher risk of gastrointestinal or renal complications.

  • Patients with a history of gastrointestinal bleeding, peptic ulcers or related gastrointestinal diseases.
  • People having severe renal or hepatic impairment
  • Patients with known hypersensitivity to Tiaprofenic acid or other NSAIDs
  • Pregnant women in the third trimester: Tiaprofenic acid is not recommended during pregnancy due to the risk of premature closure of the ductus arteriosus in the fetus.

Drug Interactions

As with other NSAIDs, Tiaprofenic acid can interact with a variety of different medications, increasing the risk of adverse reactions or diminishing therapeutic efficacy, here are some important interactions

  • Anticoagulants: Increased risk of bleeding when combined with anticoagulant drugs like warfarin or heparin.
  • ACE Inhibitors and ARBs: Reduced efficacy in the managing of blood pressure and increased risk of kidney problems.
  • Corticosteroids: Higher risk of gastrointestinal ulcers and bleeding when used in combination.
  • Diuretics: May enhance the risk of renal complications due to the effect of reduced blood flow to the kidneys.

Special Considerations

1. Gastrointestinal Safety

Tiaprofenic acid should be used cautiously in individuals with a history of gastrointestinal problems, as it may increase the risk of stomach ulcers and bleeding. Taking the medication with food and using gastroprotective agents such as proton pump inhibitors (PPIs) can help mitigate this risk.

2. Cardiovascular Health

As with other NSAIDs, patients with existing cardiovascular conditions should use Tiaprofenic acid with caution. High doses and long-term use have been associated with an increased risk of cardiovascular events, including heart attacks and strokes.

3. Kidney Function

Tiaprofenic acid may impair kidney function, especially in those with pre-existing kidney disease or in situations where renal blood flow is compromised (e.g., dehydration, heart failure). Regular monitoring of kidney function is recommended for long-term users of Tiaprofenic acid.

Warnings and Precautions

  1. Gastrointestinal Bleeding:
    Patients should watch for signs of gastrointestinal bleeding, such as black tarry stools, blood in vomit, or severe stomach pain. Early recognition of these symptoms can help to prevent more severe complications.
  2. Cardiovascular Risk:
    Patients with a history of cardiovascular disease should use Tiaprofenic acid at the lowest effective dose for the shortest duration possible with the consultation of a medical professional. Regular monitoring of blood pressure is recommended during therapy with this drug.
  3. Kidney Function:
    Long-term use of Tiaprofenic acid can lead to kidney impairment. Patients who are at higher risk of kidney problems should be closely monitored for kidney function and regular blood and urine tests.
  4. Pregnancy and Lactation:
    Tiaprofenic acid should be avoided during the third trimester of pregnancy due to the risk of fetal harm. Limited information is available on the excretion of this drug in breast milk, so breastfeeding patients must consult their healthcare provider before use.

Important Points

  • Administration: Patients should always take Tiaprofenic acid with food to minimize the risk of gastrointestinal irritation. They should also avoid alcohol during treatment, as it may increase the risk of stomach bleeding.
  • When to Seek Medical Attention: Patients should contact their healthcare provider immediately if they experience severe gastrointestinal symptoms, signs of kidney problems (e.g., decreased urine output, swelling), or cardiovascular symptoms (e.g., severe chest pain, shortness of breath).

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