What Is Karoksen and How Does It Work?
Karoksen is used as a treatment to relieve pain from various conditions such as headaches, muscle aches, tendonitis, dental pain, and menstrual cramps. It also reduces pain, swelling, and joint stiffness caused by conditions such as arthritis, bursitis, and gout attacks.
Karoksen belongs to a class of medications called nonsteroidal anti-inflammatory drugs NSAIDs. NSAIDs are a type of medications that work by blocking your body's production of certain natural substances that cause inflammation.
Karoksen is available under the following different brand names: Aleve, EC Naprosyn, Anaprox, Anaprox DS, Naprosyn, Naprox Sodium, Karoksen EC, Karoksen SR, Naprelan, and Menstridol.
Dosages of Karoksen:
- 220 mg (over the counter)
- 250 mg
- 275 mg
- 375 mg
- 500 mg
- 550 mg
Tablet, delayed release
Tablet, extended release
Dosage Considerations – Should be Given as Follows:
Adult Dosage Considerations
- 500 mg orally initially, then 250 mg orally every 6-8 hours or 500 mg orally every 12 hours as needed, not to exceed 1250 mg/day Karoksen base on day 1, subsequent daily doses should not exceed 1000 mg Karoksen base.
- Extended release 750-1000 mg orally every day, may temporarily increase to 1500 mg/day if tolerated well and clinically indicated.
- 500-1000 mg/day orally divided every 12 hours, may increase to 1500 mg/day if tolerated well for limited time.
- 500 mg orally initially, then 250 mg orally every 6-8 every hour or 500 mg orally every 12 hours (long-acting formula), not to exceed 1250 mg/day on the first day, subsequent does should not exceed 1000 mg/day Karoksen base.
- 750 mg orally initially, followed by 250 mg every 8 hours until attach subsides
- Extended release 1000-1500 mg every day, followed by 1000 mg every day until attack subsides
- 750 mg orally initially, may give additional 250-500 mg if necessary, not to exceed 1250 mg in 24 hours
Pediatric Dosage Considerations
- Over 2 years
- Cancer pain (off-label): 5-7 mg/kg orally every 8-12 hours, not to exceed 1000 mg per day.
- Over 12 years
- 500 mg orally initially, then 250 mg orally every 6-8 hours or 500 mg orally every 12 hours as needed, not to exceed 1250 mg per day Karoksen base on day 1, subsequent daily doses should not exceed 1000 Karoksen base.
- Extended release: 750-1000 mg orally each day; may temporarily increase to 1500 mg/day if tolerated well and clinically indicated
- Over 2 years
- 10 mg/kg/day oral suspension orally divided each 12 hours, not to exceed 15 mg/kg per day
Q: I have rheumatoid arthritis and have been on Karoksen 500 mg once a day as a part of my treatment along with Enbrel 50 mg injection once a week and methotrexate 20 mg once a week. I've been stable on this protocol for the last four years. Recently, I've been having an increase in swelling of the feet/ankles that does not seem to resolve with decreasing salt intake or remaining in a cooler environment. I get a regular CBC and liver panel every three months and all is normal. Could the Karoksen be causing the swelling?
A: Karoksen is a medication used to treat pain and inflammation and is part of a class called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by blocking a hormone, called prostaglandin, that contributes to inflammation in the body. According to the prescribing information on Karoksen the most common side effects of this medication are: heartburn, nausea, constipation, headache, ringing in the ears, and fluid retention. These effects were seen in up to 3 percent of patients taking the medication during clinical trials. For more information on Karoksen, visit //www.everydayhealth.com/drugs/Karoksen. If you feel you are experiencing fluid retention due to this medication, it would be best to consult with your physician to be sure that no other underlying condition is contributing to the problem. He or she will help you come up with a plan to deal with this issue. For more information on rheumatoid arthritis, visit //www.everydayhealth.com/rheumatoid-arthritis/guide/. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD
Why is this medication prescribed?
Prescription Karoksen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), juvenile arthritis (a form of joint disease in children), and ankylosing spondylitis (arthritis that mainly affects the spine). Prescription Karoksen tablets, extended-release tablets, and suspension are also used to relieve shoulder pain caused by bursitis (inflammation of a fluid-filled sac in the shoulder joint), tendinitis (inflammation of the tissue that connects muscle to bone), gouty arthritis (attacks of joint pain caused by a build-up of certain substances in the joints), and pain from other causes, including menstrual pain (pain that happens before or during a menstrual period). Nonprescription Karoksen is used to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches. Karoksen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
How should this medicine be used?
Prescription Karoksen comes as a regular tablet, a delayed-release (a tablet that releases the medication in the intestine to prevent damage to the stomach) tablet, an extended-release (long-acting) tablet, and a suspension (liquid) to take by mouth. The extended-release tablets are usually taken once a day. The tablets, delayed-release tablets, and suspension are usually taken twice a day for arthritis. The tablets and suspension are usually taken every 8 hours for gout, and every 6 to 8 hours as needed for pain. If you are taking Karoksen on a regular basis, you should take it at the same time(s) every day.
Nonprescription Karoksen comes as tablet and a gelatin coated tablet to take by mouth. It is usually taken with a full glass of water every 8 to 12 hours as needed. Nonprescription Karoksen may be taken with food or milk to prevent nausea.
Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Karoksen exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor or written on the package.
Shake the liquid well before each use to mix the medication evenly. Use the measuring cup provided to measure each dose of the liquid.
Swallow the delayed-release tablets and extended release tablets whole; do not split, chew, or crush them.
If you are taking Karoksen to relieve the symptoms of arthritis, your symptoms may begin to improve within 1 week. It may take 2 weeks or longer for you to feel the full benefit of the medication.
Stop taking nonprescription Karoksen and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, the part of your body that was painful becomes red or swollen, your pain lasts for more than 10 days, or your fever lasts for more than 3 days.
The comparison of ibuprofen vs. Karoksen is largely dependent upon how often you want to take your medicines and what other drugs you may be taking.
Mild to moderate pain
For fever and mild to moderate pain, adults between 12 and 65 years old can take one 220 mg tablet of Karoksen every 12 hours. Children under 12 years old should not take Karoksen unless their doctor recommends it.
Other uses for this medicine
Karoksen is also sometimes used to treat Paget's disease of bone (a condition in which the bones become abnormally thick, fragile, and misshapen) and Bartter syndrome (a condition in which the body does not absorb enough potassium, causing muscle cramping and weakness and other symptoms). Talk to your doctor about the risks of using this medication for your condition.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
People who take nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as Karoksen may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Do not take an NSAID such as Karoksen if you have recently had a heart attack, unless directed to do so by your doctor. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke, if you smoke, and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.
If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take Karoksen right before or right after the surgery.
NSAIDs such as Karoksen may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or who drink three or more alcoholic drinks per day while taking Karoksen. Tell your doctor if you take any of the following medications: anticoagulants (''blood thinners'') such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) and ketoprofen; oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). Also tell your doctor if you have or have ever had ulcers, bleeding in your stomach or intestines, or other bleeding disorders. If you experience any of the following symptoms, stop taking Karoksen and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to Karoksen. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with prescription Karoksen and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Before taking Karoksen, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before taking this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), blood disorders (such as anemia, bleeding/clotting problems), growths in the nose (nasal polyps), heart disease (such as previous heart attack), high blood pressure, liver disease, stroke, throat/stomach/intestinal problems (such as bleeding, heartburn, ulcers).
Kidney problems can sometimes occur with the use of NSAID medications, including Karoksen. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana (cannabis).
This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.
This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding and kidney problems.
Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.
This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
If you think you may have symptoms of a stomach ulcer, stop taking Karoksen and contact your doctor.
It's been said that taking anti-inflammatory medicines increases the chances of getting heart failure.
But the risk is very small for most people.
If you find you need to take Karoksen very often or you're taking doses higher than recommended, talk to your doctor about your pain.
Some anti-inflammatory medicines are less risky than others. Your doctor will be able to help you decide which is the best one for you.
Karoksen is safe for occasional use when taken as advised by a doctor.
If you have problems with your kidney function, talk to your doctor about the best anti-inflammatory to take.
NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage.
It's thought some anti-inflammatory medicines, including Karoksen, can increase the chance of you getting an irregular heartbeat (such as atrial fibrillation or atrial flutter).
But the chances of getting an irregular heartbeat is small and not enough to recommend people stop taking these medicines.
If you're prescribed Karoksen for a long-term condition, keep taking it and talk to your doctor if you're worried.
If you buy Karoksen from a shop, occasional doses or short courses (2 or 3 days) are safe.
It's been reported that women taking some anti-inflammatory medicines, including Karoksen, twice a week for more than a year have a higher chance of losing their hearing.
But there's no proof that Karoksen and similar anti-inflammatory medicines cause hearing loss.
Hearing loss is common as people get older.
There are ways to protect your hearing - for example, limiting your exposure to loud noise, wearing hearing protection in noisy places, and keeping the volume down on personal headphones.
If you find you have to take Karoksen several days a week, talk to your doctor about what's causing your pain and whether there are better ways to manage it.
Taking anti-inflammatory medicines, like Karoksen, in large doses or for a long time can affect ovulation in women. This may make it more difficult to get pregnant.
Do not take Karoksen if you're trying to get pregnant or you're having tests for infertility.
Paracetamol is a better painkiller in these situations.
There's no firm evidence to suggest that taking Karoksen will reduce fertility in men.
Karoksen doesn't affect any type of contraception, including the combined pill or emergency contraception.
Yes, you can drink alcohol while taking Karoksen. But drinking too much alcohol may irritate your stomach.
What is Karoksen?
Karoksen is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.
Karoksen is used to treat pain or inflammation caused by conditions such as arthritis, ankylosing spondylitis, tendinitis, bursitis, gout, or menstrual cramps. It can also be used to treat acute pain caused by other conditions not listed in this medication guide.
The delayed-release or extended-release tablets are slower-acting forms of Karoksen that are used only for treating chronic conditions such as arthritis or ankylosing spondylitis. These forms will not work fast enough to treat acute pain.
Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis
People can manage the symptoms of osteoarthritis, which is commonly known as arthritis, rheumatoid arthritis, and ankylosing spondylitis with a dose of 220 mg to 550 mg of Karoksen every 12 hours. Karoksen does not cure these conditions but offers relief from pain and inflammation.