| Ankylosing spondylitis

Naprelan vs Purified Cortrophin Gel

Side-by-side clinical, coverage, and cost comparison for ankylosing spondylitis.

Deep comparison between: Naprelan vs Purified Cortrophin Gel with Prescriber.AI

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Safety signalsPurified Cortrophin Gel has a higher rate of injection site reactions vs Naprelan based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Purified Cortrophin Gel but not Naprelan, including UnitedHealthcare

Category

Naprelan

Purified Cortrophin Gel

At A Glance

RouteOral

FrequencyDaily

ClassNSAID

RouteSC/IM injection

ClassCorticotropin (ACTH)

Indications

Rheumatoid Arthritis
Degenerative polyarthritis
Ankylosing spondylitis
Tendinitis
Bursitis
Gout
Primary dysmenorrhea

Arthritis, Psoriatic
Rheumatoid Arthritis
Ankylosing spondylitis
Primary gout
Lupus Erythematosus, Systemic
Polymyositis
Stevens-Johnson Syndrome
Psoriasis
Dermatitis, Atopic
Serum Sickness
Allergic Conjunctivitis
Keratitis
Iritis
Iridocyclitis
Uveitis
Optic Neuritis
Chorioretinitis
Sarcoidosis
Nephrotic Syndrome
Multiple Sclerosis

Dosing

Rheumatoid Arthritis, Degenerative polyarthritis, Ankylosing spondylitis 750 mg or 1,000 mg once daily; may be increased to 1,500 mg once daily for limited periods when a higher level of anti-inflammatory/analgesic activity is required.

Tendinitis, Bursitis, Primary dysmenorrhea 1,000 mg once daily; for patients requiring greater analgesic benefit, 1,500 mg may be used for a limited period; total daily dose should not exceed 1,000 mg thereafter.

Gout 1,000-1,500 mg once daily on the first day, followed by 1,000 mg once daily until the attack subsides.

Arthritis, Psoriatic, Rheumatoid Arthritis, Ankylosing spondylitis, Primary gout, Lupus Erythematosus, Systemic, Polymyositis, Stevens-Johnson Syndrome, Psoriasis, Dermatitis, Atopic, Serum Sickness, Allergic Conjunctivitis, Keratitis, Iritis, Iridocyclitis, Uveitis, Optic Neuritis, Chorioretinitis, Sarcoidosis, Nephrotic Syndrome Dose individualized based on disease severity, plasma and urine corticosteroid levels, and patient response; administer SC or IM; verify adrenal responsiveness prior to treatment (up to 80 units as a single injection); chronic doses above 40 units daily associated with uncontrollable adverse effects.

Multiple Sclerosis 80-120 units daily SC or IM for 2-3 weeks for acute exacerbations.

Contraindications

Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to naproxen or any components of the drug product
History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
Coronary artery bypass graft (CABG) surgery

Intravenous administration
Scleroderma
Osteoporosis
Systemic fungal infections
Ocular herpes simplex
Recent surgery
History of or presence of a peptic ulcer
Congestive heart failure
Hypertension
Sensitivity to proteins derived from porcine sources
Primary adrenocortical insufficiency
Adrenocortical hyperfunction

Drug Interactions

1284View drug interactions

648View drug interactions

Adverse Reactions

Most common (>=10%) headache, dyspepsia, flu syndrome

Serious cardiovascular thrombotic events, GI bleeding/ulceration/perforation, hepatotoxicity, hypertension, heart failure and edema, renal toxicity and hyperkalemia, anaphylactic reactions, serious skin reactions, hematologic toxicity

Fluid and Electrolyte Sodium retention, hypokalemic alkalosis, fluid retention, calcium loss, potassium loss

Musculoskeletal Muscle weakness, loss of muscle mass, steroid myopathy, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones

Gastrointestinal Peptic ulcer with possible perforation and hemorrhage, abdominal distention, ulcerative esophagitis, pancreatitis

Dermatologic Injection site reactions, impaired wound healing, increased sweating, thin fragile skin, suppression of skin test reactions, petechiae and ecchymoses, acne, hyperpigmentation, facial erythema

Cardiovascular Hypertension, congestive heart failure, necrotizing angiitis

Neurological Convulsions, increased intracranial pressure with papilledema, headache, vertigo

Endocrine Menstrual irregularities, Cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary insufficiency, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents, hirsutism

Ophthalmic Posterior subcapsular cataracts, increased intraocular pressure, glaucoma with possible damage to optic nerve, exophthalmos

Metabolic Negative nitrogen balance due to protein catabolism

Allergic Dizziness, nausea and vomiting, skin reactions, anaphylaxis (anaphylactic shock, urticaria, respiratory compromise, edema)

Miscellaneous Weight gain, abscess, development of antibodies and loss of stimulatory effect

Pharmacology

Naproxen is an NSAID with analgesic, anti-inflammatory, and antipyretic properties that acts by inhibiting cyclooxygenase (COX-1 and COX-2), thereby reducing prostaglandin synthesis in peripheral tissues.

Purified Cortrophin Gel is an anterior pituitary hormone (corticotropin/ACTH) that stimulates the functioning adrenal cortex to produce and secrete adrenocortical hormones; it is formulated as a porcine-derived purified ACTH in a sterile gelatin solution for prolonged activity.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Naprelan