Niper-D Tablet belongs to the group of medications called analgesics. It treats migraine headaches. Besides this, it can also be used to reduce pain in rheumatoid arthritis, gout and dysmenorrhea (menstrual pain). Migraine is a condition characterized by intense headaches. Pain is a symptom that occurs due to various underlying conditions.

Niper-D Tablet is a combination of two drugs: Naproxen and Domperidone. Naproxen works by blocking the action of the cyclo-oxygenase (COX) enzyme in the body that produces certain chemical substances such as prostaglandins that cause pain and swelling. Domperidone is an antiemetic agent which prevents nausea and vomiting symptoms by blocking certain receptors (like dopamine and serotonin) that stimulate the vomiting centre (chemoreceptor trigger zone – CTZ) located in the brain.

Take Niper-D Tablet as prescribed by your doctor. You are advised to take Niper-D Tablet for as long as your doctor has prescribed it for you based on your medical condition. Common side-effects of Niper-D Tablet are dryness of the mouth, abdominal pain, constipation, drowsiness, dizziness, visual disturbances, hearing problems and headache. Consult your doctor if you feel any discomfort.

Before taking the Niper-D Tablet , let your doctor know about all your allergic or hypersensitivity reactions to medicines or food. If you are pregnant or breastfeeding, please tell your doctor so that your doctor will weigh the benefits and any potential risks before prescribing it to you. Also, inform the doctor if you have a history of heart rhythm problems or ulcers due to pain killers. Patients with age above 65 years, pre-existing cardiac diseases such as heart failure, hypertension or stroke, gastrointestinal bleeding (due to pain killers), gastric ulcers, respiratory diseases such as asthma, liver diseases, kidney diseases or bleeding disorders should use Niper-D Tablet only when prescribed by a doctor.

Niper-D Tablet is a combination of naproxen and domperidone. Naproxen is an anti-inflammatory (reduce inflammation) and analgesic (reduce pain) agent. It inhibits the synthesis of prostaglandins, which are inflammatory mediators, thereby reducing pain and inflammation. Domperidone acts by enhancing gastric peristalsis (movements) to empty stomach. Easy movement of food through the stomach helps in relieving nausea and vomiting. It blocks the dopamine receptors present at the chemoreceptor trigger zone (responsible for regulating nausea and vomiting).

• Abdominal pain

• Constipation

• Indigestion

• Flatulence

• Dry mouth

• Glossitis (inflammation of the tongue)

• Diarrhoea

• Drowsiness

• Dizziness

• Headache

• Vision problems

• Hearing problems

Inform your doctor if you are taking any of the anticoagulants (warfarin), other NSAIDs (ibuprofen, ketorolac), corticosteroids (prednisolone), antidepressants (citalopram, fluoxetine, paroxetine, duloxetine, venlafaxine), or any other dietary or herbal supplements. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as naproxen may increase the risk of heart attack or stroke and stomach ulcers. The risk of developing ulcers is higher if you have a history of ulcers, have bleeding disorders, older in age, alcoholic or have multiple diseases. The risk of having a heart attack increases if you smoke, or you or your family has a history of heart failure, stroke, or hypertension. Call for medical help immediately, if you experience chest pain, shortness of breath, blood in the stool or dark stools, heartburn, or any other abnormal signs.

Drug-drug interactions: Niper-D Tablet may interact with other NSAIDs (ketorolac), anticoagulants (warfarin), corticosteroids (prednisolone), anti-hypertensive medications (ramipril and amlodipine), antibiotics (amikacin), lipid-lowering drugs (atorvastatin), and antidepressants (citalopram and fluoxetine).

Drug-food interactions: No interactions found.

Drug-disease interactions: Patients with peptic ulcers, inflammatory bowel disease (inflammation of the digestive tract), liver diseases, kidney diseases, heart problems, and respiratory diseases should take the Niper-D Tablet only when prescribed by a doctor.

• WARFARIN
• KETOROLAC
• PREDNISOLONE
• RAMIPRIL
• AMLODIPINE
• AMIKACIN
• ATORVASTATIN
• CITALOPRAM
• FLUOXETINE

• Drink plenty of fluids to avoid gastrointestinal problems.

• Avoid triggers that can increase your migraine headache.

• Take enough rest.

• Acupuncture, massage and physical therapy may also be helpful.

• De-stress yourself by meditating, reading books, taking a warm bubble bath or listen to soothing music.

• Avoid smoking and alcohol consumption.

• Performing yoga may also help in improving joint flexibility and pain management.

• Get adequate sleep as resting the muscles can help in reducing inflammation and swelling.

• Your doctor may monitor liver function and kidney function if you are taking Niper-D Tablet for long-term.

• Taking meals at the same time every day and sufficient sleep might help in avoiding migraine attacks. You are recommended to avoid loud music, noisy place, extreme temperatures and bright light. Also, avoid consumption of chocolates, cheese, processed food, smoking and alcohol.

Migraine: Migraine is a condition characterized by intense headaches. It also causes nausea, vomiting, sensitivity to light and sound and difficulty speaking. Bright lights, strong smells, certain foods, loud sounds, stress and hormonal changes act as triggers for migraine. These triggers lead to acute attacks. Acute migraine attacks result in throbbing headaches and pain in the eyes, face or neck.

Pain: Pain is a widely used term used to describe unpleasant feelings or discomfort. It ranges from mild to severe. The severity of the pain depends on the underlying condition.

Rheumatoid arthritis: Rheumatoid arthritis is an auto-immune disease (the body's immune system attacks its tissue) which leads to joint pain and damage. Symptoms of rheumatoid arthritis include pain, swelling, stiffness, deformities and loss of joint function.

Gout: Gout is an inflammatory condition in which uric acid deposits and crystallizes in the joints. It is characterized by acute, severe, and recurring pain attacks, especially at night, redness and swelling in the affected joints.

Dysmenorrhea: Dysmenorrhea refers to abdominal cramps/pain and an unpleasant sensory/emotional experience associated with irregular periods. It occurs just before or during menses. Menstrual cramps that cause throbbing pain in the lower belly during periods may vary from mild to severe. Some of the common symptoms of menstrual cramps include an aching pain in your belly (sometimes severe), a feeling of pressure in your belly, pain in your hips, lower back, and inner thighs.