Naproxen: Side Effects, Uses, Interactions, Warnings

Naproxen

Generic Name	Naproxen
Brand Names	Aleve, Anaprox, Naprosyn
Ingredients	Naproxen/Naproxen Sodium
Drug Class	Nonsteroidal Anti-Inflammatory Drug (NSAID)
Dosage Forms	Naproxen (Oral Suspension, Oral Tablet, Oral Delayed Release Tablet, Oral Tablet, Extended Release, Oral Capsule, Compounding Powder, Oral And Topical Kit)
Controlled Status	Not a Controlled Substance
Availability	Prescription Medication and Over the Counter

What is Naproxen? 

Naproxen belongs to the same class of medications as acetylsalicylic acid, diclofenac, ibuprofen and meloxicam, all of which are non-steroidal anti-inflammatory drugs (NSAIDs).

Naproxen is a pain relief medication known for its effectiveness in alleviating inflammation and joint stiffness. Naproxen operates by inhibiting the enzyme responsible for producing prostaglandins, which play a crucial role in the process of inflammation. When the body sustains an injury, it produces prostaglandins at the injured site, leading to symptoms such as redness, heat, swelling and pain.

Naproxen is available in two forms: naproxen and naproxen sodium. The primary distinction between the two lies in how quickly they are absorbed by the body. Naproxen sodium is absorbed more rapidly(1-2 hours) than Naproxen (2-4 hours ).

Common side effects include nausea, stomach upset, heartburn, rash, edema, headache, constipation, tinnitus, ototoxicity, pruritus etc.

What is Naproxen Used for?

Naproxen has received FDA approval for various medical conditions, including acute gout, ankylosing spondylitis, bursitis, polyarticular juvenile idiopathic arthritis, osteoarthritis, tendonitis, rheumatoid arthritis, pain management, and primary dysmenorrhea. It is recognized as the first-line treatment for acute gouty arthritis, osteoarthritis, musculoskeletal pain, inflammation, and dysmenorrhea.

Other uses of Naproxen include Backaches, Muscle Aches, Arthritis, Menstrual Cramps, Headache, Toothache, Common Cold, Fever, Gout Attacks, Pain and Menstrual Cramps. While Naproxen and other NSAIDs are FDA-approved for the treatment of inflammatory arthropathies like rheumatoid arthritis and ankylosing spondylitis, it’s important to note that they do not modify the course of these diseases or prevent joint and soft tissue damage, which are common consequences of these conditions.

In such cases, disease-modifying anti-rheumatic drugs (DMARDs) are often the primary treatment for inflammatory arthropathies, with NSAIDs like naproxen used as supplementary therapy.

How does Naproxen Work?

Naproxen is categorized as a non-steroidal anti-inflammatory drug (NSAID). Its mechanism of action involves the inhibition of enzymes called cyclooxygenase or COX within the body. These enzymes play a crucial role in initiating processes that lead to inflammation, pain, and swelling. 

By blocking the activity of COX enzymes, Naproxen effectively reduces these inflammatory responses, providing relief from discomfort and pain. This anti-inflammatory property makes Naproxen valuable for managing various conditions where inflammation and pain are central factors, such as arthritis and musculoskeletal issues.

Naproxen Dosage

Naproxen is available in various strengths, including 125 mg/5 mL, sodium 550 mg, sodium 275 mg, 500 mg, 375 mg, 250 mg, 375 mg (as sodium), 500 mg (as sodium), sodium 220 mg, 750 mg (as sodium), and sodium in varying strengths.

It is used in adult patients for conditions such as Ankylosing Spondylitis, Osteoarthritis, Rheumatoid Arthritis, Acute Gout, Bursitis, Tendonitis, Dysmenorrhea, Pain management, and Fever reduction. 

Additionally, it is suitable for pediatric patients to manage Fever, Pain, and Juvenile Rheumatoid Arthritis. The comprehensive dosage information is complemented by specific guidance on Renal Dose Adjustments, Liver Dose Adjustments, and Dose Adjustments, ensuring that dosing is individualized based on patient requirements, taking into consideration renal and hepatic function.

For adults, when using naproxen to alleviate pain and reduce fever, the highest recommended dose is 440 mg within an 8 to 12-hour interval and Maximum dose is 1375 mg/day,initial total daily dose; thereafter, not to exceed 1100 mg/day

Similarly, in pediatric patients for pain and fever management, the maximum dose should not exceed 440 mg within any 8 to 12-hour timeframe, with a total daily limit of 660 mg. These dosage guidelines help ensure safe and effective use of naproxen for both adults and children.

For more details about Naproxen Dosage

What are the Side Effects of Naproxen? 

While Naproxen is effective for many people, it’s important to be aware of these potential side effects and consult with a healthcare professional if they become severe or bothersome. 

Common side effects associated with Naproxen include edema, ecchymosis, rash, pruritus, abdominal pain, constipation, heartburn, nausea, dizziness, headache, somnolence, ototoxicity, tinnitus, and dyspnea. These side effects are relatively frequent and may occur during the use of Naproxen.

For more information about Side Effects of Naproxen

What Happens if I Miss a Dose?

Take your medication as soon as you can if you’ve missed a dose, but if it’s nearly time for your next scheduled dose, skip the missed one. Avoid taking two doses simultaneously.

What Happens if I Overdose? 

Mild symptoms of a naproxen overdose may include:

• Nausea
• Vomiting
• Ringing In The Ears
• Blurred Vision
• Confusion
• Dizziness
• Drowsiness
• Severe Headache

More Serious Overdose Symptoms Include:

• Coma
• Trouble Breathing
• Kidney Damage
• Stomach Bleeding
• Seizures

In case of a medical emergency, please seek immediate medical assistance or contact the Poison Help Line at 1-800-222-1222. Information is also available online at poisonhelp.org. Nevertheless, if you are experiencing severe symptoms, please do not hesitate to dial 911 (or your Local Emergency Number) immediately or proceed to the nearest emergency room for immediate medical attention. Your safety and well-being are paramount.

Pros and Cons of Naproxen

Pros	Cons
Effective for pain and inflammation	May cause stomach bleeding or stomach ulcers
Longer-lasting effects than other NSAIDs	Unsafe to take after 20 weeks of pregnancy
Lower doses available without a prescription	May not be the best option for individuals 65 or older or with kidney, heart, liver or bleeding problems
Available in liquid form for those who struggle with pills	Different formulations (e.g., tablets, liquid) cannot be substituted

Interaction Between Naproxen and other Drugs

What are the Risks and Warnings for Naproxen?

Naproxen and Allergy Warning

Naproxen can potentially trigger severe allergic reactions, including life-threatening responses like facial swelling, shock and anaphylaxis. It is essential to inform your healthcare provider of any allergies to aspirin or other NSAIDs before initiating naproxen treatment. If you observe symptoms such as hives, rash, skin redness, lip or tongue swelling or breathing difficulties following naproxen usage, seek immediate medical attention.

Although uncommon, naproxen has the potential to induce significant skin reactions, such as rash, blisters, skin reddening of skin peeling. If you detect any alterations in your skin condition while using naproxen, discontinue its use and promptly seek medical care.”

Naproxen and Alcohol Warning

It’s advisable to avoid taking Naproxen as it may lead to stomach bleeding.

Warning With People with Certain Health Conditions

History of asthma

Patients who have a history of asthma should be informed about the potential for this reaction and advised to seek medical assistance if their symptoms worsen upon starting a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs should be used cautiously in individuals with asthma and avoided in those with asthma and nasal polyps.

Gastrointestinal Warnings

Stomach bleeding is a potential risk associated with the use of naproxen, especially when certain risk factors are present. These risk factors include being an older adult, having a history of stomach bleeding or bleeding disorders, experiencing liver problems, taking other medications that increase the likelihood of bleeding, consuming alcohol, smoking or using naproxen for an extended period.

Naproxen, like all NSAIDs, can heighten the chances of developing stomach ulcers and experiencing gastrointestinal bleeding. Stomach bleeding is a serious medical condition that demands immediate treatment. 

Heart Disease warning

Naproxen usage can increase the likelihood of developing blood clots, which, in turn, can lead to serious conditions like heart attacks or strokes. It is advisable to use the lowest effective dose for the shortest duration possible when taking naproxen. If you have pre-existing heart issues, it is crucial to have a discussion with your healthcare provider before initiating this medication. Additionally, if you have undergone heart surgery or are scheduled to have one, you should not take naproxen.

Kidney Damage

Naproxen has the potential to lead to kidney problems and your risk of experiencing these issues may be higher if you have certain factors, such as being of older age, having specific medical conditions like diabetes or taking medications that are known to increase the risk of kidney problems.

 If there is a deterioration in your kidney function and develop any signs or symptoms of kidney failure, which can include changes in your urinary patterns, fatigue, dry and itchy skin, reduced appetite and muscle cramps. , your provider may consider discontinuing your naproxen treatment.

Liver Problem or Liver Failure

Although uncommon, naproxen has the potential to induce severe liver issues that could progress to liver failure. If you observe any of the following symptoms, it’s crucial to seek immediate medical attention: Swelling in your abdominal area, Abdominal pain, Yellowing of your skin or the whites of your eyes, known as jaundice, Changes in your stool color, such as black, tarry or bloody stools, Experiencing nausea and vomiting, Feeling confused, Noticing dark or brown urine.

Warning with other Groups

Naproxen and Breastfeeding

Small amounts of naproxen are excreted in breast milk. However, adverse effects are uncommon in infants breastfed from a mother taking naproxen.

Naproxen and Pregnancy

As with all non-steroidal anti-inflammatory medications (NSAIDs), naproxen use should be avoided in pregnancy due to the importance of prostaglandins in vascular and renal function in the fetus. NSAIDs should especially be avoided in the third trimester. 

Naproxen and Pediatric

It’s important to note that the safety and effectiveness of naproxen have not been established for children who are under 2 years of age.

Naproxen and Geriatric

If you are over the age of 65, it’s important to exercise caution when taking naproxen. Your body may metabolize this medication more slowly. Therefore, when beginning treatment, your doctor may initially prescribe a lower dose to prevent excessive accumulation of the drug in your system, as an excessive amount of the drug can be potentially harmful.

Expiration, Storage and Disposal

Do not use your Naproxen medication after the expiration date indicated on the packaging. 

Store the item or medication within the temperature range of 20°C to 25°C (68°F to 77°F) and be sure to steer clear of excessive heat, which includes temperatures above 40°C (104°F).

Store the medicine in a sealed container at room temperature, keeping it away from heat, moisture and direct exposure to light.

When a drug take-back program is not accessible, you can dispose of most medicines in your household trash, except for those listed on the FDA’s flush list (refer to the list provided by the FDA). This applies to prescription and over-the-counter (OTC) medications in various forms, including pills, liquids, drops, patches and creams. Ensure you follow proper disposal guidelines for responsible medication disposal.

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What are the Alternatives of Naproxen?

• Ibuprofen
• Meloxicam
• Diclofenac (Cambia)
• Meloxicam (Mobic)
• Acetaminophen (Tylenol)
• Aspirin (Bayer, Bufferin)
• Ibuprofen (Advil, Motrin)

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