Also called: Naproxen Sodium
Naproxen is a pain reliever and fever reducer that belongs to the class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs). It is available in over-the-counter and prescription formulations.
Pain conditions that may be treated with naproxen include:
- Menstrual pain
- Muscle aches
- Arthritis, including osteoarthritis, rheumatoid arthritis, juvenile arthritis, gout and ankylosing spondylitis
- Tendinitis and bursitis
Scientists believe that naproxen works by inhibiting prostaglandin production. Prostaglandins are hormone-like substances in the body that mediate a wide range of physiological functions.
Naproxen is available as a regular tablet, extended-release tablet and liquid. Although the drug is considered to be safe, it may not be advised for patients with some medical conditions or for certain populations. Some side effects of naproxen include drowsiness, headache and dizziness. Patients are advised not to take naproxen without first consulting a physician.
The U.S. Food and Drug Administration (FDA) has warned that naproxen and other non-aspirin NSAIDs increase the risk of cardiovascular events, such as heart attack and stroke, as well as serious gastrointestinal bleeding. Patients are advised to consult their physician before taking naproxen, especially if they are also taking other medications.
Naproxen is a pain reliever (analgesic) and fever reducer that also decreases inflammation and tenderness caused by many disorders. Pain associated with many conditions and procedures can often be alleviated by taking this nonsteroidal anti-inflammatory drug (NSAID). It is available in over-the-counter and prescription formulations.
It is unknown exactly how naproxen works. However, it is believed that naproxen inhibits prostaglandin production. Prostaglandins are hormone-like substances in the body that mediate a wide range of physiological functions.
Naproxen is available as a regular tablet, extended–release tablet, caplet and liquid. The U.S. Food and Drug Administration (FDA) approved naproxen for over-the-counter use in 1994. Prescribed dosages may be higher than dosages available over the counter. Dosages vary for children and elders.
Patients should always take naproxen exactly as directed by a physician. Prolonged use of naproxen above the recommended dosage may increase an individual’s risk of gastrointestinal and cardiovascular events and severe skin reactions. If pain persists for longer than the recommended dosage period, a physician should be consulted. According to the FDA, people should not take more than 220 milligrams of naproxen twice a day and should not take it for more than 10 days without a physician’s approval.
Types and differences of naproxen
Naproxen is available over the counter and by prescription in several brands. It is available in combination with other medications such as antacids. Brands include:
In addition, the U.S. Food and Drug Administration has received an application for a headache medication for migraines that combines naproxen and a triptan.
Conditions treated with naproxen
Many conditions can be treated with naproxen. Over-the-counter naproxen may be used to treat conditions including:
- Headache, including tension headache and migraine
- Minor arthritic or other joint pain
- Menstrual pain
- Muscle aches
- Common colds
In addition, a physician may prescribe naproxen to treat more significant pain associated with conditions such as:
- Arthritis, including osteoarthritis, gout, rheumatoid arthritis, juvenile arthritis and ankylosing spondylitis
- Tendinitis and bursitis
Naproxen may also be used to help relieve pain associated with childbirth, surgery or dental work.
In addition, research has linked regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), a class that includes naproxen, to reduce risk of some cancers and benign prostatic hyperplasia. For more information, and for a more extensive list of conditions treated by these drugs, see NSAIDs.
Conditions of concern with naproxen
Patients should not take naproxen if they have a history of asthma or nasal polyps caused by taking aspirin. Other conditions that may prohibit or limit use of naproxen include:
- Peptic ulcer disease
- Bleeding disorder or blood cell disorder
- Kidney damage, including that caused by lupus, sickle cell anemia or diabetes
- Diminished liver function
- History of high blood pressure or heart failure
- Allergy to aspirin or other NSAIDs
- History of gastrointestinal disease
- History of fluid retention
Potential side effects of naproxen
The U.S. Food and Drug Administration (FDA) announced in 2005 that it was asking all manufacturers of prescription nonsteroidal anti-inflammatory drugs (NSAIDs), including naproxen, to include new warnings on their labeling about certain dangers associated with these medications. These dangers include increased risk of cardiovascular events such as heart attack and stroke, and gastrointestinal bleeding that could be potentially life-threatening. The FDA also asked that the labeling state that patients who have recently undergone heart surgery should not take NSAIDs.
In addition, the FDA is asking manufacturers of over-the-counter NSAIDs to include the warnings about cardiovascular and gastrointestinal dangers, as well as a warning about the danger of skin reactions associated with these drugs.
Patients should consult a physician if they have concerns about taking these medications in light of the FDA’s recommendations.
Naproxen has a lower incidence of side effects than some other NSAIDs, including reduced gastrointestinal irritation and a lower incidence of liver and kidney complications. However, naproxen sometimes causes upset stomach, despite the fact that it usually is gentler on the stomach than aspirin. Patients can reduce the risk of upsetting the stomach by taking naproxen with food or milk, refraining from lying down for 30 minutes after taking the medication, and taking antacids while on naproxen.
In additional, the National Institutes of Health has warned that over-the-counter painkillers including naproxen can cause serious kidney damage, including sudden-onset acute kidney failure in people with risk factors such as systemic lupus erythematosus and chronic kidney disease that could develop in someone taking analgesics daily for years.
Women who use naproxen may experience changes in the pattern and timing of their menstrual cycle. Naproxen use can also cause false positives in fecal occult blood tests, which are used to reveal the presence of blood hidden in a patient’s stool.
Other side effects associated with naproxen include:
- Upset stomach
- Stomach pain or cramps
- Constipation, diarrhea or gas
In some cases, use of naproxen may cause more serious symptoms. For example, patients who take naproxen over long periods of time or at higher dosage levels may develop stomach ulcers that bleed. Patients should stop taking naproxen if they experience:
- Burning stomach pain
- Bloody diarrhea or black, tarry stools
- Bloody vomit
Naproxen can also cause serious allergic reactions that may manifest as problems breathing or swallowing, wheezing or rash. Naproxen may cause liver or kidney problems in some patients, and can cause others to retain fluid. Patients should consult a physician if they experience any of the following:
- Ringing in the ears (tinnitus) or ear pain
- Blurred vision
- Swelling of the hands, feet, ankles or lower legs
- Tiredness or fatigue
- Yellow coloring of the skin or eyes (jaundice)
- Loss of appetite
- Darkened urine
- Flu-like symptoms
Drug or other interactions with naproxen
Patients should consult their physician before taking any additional prescriptions, over-the-counter medications, nutritional supplements or herbal medications. Patients should not drink alcohol while taking naproxen, as it can cause marked drowsiness. In addition, patients should not take aspirin or acetaminophen with naproxen unless directed to do so by a physician.
Patients also should inform their physician if they are taking any of the following medications:
- Beta blockers, ACE inhibitors or diuretics (blood pressure medications)
- Cyclosporine or methotrexate (disease-modifying antirheumatic drugs)
- Lithium (used to treat bipolar disorder and sometimes used to prevent cluster headaches)
- Medications for arthritis, including probenecid, a treatment for gout
- Medications for diabetes (antidiabetic agents)
- Phenytoin (an anticonvulsant)
Symptoms of naproxen overdose
Symptoms of overdose can be similar to the medication’s side effects, but are usually more severe. Symptoms associated with overdose include:
- Heartburn or indigestion
- Nausea or vomiting
- Ringing in the ears or ear pain
Patients should contact their physician immediately if they suspect overdose with naproxen. Patients who overdose on naproxen can usually be treated with ipecac syrup (medication that induces vomiting) or activated charcoal (medication that neutralizes poisons that have been swallowed).
Pregnancy use issues with naproxen
There is no evidence that naproxen causes birth defects in humans. However, it is recommended that pregnant women refrain from using naproxen during the last three months of pregnancy. Pregnant women should not take naproxen without doing so in close consultation with a physician.
Naproxen passes into breast milk, but only in very small amounts. However, it should not be taken by women who are breastfeeding unless recommended by a physician.
Child use issues with naproxen
Over-the-counter naproxen is often not given to children under age 12, unless specifically directed by a physician. In some situations, a physician may give prescription naproxen to a child. Dosage levels for children usually depend upon a child’s weight.
Elderly use issues with naproxen
Patients over the age of 60 are more sensitive to the adverse effects of naproxen, particularly gastrointestinal toxicity and retention of fluid.
Questions for your doctor regarding naproxen
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about naproxen:
- What kinds of pain can be treated with naproxen?
- I know naproxen relieves pain, but what other conditions can it treat?
- Do you recommend naproxen for me?
- Can it interact with other medications I’m taking?
- Is naproxen available to me in prescription dosages to treat more substantial pain?
- What side effects might I experience while taking naproxen?
- At what point should I report side effects to you?
- Do some populations need to be careful when using naproxen?
- I heard about an FDA warning regarding NSAIDs such as naproxen. Is naproxen safe for me?
- What other drugs or treatments will be considered if I have difficulty using naproxen?