Naproxen Drug Profile

What is Naproxen?

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to reduce pain, inflammation, and fever. It belongs to the propionic acid class of NSAIDs and is available both over-the-counter and by prescription in various strengths. Naproxen works by blocking enzymes that produce inflammatory substances in the body, making it effective for treating conditions ranging from headaches to arthritis.

Uses

Naproxen is approved for several pain and inflammatory conditions:

• Arthritis: Reduces joint pain and stiffness associated with osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis
• Acute pain: Treats moderate pain from injuries, dental procedures, or minor surgeries
• Menstrual cramps: Alleviates pain and discomfort associated with primary dysmenorrhea
• Headaches and migraines: Provides relief from tension headaches and some types of migraines
• Fever reduction: Lowers elevated body temperature in adults and children over 12 years
• Tendinitis and bursitis: Reduces inflammation and pain in affected tendons and joints

How it works

Naproxen works by inhibiting cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2, which are responsible for producing prostaglandins. Prostaglandins are chemical messengers that promote inflammation, pain, and fever in the body. By blocking these enzymes, naproxen reduces the production of prostaglandins, thereby decreasing inflammation, relieving pain, and lowering fever.

Side effects

Common side effects include:

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• Stomach upset or nausea
• Heartburn or indigestion
• Dizziness or headache
• Drowsiness or fatigue
• Constipation or diarrhea
• Gas or bloating
• Ringing in the ears
• Fluid retention or swelling

Serious side effects requiring immediate medical attention:

• Stomach bleeding or ulcers (black, tarry stools or vomiting blood)
• Heart attack or stroke symptoms (chest pain, shortness of breath, weakness on one side)
• Severe allergic reactions (difficulty breathing, swelling of face or throat)
• Liver problems (yellowing of skin or eyes, dark urine)
• Kidney problems (changes in urination, swelling of legs or feet)

Warnings and precautions

• Cardiovascular risk: May increase risk of heart attack and stroke, especially with long-term use or in people with existing heart conditions
• Gastrointestinal bleeding: Can cause stomach ulcers and bleeding, particularly in elderly patients or those with a history of ulcers
• Pregnancy considerations: Should be avoided during the third trimester as it may cause harm to the unborn baby and complicate delivery
• Kidney and liver function: Use with caution in patients with impaired kidney or liver function, as naproxen is processed by these organs
• Elderly patients: Higher risk of serious side effects, particularly gastrointestinal and cardiovascular complications

Interactions

• Blood thinners (warfarin): Increases bleeding risk when combined with naproxen
• ACE inhibitors and ARBs: May reduce effectiveness of these blood pressure medications and increase kidney damage risk
• Diuretics: Naproxen can reduce the effectiveness of water pills and worsen kidney function
• Lithium: Naproxen can increase lithium levels in the blood, leading to toxicity
• Methotrexate: Increases risk of methotrexate toxicity by reducing its elimination from the body
• Other NSAIDs: Taking multiple NSAIDs together increases risk of side effects without added benefit
• Corticosteroids: Combined use increases risk of gastrointestinal bleeding and ulcers
• Alcohol: Increases risk of stomach bleeding and liver damage

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Dosage

Adult dosing varies based on the condition being treated and formulation used. For over-the-counter use, the typical dose is 220 mg every 8-12 hours, not exceeding 660 mg in 24 hours. Prescription strengths may range from 250 mg to 500 mg taken twice daily, with maximum daily doses typically not exceeding 1,500 mg. For arthritis, doses are usually higher and taken regularly, while for acute pain, lower doses may be used as needed. Always start with the lowest effective dose for the shortest duration necessary. Dosage should always be determined by a healthcare provider based on individual medical conditions, age, and response to treatment.

Sources: FDA DailyMed drug labels (public domain), BNF, WHO Essential Medicines List. This article is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before starting or stopping any medication.

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