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Why it's used

Naproxen is a prescription medicine that is used to treat various types of muscle and joint disorders which includes pain, swelling, and inflammation in the joints (rheumatoid arthritis), breakdown of the lining of the joints (osteoarthritis), pain and stiffness from the neck down to the lower back (ankylosing spondylitis), acute pain, redness, and tenderness in joints (acute gout), joint inflammation and stiffness in the children (juvenile arthritis), and acute musculoskeletal disorders such as sprains, back pains and muscle pain and tenderness (fibrositis). This medicine works by blocking the activity of body chemicals that cause fever, inflammation, and pain. Naproxen is also used to relieve mild to moderate pain from headache, muscle aches, menstrual periods, common cold, toothache, and backache, for the management of acute inflammation or irritation of a tendon (tendinitis) and inflammation of a fluid-filled sac in the shoulder joint (bursitis), painful periods (primary dysmenorrhea), and to reduce fever.
When not to use
Naproxen cannot be used to treat pain before or after the time of heart operation (coronary artery bypass graft surgery).
Nonsteroidal Anti-inflammatory Drugs
Naproxen belongs to the Nonsteroidal Anti-inflammatory Drugs class of medicines. Nonsteroidal anti-inflammatory drugs, also called as NSAIDs, help reduce fever, decrease pain, and prevent clotting of blood. NSAIDs also reduce inflammation in the body when used in higher doses.

How to use

Follow directions on the product label, information guide, and provided by your doctor before using Naproxen. Use this medicine as per your doctor's instructions.
Naproxen is used with or after food. Take this medicine with food or milk, to prevent stomach upset. This medicine should be taken with a full glass of water for every 8 to 12 hours as needed.
The typical adult dose of Naproxen is 500-1000 mg/day (not more than 1500 mg in one day). The typical dose for children is 10 mg/kg (4.54 mg/lb) daily in two doses at 12 hour intervals. The maximum dose for adults of Naproxen is 1500 mg/day per day. This medicine is commonly used for a period of 3 days for fever, and 10 days for pain. Naproxen is typically used at the same time every day. If you are taking this medicine on a regular basis, it is recommended that you use Naproxen at the same time every day. It takes 30 minutes for this medicine to start its action. There are no known habit-forming tendencies with this medicine.
Naproxen is to be used for longer periods of time. Naproxen may be prescribed for the long-term use for the treatment of rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. You should continue to use this medicine as directed by the doctor even if you feel well.
Tell your doctor if your condition persists or worsens or if you develop new symptoms. Talk to your doctor if nausea, fatigue, lack of energy (lethargy), diarrhea, severe skin itching, jaundice, right upper quadrant tenderness, flu-like symptoms, increase in the number of eosinophils (eosinophilia), rash, redness or swelling in the body, and high blood pressure. If you have any kidney disease, a lowest effective dose should be considered in patients with mild kidney problems, and if possible, the use of Naproxen should be avoided in patients with moderate to severe kidney problems. If you have issues with the health of your liver, a lowest effective dose should be considered in patients with abnormal functioning of the liver and the use of Naproxen should be avoided in patients with severe liver problems.
Taking a high dose of this medicine is known to increase the chances of side-effects. A lower dose of Naproxen may be recommended to reduce the risk of side-effects. Older patients may see an increase in the risk of side-effects. Hence, a lower dose may be recommended.
If you are giving Naproxen to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.
If using the delayed-release form of this medicine, do not crush or chew the medicine, unless indicated on the package. Crushing or chewing of the medicine can result in unpleasant taste resulting in patients not following the medicine schedule. Crushing or chewing can also release all of the medicine at once, resulting in a decrease of effectiveness and a possible increase in side-effects.
To decrease the possibility of side-effects, you might be recommended to use the extended-release form of this medicine by your doctor. The extended-release medicine helps in maintaining a steady level of the medicine in your body for a longer period of time. Do not crush or chew the medicine, unless indicated on the package or by your doctor.
Avoid drinking alcohol with Naproxen.
Your doctor may require that certain tests be performed before using Naproxen. The doctor may ask you to have Blood Pressure | Lipid Panel | Diabetes-related Autoantibodies test. Blood pressure, lipid levels and sugar levels should be checked before starting the treatment because high blood pressure, high lipid levels, and abnormal sugar level can happen during the therapy.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Naproxen for symptoms for which it was not prescribed. Do not give Naproxen to others who may have similar symptoms as you. Self-medication can cause harm.
Store Naproxen at room temperature, 15° to 30° C (59° to 86° F), and away from moisture. Keep this medicine away from children and pets.

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How to take Naproxen

The dose and frequency of using Naproxen will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • the health of the patient's liver
  • the health of the patient's kidneys
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements being used
  • response to the medicine

Naproxen Dosage

Dosage for pain, swelling, and inflammation in the joints (rheumatoid arthritis), breakdown of the lining of the joints (osteoarthritis), pain and stiffness from the neck down to the lower back (ankylosing spondylitis)

Adult
  • Recommended: 500-1000 mg/day in two doses at 12 hour intervals
  • Maximum: 1500 mg/day

Dosage for management of pain, acute inflammation or irritation of a tendon and inflammation of a fluid-filled sac in the shoulder joint, and painful periods

Adult
  • Recommended: 1000 mg/day (2 tablets of 500mg/day) and 1500 mg/day (2 tablets of 750 mg/day or 3 tablets of 500 mg for greater analgesic benefit)
  • Maximum: 1000 mg/day

Dosage for acute pain, redness, and tenderness in joints (acute gout)

Adult
  • Recommended: 1000 to 1500 mg/day (two to three tablets of 500 mg/day), followed by 1000 mg/day (two tablets of 500 mg/day until the attack become less intense)

Dosage for acute musculoskeletal disorders

Adult
  • Recommended: 500 mg initially followed by 250mg at 6-8 hour intervals
  • Maximum: 1250 mg/day

Dosage for joint inflammation and stiffness in the children (juvenile rheumatoid arthritis)

Children (children over 5 years)
  • Recommended: 10 mg/kg (4.54 mg/lb) daily in two doses at 12-hour intervals

Minimum Age

Capsule, liquid filled

Maximum Age

220 mg

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Tablet
Strength: 125 mg, 250 mg, 275 mg, 375 mg, 500 mg, 550 mg, 750 mg, 220 mg, 200 mg
Tablet, delayed release
Strength: 250 mg, 375 mg, 500 mg
Suspension
Strength: 125 mg/5ml, 25 mg/ml
Tablet, film coated
Strength: 220 mg, 275 mg, 375 mg, 500 mg, 750 mg
Tablet, extended release
Strength: 375 mg, 500 mg, 750 mg
Suppository
Strength: 500 mg
Tablet, film coated, extended release
Strength: 375 mg, 500 mg, 750 mg

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed one.

Overdose

What to do if you overdose on Naproxen?
No specific antidote is available for an overdose of Naproxen. However, the treatment according to the symptoms should be given. If the overdose has happened within 1 to 4 hours in symptomatic patients, the harmful effect can be reduced by inducing emesis as well as the use of activated charcoal (60 to 100 grams in adults, 1 to 2 grams per kg (454.5-909 mg/lb) of body weight in children) and substance that softening the feces (osmotic cathartic). In case of overdose, forced diuresis, blood purify process (hemodialysis and hemoperfusion), and alkalinization of urine may not be useful due to high protein binding. The patient should be observed for at least four hours after ingestion of harmful amount and kidney and liver function also monitored in such patients. Intravenous diazepam should be used on the occurrence of prolonged convulsions.
Symptoms of an overdose of Naproxen
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Naproxen, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Naproxen

Before you use Naproxen, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Discuss with your doctor if you are allergic to aspirin, or other NSAIDs.
Before you use Naproxen, tell your doctor of your medical history including stomach and intestinal ulcer, asthma, allergic skin reaction, high blood pressure, heart failure (mild to moderate congestive heart failure), inflammation in the colon (ulcerative colitis), inflammation in any part of digestive tract (Crohn's disease), drug-induced harmful effect of the digestive tract, smoking, heart bypass surgery (coronary artery bypass graft or CABG), bleeding or blood clotting disorder such as slow blood clotting process (hemophilia), platelet functioning disorders, or hives. Using Naproxen in patient with a history of stomach and intestinal ulcer may are at an increased risk of stomach and intestinal bleeding which may be fatal sometime. Elder patients and patients with a history of smoking may are at an increased risk of developing stomach and intestinal bleeding while using this medicine. Using Naproxen in patient with a history of ulcerative colitis and Crohn's disease may are at an increased risk of developing undesirable effects such as nausea, vomiting, diarrhea, flatulence, constipation, indigestion, stomach pain, heartburn, salivary gland enlargement, blood in feces (melaena), vomiting of blood and inflammation in the stomach due to ulcer. Naproxen may cause fluid retention and accumulation of fluid in the body cells and tissues in patient with a history of high blood pressure and heart failure. Patients with a recent history of heart bypass surgery (coronary artery bypass graft or CABG) are at an increased risk of heart attack and stroke. Before having any surgery, discuss with your doctor and dentist about medicines you use including prescription medicines, non-prescription medicines, and herbal supplements.
The use of Naproxen may change sodium levels. Use of Naproxen may decrease the levels of sodium in the blood.
The use of this medicine may change lithium levels. Use of Naproxen may increase the levels of lithium in the blood.
The use of Naproxen may change potassium levels. Use of Naproxen may increase the levels of potassium in the blood which leads to decreased levels of renin and aldosterone in the blood (hyporeninaemic hypoaldosteronism).
Consult with your doctor on the use of Naproxen during pregnancy or if you are planning to become pregnant. Naproxen should not be taken after 29 weeks of pregnancy or third trimester of pregnancy which may lead to blood vessels disease between heart and lungs (fetal ductus arteriosus) in newborn babies. It may increase the risk of miscarriage, undeveloped heart (cardiac malformation), neonates' intestine extends outside the body (gastroschisis), and abnormal functioning of kidney or kidney failure in newborn babies. At the end of pregnancy, Naproxen may also cause inhibition of uterine contractions in pregnant mother which can lead to delayed or prolonged labour and prolongation of bleeding time in mother and baby. Naproxen belongs to the NSAID class of medicines. NSAIDs should not be taken after 29 weeks of pregnancy as these medicines may cause serious harm to the unborn baby. Consult with your doctor on the use of Naproxen during breastfeeding. Naproxen can appear in breast milk in low amount, so if possible Naproxen should be avoided during breastfeeding. Consideration should be taken if health benefits of medicine to breastfeeding mother justify the possible risk to breastfeeding baby. Consult with your doctor on the use of Naproxen, if you are trying to conceive. Naproxen may reduce the woman fertility so avoid the use of this medicine in women while attempting to conceive.
Avoid drinking alcohol with Naproxen. Consumption of alcohol may cause stomach and intestinal bleeding and ulcer, rupture in the walls lining of stomach and intestine (perforation), and drowsiness.
Naproxen can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Naproxen can worsen the sleepiness. Naproxen may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.
This medicine may cause stomach bleeding. Regular use of tobacco and alcohol may increase your risk. Discuss with your doctor if you smoke and drink alcohol regularly. Naproxen can increase your risk of getting infections/worsen existing infections. Reduce your chances of getting new infections by washing your hand regularly. Prevent cuts, bruises or injuries. Avoid people who may have infectious diseases. Avoid getting vaccinated. Naproxen may increase your risk of infection if you suffer from chickenpox (varicella infection) and hence must be used with precaution in patients, particularly children, with varicella infection. This medicine may increase your sensitivity to sunlight and make you prone to sunburn. If this happens, limit your time outdoors to prevent sunburn. Use a sunscreen and cover your skin when you are outdoors. If you get sunburns on your body, consult with your doctor.
Older patients may have a higher incidence of side-effects when using Naproxen. Elderly patients may see an increased risk of heart and blood vessels related harmful effects, stomach and intestine bleeding (gastrointestinal bleeding), rupturing of walls of the stomach (perforation), high potassium level, drug-induced harmful effects of the liver, and acute kidney failure.
Long-term treatment of Naproxen may increase the risk of stomach and intestine bleeding, kidney injury and damage, harmful effects to the liver, heart attack and stroke.

Naproxen Side-effects

The following side-effects may commonly occur when using Naproxen. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Naproxen may cause the following side-effects:
  • abnormal electrocardiogram
  • abnormal functioning of the kidney
  • abnormal liver function
  • abnormal red blood cells
  • abnormal urinary frequency
  • abnormal white blood cells
  • acne
  • back pain
  • black tarry stools (melaena)
  • bleeding from the uterus (metrorrhagia)
  • blood during vomiting (haematemesis)
  • blood urea nitrogen (BUN) increased
  • bone pain
  • burning or prickling sensation
  • chest pain
  • chest pain due to reduced blood flow to the heart (angina pectoris)
  • co-ordination
  • constipation
  • contact dermatitis
  • damage of heart due to blockage in major blood vessels (coronary artery disease)
  • deafness
  • decrease breathing due to fluid accumulation in the lungs (respiratory distress)
  • decrease levels of renin and aldosterone hormone (hyporeninaemic hypoaldosteronism)
  • decreased weight
  • defect in the blood vessels (vascular anomaly)
  • development of excess connective tissues in internal organs (interstitial fibrosis)
  • diarrhea
  • difficulties in moving body parts (fibrotendinitis)
  • dilation of blood vessels (vasodilation)
  • discoloration of the skin (ecchymosis)
  • disorientation
  • double vision (abnormal diplopia)
  • dream abnormalities
  • drop of eyes due to paralysis (ptosis)
  • drowsiness
  • drug induced harmful effects of the kidney
  • dry skin
  • ear disorder
  • emotional lability
  • enlarged stomach (abdomen)
  • enlargement of liver and spleen (hepatosplenomegaly)
  • excess fluids build up inside the body
  • excessive urination at night (nocturia)
  • expelling gas from the stomach through the mouth
  • eye pain
  • fatigue
  • feeling of discomfort, illness and depression
  • flatulence
  • formation of blood clot in veins (deep thrombophlebitis)
  • fungus infection in the vagina (monilia)
  • glucose tolerance decrease
  • hair loss
  • heartburn
  • high level of cholestrol in the blood (hypercholesteremia)
  • hives
  • hypertonia
  • impotence
  • inability to completely or partially empty the bladder
  • inability to concentrate
  • inability to concentrate
  • increased bleeding time
  • increased cough
  • increased number of disease-fighting white blood cell (eosinophilia)
  • inflammation and scarring of the intestine (Crohn's disease)
  • inflammation in tooth sockets (alveolitis)
  • inflammation of glomerular part of the kidney (glomerular nephritis)
  • inflammation of joints due to fluid accumulation (bursitis)
  • inflammation of nerves (neuritis)
  • inflammation of nerves of eyes (optic neuritis)
  • inflammation of skin cells or tissues (cellulitis)
  • inflammation of the blood vessels of the skin (angiodermatitis)
  • inflammation of the cornea and conjunctiva of eyes (keratoconjunctivitis)
  • inflammation of the eyes (scleritis)
  • inflammation of the kidney (pyelonephritis)
  • inflammation of the skin
  • inflammation of the vagina (vaginitis)
  • inflammatory condition of the skin and mucous membranes (lichen planus)
  • insomnia
  • irregular heartbeat
  • itchy skin inflammation (eczema)
  • joint disorder
  • joints pain (arthralgia)
  • kidney failure due to less blood flow (nephrosclerosis)
  • kidney inflammation (interstitial nephritis)
  • kidney pain
  • kidney stone
  • leg cramps
  • less memory and learning ability of the brain (cognitive dysfunction)
  • loss of consciousness due to less blood flow to the brain
  • loss of strength
  • lung disorder
  • menstrual disturbances
  • migraine
  • mouth ulcer
  • mucous membrane disorder
  • muscle pain
  • muscle weakness
  • nail disorder
  • narrowing of the valve in the large blood vessel branching off the heart (aortic stenosis)
  • nausea
  • neck pain
  • nervousness
  • nightmares
  • node on the skin (subcutaneous nodule)
  • pain in esophagus and stomach (cardiospasm)
  • pain in nerves (neuralgia)
  • pain in the uterus (uterine spasm)
  • painful menstruations (dysmenorrhea)
  • painful urination
  • paralysis
  • partial or full memory loss (amnesia)
  • pelvic pain
  • presence of albumin in urine (albuminuria)
  • presence of high levels of glucose in urine (glucosuria)
  • presence of white blood cells in urine (pyuria)
  • prostate disorder
  • pus in teeth (periodontal abscess)
  • puss formation at inflamed areas (abscess)
  • rectal disorder
  • red or purple discolored spots on the skin
  • redness of skin (erythema nodosum)
  • redness of the skin due to photosensitivity (pseudoporphyria)
  • respiratory disorder
  • reversible infertility
  • ringing sensation in ears (tinnitus)
  • salivary gland enlargement
  • sensation of spinning dizziness (vertigo)
  • severe itching of the skin
  • skin eruptions
  • skin inflammation disease due to own immune system (lupus erythematosus syndrome)
  • skin rash
  • sneezing and watery eyes (rhinitis)
  • spasm
  • spontaneous bone fracture
  • stiff neck
  • stomach and intestine disorder
  • stomach and intestine inflammation (gastroenteritis)
  • stomach pain
  • stones in the gallbladder (cholelithiasis)
  • sweating
  • swelling of the brain due to blood (hematoma subdural)
  • swelling of the legs, hands and feets
  • swelling of the lung
  • tears (lacrimation) disorder
  • tendon disorder
  • thirst
  • tooth disorder
  • ulcer in esophagus
  • urinary incontinence
  • visual problems (amblyopia)
The following severe side-effects may also occur when using Naproxen:
  • Symptoms: abnormally low levels of thrombocytes, decreased in the number of granulocytes, low level of neutrophils, low red blood cells (anemia), the body stops producing enough new blood cell (aplastic anaemia), abnormal breakdown of red blood cells (haemolytic anaemia) decrease in the number of leukocytes (leukopenia)
    If signs or symptoms of anemia occur while using Naproxen, patients should be monitored for blood levels (hemoglobin or hematocrit).
  • immune system disorders such as life-threatening allergic reactions (anaphylactoid reaction/anaphylactic shock/anaphylaxis) and fever (possibly fatal)
    Symptoms: difficulty breathing swelling of the face or throat
    Patients should take immediate medical attention if such symptoms occur.
  • metabolism and nutrition disorders
    Symptoms: low levels of sodium, high blood sugar, increased creatinine, high level of bicarbonate in the blood (alkalosis), dehydration, high level of uric acid in the blood (hyperuricemia), low potassium levels, increased blood glutamic-oxaloacetic transaminase increased blood glutamic-pyruvic transaminase
  • central nervous system disorders (possibly fatal)
    Symptoms: depression, confusion, hallucinations, anxiety, stroke, weakness, numbness and pain from nerve damage (peripheral neuropathy) inflammation of the linings of the brain (aseptic meningitis with fever)
    Patients should inform their doctor if these symptoms occur.
  • ear and eye disorders
    Symptoms: blurred vision, optic disc swelling, hearing problem, middle ear infection, clouding of the eye lens (cataract) inflammation of the conjunctiva of the eye (conjunctivitis)
  • heart and blood vessels related blood clotting events (possibly fatal)
    Symptoms: heart attack, abnormal heartbeat, heart blockage (bundle branch block), increased heartbeat, congestive heart failure, high blood pressure, inflammation of a blood vessel (vasculitis), bleeding, shortness of breath, chest pain, weakness slurring of speech
    Patients should inform their doctor immediately if such symptoms occur.
  • respiratory disorders (when used inflammation of lung tissue (pneumonitis) | inflammation of the nasal sinus (sinusitis) | infection of the airways of the lungs (bronchitis) | shortness of breath | asthma/aggravated asthma | difficult to breathe (bronchospasm) | buildup of white blood cells in the lungs (eosinophilic pneumonia) | inflammation of the pharynx (pharyngitis) | inflammation of the mucous membrane of the larynx (laryngitis) | nose bleeding (epistaxis) |)
  • liver disorders such as drug-induced harmful effects of the liver (possibly fatal)
    Symptoms: jaundice, inflammation of the liver (hepatitis), obstruction to bile flow due to inflammation of the liver (cholestatic hepatitis), obstruction to bile flow due to jaundice (cholestatic jaundice), nausea, fatigue, lack of energy (lethargy), severe skin itching, diarrhea, right upper quadrant tenderness, flu-like symptoms, liver failure, increased aspartate transaminase and alanine transaminase increase number of disease-fighting white blood cell (eosinophilia)
    Use of Naproxen should be discontinued immediately if these occur and patients should take immediate medical therapy.
  • stomach and intestinal disorders (possibly fatal)
    Symptoms: eating disorder (anorexia), gallbladder inflammation (cholecystitis), rectal hemorrhage, stomach ulcer, esophagus inflammation (esophagitis), stomach or intestinal erosion, stomach or intestinal ulceration, rupture in the walls lining of stomach and intestine (gastrointestinal perforation), stomach or intestinal bleeding (GI hemorrhage), painful swelling and sores inside the mouth, inflammation in the digestive tract (colitis), inflammation of the lining of the stomach (gastritis), pancreas inflammation (pancreatitis), vomiting indigestion (dysphagia)
    Use of Naproxen should be discontinued if a serious stomach and intestinal adverse event occur.
  • kidney and urinary disorders such as a drug-induced harmful effect of the kidney (possibly fatal)
    Symptoms: swelling of the skin, redness and peeling of the skin (exfoliative and bullous dermatoses), life-threatening skin reaction (Stevens-Johnson Syndrome), skin allergic reaction caused by infection (erythema multiforme), life-threatening drug-induced skin reaction, sun allergy, inflammation of the blood vessels in the skin (cutaneous vasculitis), allergic reaction, sores on the genitals or mouth caused by virus (herpes simplex), skin ulcer, chickenpox (herpes zoster), skin cell damage (skin necrosis), skin cancer (neoplasm skin), sunburn (photosensitive dermatitis), painful, blistering lesions of the skin (porphyria cutaneous tarda) broken and swelling of skin (epidermolysis bullosa)
    Use of Naproxen should be discontinued at the first occurrence of skin rash and any other sign of allergic reaction. Informed the patients about the symptoms of serious skin reactions.
Your doctor has prescribed this medicine because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious cases of side-effects. This page does not contain a complete list of all possible side-effects.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Patients with long-term treatment of Naproxen

Patients with long-term treatment of Naproxen are at an increased risk when using this medicine. Long-term use of Naproxen may cause severe skin rashes, scars and redness after sun exposure (pseudoporphyria).

Allergic reactions or skin inflammation disease due to the immune system (systemic lupus erythematosus)

Patients with systemic lupus erythematosus are at an increased risk when using this medicine. Using Naproxen in these patients may cause inflammation of the brain covering membrane (aseptic meningitis). The use of non-steroidal anti-inflammatory drugs may cause redness or scaling of the skin (exfoliative dermatitis), life-threatening allergic reactions (Stevens-Johnson Syndrome) and life-threatening drug-induced allergic reactions in the starting of therapy. Naproxen should be discontinued on the first appearance of oral lesions, skin rash or other allergic reactions. Precaution should be taken in patients with allergic disorders.

Female patients

Female patients are at an increased risk when using this medicine. Long-term use of Naproxen may reduce the female fertility by blocking the different phases of the menstrual cycle such as ovulation. Naproxen should not be used in women attempting to conceive.

Patient with a history of stomach and intestine bleeding, ulcers and smoking

Patient with a history of stomach and intestine bleeding, ulcers and smoking are at an increased risk when using this medicine. Using Naproxen in such patients may worse the complication of stomach and intestine bleeding and ulcers. The lowest effective dose of Naproxen should be used in such patients.

Patients with blood vessel related heart and brain disease

Patients with high blood pressure, heart failure, heart disease, narrowing of blood vessels leading to reduced blood flow to the limbs (peripheral arterial disease) and blood vessel related brain disease (cerebrovascular disease) are at an increased risk when using this medicine. Using Naproxen in these patients may cause fluid retention in the body. Proper monitoring and advise are required for such patients. After careful consideration, Naproxen should be used in patients. Careful consideration should also be made in patients with risk factors such as high blood pressure, smoking, high blood sugar, or high levels of fat particles in the blood before starting long-term treatment with Naproxen.

Patients with slow blood clotting process (hemophilia) or other bleeding problems

Patients with bleeding or blood clotting disorders such as slow blood clotting process and platelet functioning disorders are at an increased risk when using this medicine. Use of Naproxen may cause stomach and intestinal bleeding in such patients. Precaution should be taken while using this medicine in such patients.

Patients with difficulty in breathing

Patients with difficulty in breathing (bronchial asthma) are at an increased risk when using this medicine. Using Naproxen therapy may cause pain during breathing (bronchospasm) in such patients. Precaution should be taken while using this medicine in such patients.

Patients with infections

Patients with infections are at an increased risk of when using this medicine. Using Naproxen in these patients may experience signs and symptoms such as fever, inflammation and pain of infection. Precaution should be taken while using this medicine in such patients.

Patients with chickenpox

Patients with chickenpox (Varicella infections) are at an increased risk of when using this medicine. Using Naproxen in these patients may cause the development of secondary infection. Precaution should be taken while using this medicine in such patients.

Elderly patients

Elderly patients are at an increased risk of when using this medicine. Use of Naproxen may increase the occurrence of harmful effects of non-steroidal anti-inflammatory drugs particularly fatal stomach and intestinal rupturing and bleeding in such patients. The lowest effective dose for the shortest possible duration of non-steroidal anti-inflammatory drugs should be considered when necessary. Regular monitoring of stomach and intestinal tract should be considered in such patients.

Gastrointestinal bleeding, ulceration and perforation

Patients taking Naproxen therapy are at an increased risk when using this medicine. Such patients may have an increased risk of development of undesirable effects of the digestive tract (gastrointestinal), such as inflammation, bleeding, ulcers, rupture of walls (perforation) of the esophagus, stomach, small intestine, and large intestine. It can be possibly fatal. A lowest effective dose of Naproxen for a short period of time should be used in such patients. Patients should avoid taking more than one dose of Naproxen at a time. Patients should always be monitored for the signs and symptoms of stomach and intestinal ulceration and bleeding during NSAID therapy, proper evaluation of therapy or discontinuation of therapy should be considered if these side-effects are suspected. Alternate therapies other than NSAIDs should be considered in patients with higher risk of bleeding disorders.

Heart-related blood clotting problems

Patients taking Naproxen therapy are at an increased risk when using this medicine. Taking Naproxen therapy for more than 3 years may develop the risk of undesirable effects of heart and blood vessels disorders such as thickening of the walls of heart and stroke. The lowest effective dose for the short period of time should be used in such patients. Patients and doctors should remain alert for the occurrence of undesirable effects of heart and blood vessels disorders during the therapy. This should also be considered in the absence of heart disease symptoms. Patients should be notified about the symptoms of heart disease events and important measures to take if symptoms occur.

Patients with a recent history of heart bypass surgery (coronary artery bypass graft or CABG)

Patients with a recent history of heart bypass surgery are at an increased risk when using this medicine. Such patients are at an increased risk of heart attack and stroke. Naproxen therapy should not be used in such patients.

Patients with liver abnormalities

Patients with liver abnormalities are at an increased risk when using this medicine. Increased levels of Naproxen are observed in patients with long-term liver injury (liver cirrhosis). These patients are at an increased risk of stomach or intestinal bleeding and fluid retention. The lowest effective dose should be used in such patients. Naproxen should be avoided in patients with severe liver disease.

Patients with kidney abnormalities

Patients with kidney abnormalities are at an increased risk when using this medicine. The use of Naproxen may decrease the functioning of kidney and excretion of Naproxen through kidney which may lead to kidney failure. The lowest effective dose should be used in such patients and the use of Naproxen should be avoided in patients with moderate to severe kidney abnormalities.

Interactions with Naproxen

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Your doctor's guidelines may need to be followed while taking this medicine along with lithium, which is used to treat depression. When Naproxen is used with lithium, it may decrease the excretion and increase the levels of the lithium in the blood. Patients using Naproxen with lithium should be monitored for the signs of harmful effects of the lithium.
Naproxen interacts with diuretics (loop diuretics, potassium-sparing diuretics, and thiazide diuretics), which are used to treat heart failure or high blood pressure. Non-steroidal anti-inflammatory drugs such as Naproxen may decrease the prostaglandin formation, precipitate the functioning of the kidney, decrease the sodium excretion effect, and blood pressure lowering effect of diuretics such as furosemide and thiazides. Elderly patients, patients with liver failure, abnormal functioning of the kidney or heart, or taking diuretics may experience an increased risk of decreased functioning of the kidney and prostaglandin formation. Patients using Naproxen with diuretics may experience an increased risk of potassium levels in the blood and harmful effects of the kidney. Monitoring should be considered in patients using Naproxen with diuretics. Also, monitoring of the functioning of the kidney should be considered in elderly patients, patients with liver failure, abnormal functioning of the kidney or heart, and taking diuretics. The lowest effective dose of Naproxen should be recommended in patients with mild abnormal functioning of the kidney. Also, Naproxen should not be used in patients with severe abnormal functioning of the kidney.
There may be an interaction of Naproxen with antihypertensive drugs (angiotensin-II receptor blockers, angiotensin-converting enzyme inhibitors, methyldopa, hydralazine, or beta-blockers), which are used to treat high blood pressure. When Naproxen is used with angiotensin-II receptor blockers, angiotensin-converting enzyme inhibitors, methyldopa, hydralazine, or beta-blockers (including propranolol), it may diminish the blood pressure lowering effect of these medicines. Elderly patients, patients with an abnormality in the functioning of the kidney or with loss of body fluid may experience reduced functioning of the kidney including kidney failure when using Naproxen with angiotensin receptor blockers or angiotensin-converting enzyme inhibitors. When NSAIDs is used with angiotensin-II receptor blockers or angiotensin-converting enzyme inhibitors, it also increases the risk of the harmful effect of the kidney and high potassium level. During combined use patients should be monitored for the established effect of anti-hypertensive agents. Elderly patients, patients with an abnormality in the functioning of the kidney or with the low level of body fluid should be monitored for the signs of worsening of the functioning of the kidney when using Naproxen with angiotensin-II receptor blockers, or angiotensin-converting enzyme inhibitors. Hydration along with monitoring of the functioning of the kidney in the starting and periodically should be considered when using these drugs in combination.
Naproxen may interact with drugs that interfere with blood clotting system (anticoagulants such as warfarin or heparin, antiplatelet drugs such as aspirin, selective serotonin reuptake inhibitors, and antidepressants). The use of Naproxen with drugs that interfere with blood clotting system may increase the risk of adverse effects of stomach and intestine such as bleeding, ulcers, inflammation, and rupture (perforation) of the wall of the stomach, esophagus, large intestine, or small intestine. Also using Naproxen with antidepressants such as serotonin-norepinephrine reuptake inhibitors may increase the risk of bleeding. Precaution along with monitoring of the bleeding in these patients should be considered. Naproxen should not be recommended with analgesic dose of aspirin.
Special instructions need to be followed while taking this medicine along with cardiac glycosides (digoxin), which are used to treat heart failure. When Naproxen is used with cardiac glycosides such as digoxin, it may decrease the functioning of the kidney (glomerular filtration rate), increase the level of digoxin in the blood, or may increase the time required for the amount of drug in the body to decrease by one-half (half-life). The combined use of these medicines may also worsen heart failure. Monitoring of the level of digoxin in the blood should be considered in patients using Naproxen with digoxin.
Your doctor's guidelines may need to be followed while taking this medicine along with antacids (aluminum hydroxide or magnesium oxide) and sucralfate, which are used to treat stomach ulcers (duodenal ulcers). When Naproxen is used with antacids (aluminum hydroxide or magnesium oxide) and sucralfate, it may decrease the absorption of Naproxen. Patients should not use both medicines together.
Naproxen interacts with salicylates (diflunisal, salsalate) and nonsteroidal anti-inflammatory drugs, which are used to treat pain and stiffness of joints (arthirits). The use of Naproxen with salicylates or other nonsteroidal anti-inflammatory drugs may increase the risk of harmful effects of stomach and intestinal tract such as bleeding, ulcers, inflammation, and rupture (perforation) of the wall of the stomach, esophagus, large intestine, or small intestine. Patients should not use Naproxen with other nonsteroidal anti-inflammatory drugs or salicylates.
Special instructions need to be followed while taking this medicine along with pemetrexed, which is used to treat lung cancer. When Naproxen is used with pemetrexed, it may increase the risk of pemetrexed induced decreased production of platelets, red blood cells, or white blood cells, and harmful effects of the kidney, stomach or intestinal tract. When using Naproxen with pemetrexed, patients with abnormal functioning of the kidney should be monitored for the harmful effects of the kidney, stomach or intestinal tract and for the decreased production of blood cells. Non-steroidal anti-inflammatory drugs with short elimination half-live such as indomethacin and diclofenac should be avoided for two days before, on the day of therapy, or after taking pemetrexed. In the case of non-steroidal anti-inflammatory drugs with long elimination half-live such as nabumetone or meloxicam, patients should avoid these medicines on the day of, five days before or two days after taking pemetrexed.
There may be an interaction of Naproxen with immunosuppressants (ciclosporin or tacrolimus), which are used to prevent organ rejection of the heart, liver or kidney. When Naproxen is used with cyclosporin or tacrolimus, it may increase the risk of cyclosporin or tacrolimus induced kidney damage. Patients using Naproxen with immunosuppressants should be monitored for the signs of worsening of the functioning of the kidney.
Naproxen may interact with cytotoxic drugs (methotrexate), which are used to treat cancer. When Naproxen is used with methotrexate, it may decrease the excretion of methotrexate which may lead to harmful effects of methotrexate such as kidney failure, decreased levels of neutrophils and thrombocytes in the blood. Patients should be monitored for the harmful effects of methotrexate.
Naproxen may interact with anion-exchange resins such as cholestyramine, which is used to treat severe itching due to liver or bile duct disease. When Naproxen is used with cholestyramine, it may decrease the absorption of Naproxen. Patients should not use both medicines together.
Your doctor's guidelines may need to be followed while taking this medicine along with antibacterials (sulphonamides, quinolones, and aminoglycosides), which are used to treat bacterial infections. When Naproxen is used with quinolones such as ciprofloxacin, it may increase the risk of convulsions. Also, using Naproxen with aminoglycosides may increase the risk of harmful effects of the kidney. Dose adjustment along with monitoring of increased levels of sulphonamides should be considered in patients using Naproxen with sulphonamides.
Special instructions need to be followed while taking this medicine along with anti-diabetics (sulphonylureas) and antiepileptics (hydantoins), which are used to treat high blood sugar and epilepsy respectively. When Naproxen is used with sulphonylureas, it may increase the blood sugar lowering effect of sulphonylureas. Also, using Naproxen with hydantoins or sulphonylureas may increase the levels of these drugs in the body. Dose adjustment should be considered in patients using these medicines together. Also, such patients should be monitored for the increased levels of hydantoins and sulphonylureas in the body.
Naproxen interacts with probenecid, which is used to treat pain, tenderness or redness of joints (gout). When Naproxen is used with probenecid, it may increase the level of Naproxen. Also, it may increase the time required for the amount of medicine in the blood to decrease by one-half (half-life). Dose adjustment should be considered in patients using both medicines together.
This page does not contain all the possible interactions of Naproxen. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Naproxen is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Naproxen .
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