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.