Naproxen

Know the basics

What is naproxen used for?

Naproxen is used to relieve pain from various conditions such as headaches, muscle aches, tendonitis, dental pain, and menstrual cramps. It also reduces pain, swelling, and joint stiffness caused by arthritis, bursitis, and gout attacks. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body’s production of certain natural substances that cause inflammation.

If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.

How should I take naproxen?

Take this medication by mouth as directed by your doctor, usually 2 or 3 times a day with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.

The dosage is based on your medical condition and response to treatment. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose or take this drug more often than directed. For ongoing conditions such as arthritis, continue taking this medication as directed by your doctor.

For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.

If you are taking this drug “as needed’ (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.

Tell your doctor if your condition does not improve or if it worsens.

How do I store naproxen?

Naproxen is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store naproxen in the bathroom or the freezer. There may be different brands of naproxen that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush naproxen down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using naproxen?

Before taking naproxen,

• tell your doctor and pharmacist if you are allergic to naproxen, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and ketoprofen (Orudis KT, Actron), any medications for pain or fever, or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); angiotensin II receptor antagonists (angiotensin receptor blockers; ARBs) such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); cholestyramine (Questran); diuretics (‘water pills’); lithium (Eskalith, Lithobid), medications for diabetes; methotrexate (Rheumatrex); probenecid (Benemid); selective serotonin reuptake inhibitors such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sulfa medications such as sulfamethoxazole (in Septra, Bactrim); and warfarin (Coumadin). If you are taking the delayed-release tablets, also tell your doctor if you are taking antacids or sucralfate (Carafate). Your doctor may need to change the doses of your medication or monitor you more carefully for side effects.
• do not take nonprescription naproxen with any other medication for pain unless your doctor tells you that you should.
• tell your doctor if you have been told to follow a low sodium diet and if you have or have ever had any conditions or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the inside of the nose); swelling of the hands, arms, feet, ankles, or lower legs; anemia (red blood cells do not bring enough oxygen to all parts of the body); or liver or kidney disease.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking naproxen, call your doctor.
• talk to your doctor about the risks and benefits of taking naproxen if you are 65 years of age or older. Older adults should usually take lower doses of naproxen for short periods of time because higher doses used regularly may not be more effective and are more likely to cause serious side effects.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking naproxen.
• you should know that this medication may make you dizzy, drowsy, or depressed. Do not drive a car or operate machinery until you know how this drug affects you.
• remember that alcohol can add to the drowsiness caused by this medication.

Is it safe to take naproxen during pregnancy or breast-feeding?

There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.

Know the side effects

What are the side effects of naproxen?

Get emergency medical help if you have any of these signs of an allergic reaction to naproxen: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using naproxen and call your doctor at once if you have:

• chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;
• black, bloody, or tarry stools;
• coughing up blood or vomit that looks like coffee grounds;
• swelling or rapid weight gain, little or no urinating;
• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• bruising, severe tingling, numbness, pain, muscle weakness;
• fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions) or
• severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common naproxen side effects may include:

• upset stomach, mild heartburn or stomach pain, diarrhea, constipation;
• bloating, gas;
• dizziness, headache, nervousness;
• skin itching or rash;
• blurred vision; or
• ringing in your ears.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with naproxen?

Naproxen may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Ask your doctor before using naproxen if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Ask a doctor or pharmacist if it is safe for you to use this medicine if you are also using any of the following drugs:

• a blood thinner (warfarin, Coumadin);
• lithium;
• methotrexate;
• a diuretic or “water pill’;
• steroids (prednisone and others);
• aspirin or other NSAIDs–ibuprofen (Advil, Motrin), celecoxib, diclofenac, indomethacin, meloxicam, and others;
• heart or blood pressure medication–benazepril, candesartan, enalapril, lisinopril, losartan, olmesartan, quinapril, ramipril, telmisartan, valsartan, and others.

Does food or alcohol interact with naproxen?

Naproxen may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with naproxen?

Naproxen may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

• Anemia or
• Bleeding problems or
• Blood clots or
• Edema (fluid retention or body swelling) or
• Heart attack, history of or
• Heart disease (e.g., congestive heart failure) or
• Hypertension (high blood pressure) or
• Kidney disease or
• Liver disease (e.g., hepatitis) or
• Stomach or intestinal ulcers or bleeding, history of or
• Stroke, history of—Use with caution. May make these conditions worse.
• Aspirin-sensitive asthma or
• Aspirin sensitivity, history of—Should not be used in patients with these conditions.
• Heart surgery (e.g., coronary artery bypass graft [CABG])—Should not be used to relieve pain right before or after the surgery.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.

What is the dose of naproxen for an adult?

Usual Adult Dose for Ankylosing Spondylitis: Initial: 250 mg to 500 mg (naproxen) or 275 mg to 550 mg (naproxen sodium) orally twice a day. The initial dose for naproxen sodium controlled-release is two 375 mg tablets (750 mg) orally once a day, one 750 mg tablet orally once a day, or two 500 mg tablets (1000 mg) orally once a day.

Usual Adult Dose for Osteoarthritis: Initial: 250 mg to 500 mg (naproxen) or 275 mg to 550 mg (naproxen sodium) orally twice a day. The initial dose for naproxen sodium controlled-release is two 375 mg tablets (750 mg) orally once a day, one 750 mg tablet orally once a day, or two 500 mg tablets (1000 mg) orally once a day.

Usual Adult Dose for Rheumatoid Arthritis: Initial: 250 mg to 500 mg (naproxen) or 275 mg to 550 mg (naproxen sodium) orally twice a day. The initial dose for naproxen sodium controlled-release is two 375 mg tablets (750 mg) orally once a day, one 750 mg tablet orally once a day, or two 500 mg tablets (1000 mg) orally once a day.

Usual Adult Dose for Acute Gout: 750 mg (naproxen) or 825 mg (naproxen sodium) orally one time, followed by 250 mg (naproxen) or 275 mg (naproxen sodium) every 8 hours until the gouty attack has resolved, usually 2 to 3 days. The recommended dose of naproxen sodium controlled-release is two to three 500 mg tablets (1000 to 1500 mg) orally on the first day, followed by two 500 mg tablets (1000 mg) orally daily until the attack has subsided.

Usual Adult Dose for Bursitis: 550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen. The recommended initial dose of naproxen sodium controlled-release is two 500 mg tablets (1000 mg) orally once a day. For patients requiring greater analgesic benefit, two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) may be used for a limited period. Thereafter, the total daily dose should not exceed two 500 mg tablets (1000 mg).

Usual Adult Dose for Tendonitis: 550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen. The recommended initial dose of naproxen sodium controlled-release is two 500 mg tablets (1000 mg) orally once a day. For patients requiring greater analgesic benefit, two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) may be used for a limited period. Thereafter, the total daily dose should not exceed two 500 mg tablets (1000 mg).

Usual Adult Dose for Dysmenorrhea: 550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen.

Usual Adult Dose for Pain: 550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen.

What is the dose of naproxen for a child?

Usual Pediatric Dose for Fever

Dosage guidelines are based on naproxen:

Greater than 2 years: 2.5 to 10 mg/kg/dose. Maximum daily dose is 10 mg/kg, given every 8 to 12 hours.

Usual Pediatric Dose for Pain

Dosage guidelines are based on naproxen:

Greater than 2 years: 2.5 to 10 mg/kg/dose. Maximum daily dose is 10 mg/kg, given every 8 to 12 hours.

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

Dosage guidelines are based on naproxen:

Greater than or equal to 2 years: 5 mg/kg orally twice a day. Maximum dose: 1000 mg/day.

How is naproxen available?

Naproxen is available in the following dosage forms and strengths:

Tablet, Oral: 220 mg.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Symptoms of overdose may include the following:

• dizziness
• extreme tiredness
• drowsiness
• stomach pain
• heartburn
• nausea
• vomiting
• slow or difficult breathing

What should I do if I miss a dose?

If you miss a dose of naproxen, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.