Generic
Naproxen
130 brands available in the market
At a glance
Naproxen is a non-steroidal anti-inflammatory drug (NSAID) used for pain and inflammation relief. It is effective in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout and juvenile arthritis.
Description
Naproxen is a propionic acid derivative NSAID that inhibits COX-1 and COX-2 enzymes to reduce prostaglandin synthesis. It inhibits platelet aggregation and has anti-inflammatory, analgesic and antipyretic actions.
Indications
- Osteoarthritis
- Rheumatoid arthritis
- Ankylosing spondylitis
- Juvenile idiopathic arthritis
- Tendonitis, bursitis
- Acute gout
- Primary dysmenorrhea
- Pain
Therapeutic class
Drugs for Osteoarthritis, Drugs for Rheumatoid Arthritis, NSAIDs
Pharmacological class
NSAID (Propionic Acid Derivative)
Pharmacology
Naproxen inhibits COX-1 and COX-2 enzymes to reduce prostaglandin synthesis. COX-2 enzyme mediates antipyretic, analgesic and anti-inflammatory properties, while COX-1 enzyme is linked to GI upset and renal toxicities.
Mechanism of action
Relieves pain, fever and inflammation by inhibiting prostaglandin synthesis.
Dosage
Adult Dose (Oral):
- Pain: 500 mg initially, then 250 mg q6-8hr or 500 mg q12hr; max 1250 mg/day (day 1), subsequent 1000 mg/day
- OA/RA/AS: 500-1000 mg/day divided q12hr; may increase to 1500 mg/day
- Dysmenorrhea: 500 mg initially, then 250 mg q6-8hr
- Gout: 750 mg initially, then 250 mg q8hr
Pediatric Dose (>2 years): JIA: 10 mg/kg/day divided q12hr; max 15 mg/kg/day
Administration
- Take with food or milk (to prevent stomach upset)
- Swallow tablet whole; do not chew, crush or break
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Heartburn, abdominal pain, nausea, diarrhea, dyspepsia
- Headache, vertigo, drowsiness
- Pruritus, purpura
- Edema, palpitation
- Visual and hearing disturbances
Precautions & warnings
- Risk of stomach ulcers and bleeding
- Risk of kidney problems (with long-term use)
- Caution if history of heart disease or stroke
- May cause dizziness, drowsiness or visual disturbances; caution while driving
- Avoid alcohol
- Do not use in third trimester of pregnancy
Contraindications
- Hypersensitivity
- Aspirin or NSAID allergy
- Perioperative pain in CABG surgery
- Pregnancy (3rd trimester)
Drug interactions
- May enhance methotrexate toxicity
- Reduced BP response to ACE inhibitors
- Increased risk of GI events with aspirin
- Increased risk of GI bleeding with warfarin
- May reduce diuretic efficacy
- May increase serum lithium concentrations
- Delayed absorption with antacids, colestyramine or sucralfate
Food interactions
Alcohol may increase stomach problems; avoid.
Use in pregnancy
Use in Pregnancy: Naproxen may be unsafe during pregnancy (Category C); not recommended in third trimester (may cause premature closure of ductus arteriosus).
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Naproxen is safe during breastfeeding; not significantly excreted in breast milk.
Pediatric use
Dose established for JIA in children >2 years; not recommended in children <2 years.
Geriatric use
Elderly may require dose adjustment.
Renal / hepatic impairment
Renal Impairment: CrCl <30 mL/min: Not recommended; Severe: Contraindicated.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed.
Overdose effects
Overdose: Lethargy, drowsiness, nausea, vomiting, epigastric pain; GI bleeding may occur; no specific antidote; symptomatic treatment.
Storage conditions
Store below 30°C; protect from light & moisture; keep out of reach of children.
Chemical structure
Naproxen