Naproxen

1 What is naproxen?

Brand: Aleve, Pamprin All Day, Midol Extended Relief, Anaprox and Anaprox DS, Naprelan, EC-Naprosyn and Naprosyn

Generic: Naproxen

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID). NSAID is one of the most common class of drugs. It is readily available, with or without a prescription.

This drug comes as naproxen, the base alone, and as naproxen sodium. The former comes in 200-, 250- and 500-mg doses while the latter is in 220-, 275- and 550-mg, adjusted to accommodate the sodium added. Base naproxen, compared in the milligram-to-milligram level, is stronger than naproxen sodium. But despite the lower concentration, sodium enhances the body’s absorption of the medicine so it is just as effective, if not more so.

Generic and branded formulations of naproxen are available. If budget is an issue, opt for generic medication. They work just as well, so be sure to inform your doctor. There are variations in concentration between generic and branded formulations. Your doctor will have to adjust the dosage based on your indication.

However, as previously mentioned, naproxen can easily be purchased over the counter, so getting a prescription is not absolutely necessary. Over the counter naproxen sodium brands are also available. These are Aleve, Pamprin All Day, and Midol Extended Relief. There are also prescription naproxen brands, namely: Anaprox and Anaprox DS, and Naprelan. Some prescription-only brands of base naproxen are EC-Naprosyn and Naprosyn.

Naproxen is taken orally. It comes in various forms - as a regular tablet, a delayed-release tablet, an extended-release tablet, or in liquid suspension. Delayed-release tablets are enclosed in enteric coating or combined with a proton pump inhibitor. These mechanisms provide added protection for the stomach for people who have ulcers or are prone to it.

2 What is naproxen used for?

Naproxen is used to treat inflammation, pain, and even fever. Common conditions for which naproxen is taken include: headaches, dysmenorrhea or menstrual cramps, general muscle pain, toothaches, and sports injuries.

It can also be used to relieve pain, swelling, tenderness, and stiffness caused by rheumatoid arthritis, swelling of the lining of the joints; osteoarthritis, breakdown of the lining of the joints; juvenile arthritis, a form of joint disease in children; ankylosing spondylitis, arthritis in the spine; bursitis, and tendinitis.

It is important to note that naproxen does not treat any of these diseases. Instead, naproxen relieves the pain and inflammation associated with the conditions listed above. This way, naproxen helps reduce the discomfort and symptoms experienced by the patient, allowing him to go by his day-to-day routine with ease.

Less commonly, naproxen is also sometimes prescribed to treat Paget’s disease, a condition where bones become unnaturally thick, misshapen and fragile; and Bartter syndrome, a disease in which the body is unable to absorb sufficient levels of potassium, thereby causing weakness and muscle cramping.

3 Naproxen dosage

Listed below are the usual dosages for adults:

  • For dysmenorrhea
    • Immediate-release naproxen sodium tablets: 550-mg orally once; then 275-mg every six to eight hours, or 550-mg orally every 12 hours or as needed
    • Controlled-release tablets: 1000-mg orally once a day
    • Over the counter naproxen sodium: 220-mg orally every 8-12 hours while symptoms persist
    • Base naproxen and delayed-release tablets are not suitable. The delay in absorption will reduce the efficacy of the medication to relieve pain.
  • For general pain
    • Immediate-release naproxen sodium tablets: 550-mg orally once; then 275-mg every six to eight hours, or 550-mg orally every 12 hours or as needed
    • Controlled-release tablets: 1000-mg orally once a day
    • Over the counter naproxen sodium: 220-mg orally every 8-12 hours while symptoms persist
    • Depending on the intensity of the pain, base naproxen and delayed-release tablets may not be appropriate. The delay in absorption will reduce the efficacy of the medication to relieve pain.
  • For fever
    • Over the counter naproxen sodium: 220-mg orally every 8-12 hours while symptoms persist
  • For rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis
    • Immediate-release tablets and liquid suspension: 250- to 500-mg of naproxen or 275- to 550-mg naproxen sodium, take twice a day orally
    • Extended-release tablets: 750- to 1000-mg, take once a day orally
    • Delayed-release tablets: 375- to 500-mg, take twice a day orally
  • For acute gout
    • Immediate-release tablets and liquid suspension: initial dose of 750-mg naproxen or 825-mg naproxen sodium, once orally on the first day of attack; for succeeding doses, 250-mg naproxen or 275-mg naproxen sodium every eight hours until the attack subsides
    • Extended-release tablets: 1000- to 1500-mg orally, on the first day of attack; for succeeding doses, 1000-mg orally once a day until the attack subsides
    • Delayed-release tablets are not suitable for this condition. The delay in absorption will reduce the efficacy of the medication to relieve pain.
  • For bursitis and tendinitis
    • Immediate-release naproxen sodium tablets: 500-mg orally once; then 275-mg orally every six to eight hours, or 550-mg orally every 12 hours or as needed
    • Controlled-release tablets: 1000 to 1500-mg orally once on the first day of attack; for succeeding doses, 1000-mg orally once a day until the attack subsides
    • Base naproxen and delayed-release tablets are not suitable for this condition. The delay in absorption will reduce the efficacy of the medication to relieve pain.

Naproxen can be used by people of various ages. Over-the-counter (OTC) naproxen are labeled to be usable by children aged 12 and up. In certain cases, however, prescription naproxen can be used for kids as young as two, with proper guidance of a physician.

Listed below are the usual pediatric dosages:

  • For fever and minor aches and pains in children aged 12 and above
    • Over the counter naproxen sodium: 220-mg orally, every 8-12 hours while symptoms persist
  • For juvenile rheumatoid arthritis in children aged two and above
    • Immediate-release tablets or liquid suspension: depending on the patient’s weight, give 5-mg/kg orally, twice a day
    • Because the dosage is closely linked to the patient’s weight, liquid suspension is the more suitable form because of its flexibility in dose titration

As for the elderly, naproxen should be used with caution and only in the lowest doses. This is especially important if the patient is at risk or has a history of intestinal bleeding.

Treatment with naproxen should be done in the lowest doses possible and for the shortest time needed. It is recommended that naproxen not be taken on an empty stomach. It is best to take it after a meal or at least with a light snack.

In the case of missed doses, take it as soon as you remember it. If it is too close to the next dose, skip it and continue with your regular schedule. Be careful to avoid taking double doses.

If you feel that you may have overdosed, check for the following symptoms:

Seek help from your local poison control center or call for local emergency services.

4 Naproxen ingredients

Listed below are the active and inactive ingredients for naproxen:

  • Naproxen
    • Active ingredient: naproxen
    • Inactive ingredients: cellulose, microcrystalline; croscarmellose sodium; povidone; magnesium stearate
  • Naproxen Sodium
    • Active ingredient: naproxen sodium
    • Inactive ingredients: cellulose, microcrystalline; povidone; magnesium stearate; talc; colloidal silicon dioxide
  • Naproxen Suspension
    • Active ingredient: 125-mg naproxen per 5mL
    • Inactive ingredients: FD&C Yellow #6; fumaric acid; imitation orange flavor; imitation pineapple flavor; magnesium aluminum silicate; methylparaben; purified water; sodium chloride; sorbitol solution; sucrose

This serves as a general guideline and resource for naproxen ingredients. Depending on your brand of naproxen and its manufacturer, some ingredients may vary.

5 Naproxen availability

Naproxen is the type of medication that doesn’t require prescription. This class of drugs will be readily available in your local pharmacy and even in most supermarkets. It is also available in online stores like Amazon. When making purchases online, just make sure that you are transacting with a legitimate and reliable source.

You can easily purchase it in different quantities from containers of 10 pills to big 400-tablet bottles, depending on your need. For example, if you are periodically suffering from headaches and have been taking naproxen for a while already, it may be wiser and more economical for you to buy a big bottle. However, if you are just taking the medication to fill a prescription and you are not anticipating to need it again, buying the exact amount indicated by your doctor should be enough.

Naproxen is available as a tablet, a caplet, or syrup, to be taken orally. There are regular tablets, delayed-release tablets, and extended-release tablets. Delayed-release tablets are enclosed in enteric coating or combined with a proton pump inhibitor. These mechanisms provide added protection for the stomach for people who are prone to ulcers or irritations in the stomach. These tend to have gentler effects on the gastrointestinal tract. Extended-release tablets are designed to last longer. This type of naproxen is more suitable for people who have constant pain with conditions like arthritis and dysmenorrhea, to name a few. The syrup form is best for kids in treatments of juvenile arthritis since the recommended dosage is dependent on the child’s weight. With syrup, dosage can be easily adjusted to the exact needs of the child.

The tablets are also available in different dosages. Base naproxen comes in 200-, 250- and 500-mg doses. Naproxen sodium comes in 220-, 275- and 550-mg doses. The difference in dosages is to accommodate the weight of the sodium added to the base. You may also choose between generic and different brands of naproxen.

6 Naproxen drug class

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that belongs in the propionic acid class. NSAID is one of the most common classes of drugs. It is readily available, with or without a prescription.

This class of drugs works by blocking COX enzymes. These enzymes are responsible for producing prostaglandins in the body, which in turn promote inflammation. While this is necessary for the body’s healing process, it also results in pain and fever. By reducing prostaglandins, NSAIDs are able to reduce pain and fever.

However, prostaglandins are also responsible for supporting the clotting of the platelets in the blood as well as protecting the lining of the stomach from acid. Because of this, taking NSAIDs increases a person’s risk of bleeding and developing stomach ulcers.

The use of NSAIDs should be at the lowest dose possible and for the shortest time needed. Extended use of this medicine is linked to heart attack, stroke, high blood pressure, heart failure, kidney problems, stomach and intestinal bleeding and ulcers, anemia, and liver problems.

7 Other drugs in same class

NSAIDs are very popular due to their ability to reduce pain, inflammation and fever. Some NSAIDs, however, have more notable uses.

  • Aspirin is probably the most popular NSAID. It is effective in treating mild to moderate pain, fever, and inflammation. Among other NSAIDs, aspirin is unique in its ability to inhibit blood clotting longer than other NSAIDs. Therefore, it may be used to prevent stroke and heart attack in individuals who are at high risk for these conditions.
  • Celecoxib is used to treat familial adenomatous polyposis (FAP). This prevents the formation and growth of colon polyps.
  • Ketorolac is used for short-term treatment of moderately severe acute pain that would otherwise be treated with narcotics.

Other NSAIDs include:

  • Diclofenac
  • Diflunisal
  • Ibuprofen
  • Indomethacin
  • Ketoprofen
  • Nabumetone
  • Oxaprozin
  • Piroxicam
  • Salsalate
  • Sulindac
  • Tolmetin

8 Naproxen vs. ibuprofen

Naproxen and Ibuprofen both fall under the same class of drugs. They are nonsteroidal anti-inflammatory drugs (NSAIDs). Because of this, they share many characteristics. They are both effective in relieving fever, as well as mild to moderate pain and inflammation.

However, they still have some differences that could help you decide which drug is more appropriate for the condition or symptom you are dealing with.

  • Ibuprofen works faster than naproxen. If you want to get rid of a headache to get through a big meeting or presentation, ibuprofen is your friend. It offers quick pain relief, so if speed is your biggest consideration, opt for ibuprofen.
  • Naproxen offers long-lasting relief. Naproxen works slower than ibuprofen, and it is both an advantage and a disadvantage. Naproxen works slower; this means it lasts longer as well. So if you are experiencing dysmenorrhea or arthritis, you can take naproxen for more long-lasting relief throughout the day. The effects of ibuprofen last from four to eight hours, while that of naproxen is from eight to 12 hours.
  • Naproxen targets muscle tissue inflammation better. You can forget sore muscles after a hard day’s work at the gym by taking naproxen before bed for best results. Aside from strained muscles, it is also better in relieving pain from sprains and arthritis when compared with ibuprofen.
  • Ibuprofen has negative effects on the heart and the liver. If you have a history of heart or liver problems, go with naproxen instead of ibuprofen. Because naproxen also lasts longer, you will not have to take the medicine as often as ibuprofen, reducing the risk further.

Because both naproxen and ibuprofen are NSAIDs, they also share many side effects, including nausea, heartburn and dizziness among others.

9 Naproxen side effects

Upon first taking naproxen, observe for any allergic reactions. These include sneezing and runny or stuffy nose, hives, wheezing or difficulty breathing, swelling in the face, lips, tongue or throat. If you experience any of these symptoms, seek emergency medical help.

Here is a list of common side effects associated with naproxen:

  • Constipation or diarrhea
  • Indigestion, gas, heartburn, nausea or stomach pains
  • Excessive thirst
  • Headache, dizziness, drowsiness or lightheadedness
  • Bruising, itching, rash or sweating
  • Difficulty falling or staying asleep
  • Burning or tingling sensation in the limbs
  • Ringing in the ears and other hearing problems

There are also serious side effects. This list covers symptoms that require medical attention. If you experience any of these, discontinue using the medication and contact your doctor immediately.

  • Changes in vision
  • Swelling or rapid weight gain
  • Shortness of breath or difficulty breathing
  • Signs of stomach bleeding - coughing up blood, vomit that looks like coffee grounds, bloody or tarry stools
  • Signs of liver problem - nausea, itching, exhaustion, loss of appetite, dark urine, clay-colored stools, jaundice or yellowing of the skin, flu-like symptoms, pain in the upper part of the stomach
  • Signs of anemia - pale skin, shortness of breath, lightheadedness, increased heart rate, difficulty in concentrating
  • Severe skin reaction - fever, sore throat, swelling in the face or tongue, burning sensation in the eyes, pain in the skin followed by red or purple skin rashes that spread, blister and peel
  • Signs of kidney problems - painful or decreased urination, swelling in the feet or ankles, exhaustion and shortness of breath

Naproxen can cause other side effects that are not on these lists. If you are in doubt, contact your doctor.

The use of naproxen is not advisable for people with history of heart attack, liver or kidney disease, stomach ulcers, asthma, bleeding disorders, smoking or nasal polyps.

If you are worried about getting a naproxen high or addiction, you may rest assured that this medication is not habit-forming. People who have taken the medicine for long periods of time do not develop dependence or tolerance on naproxen. There are also no withdrawal symptoms once a person stops using naproxen after having used it for a while.

10 Naproxen and alcohol

Avoid the consumption of alcoholic beverages while you are taking naproxen and other NSAIDs.

NSAIDs reduce the integrity of the gastrointestinal (GI) lining and they inhibit the clotting mechanics of the platelets in blood. When combined with alcohol consumption, this could lead to gastrointestinal bleeding.

If you consumed alcoholic beverages while on medication by mistake, watch out for the following symptoms of GI bleeding: black, bloody or tarry stools; coughing up blood; or vomit that looks like coffee grounds.

Be sure to inform your doctor of all the vitamins and herbal medications that you are taking as well. Some of them may contain substances that will react badly with his or her prescriptions.

11 How long does naproxen take to work?

After taking naproxen, you should begin to feel some relief from pain any time from 30 minutes to two hours. This varies from person to person, and it also depends on the type of naproxen you took. Taking it for longer periods of time will result in greater relief. It will also take longer, about one to two days, for inflammation to subside. As presence of the medicine in your body becomes consistent, its effects build up in one to two weeks to provide relief at a therapeutic level.

If you feel that the drug provides you no relief, you may switch to another type of medication on your next dosage. If naproxen was specifically prescribed to you by a medical professional, consult your doctor before deciding to change your treatment plan.

12 Does naproxen expire?

Yes, like all medications, expiration dates on naproxen will be printed on its label. This indicates the final date that the manufacturer can guarantee its effectiveness and safety. Manufacturers are required by law to place these dates visibly prior to the distribution and sale of these drugs. This is done for legal and liability reasons.

It is important to note that these expiration dates only hold while the packaging is sealed. Once opened, the expiration date printed on the label cannot be relied upon anymore. Manufacturers claim that the stability of the drug changes once the packaging is opened.

This is why upon purchase, pharmacies often indicate use-by dates which are typically a year after the date on the stock bottle.

Medications like naproxen, that are used only for minor health problems, are generally considered safe to use even if the expiration date has passed. In addition to that, medications in solid dosage forms such as capsules and tablets, are generally more stable. This is in comparison to liquid suspension medicines, which will often show changes in color or consistency.

Of course, it is still best to exercise caution. If the expiration date is only a month or two ago, it may be safe to take the medicine. If there is no therapeutic effect, the medicine should be discarded properly. However, if the medicine has been expired for a year or two already, it is better to throw these away rather than risk your safety.

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