Overview
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that provides analgesic, anti-inflammatory, and antipyretic effects by inhibiting prostaglandin synthesis. It is commonly used for pain relief, inflammation reduction, and fever management in various musculoskeletal and inflammatory conditions.
Mechanism of Action
Naproxen exerts its therapeutic effects by non-selectively inhibiting both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, thereby reducing the synthesis of prostaglandins that mediate pain, inflammation, and fever.
Indications
- Rheumatoid arthritis
- Osteoarthritis
- Ankylosing spondylitis
- Polyarticular Juvenile Idiopathic Arthritis
- Tendonitis
- Bursitis
- Acute gout
- Pain management
- Primary dysmenorrhea
Common Doses
- 220 mg
- 250 mg
- 275 mg
- 375 mg
- 500 mg
- 550 mg
- 750 mg
Dosage
Typical adult dosage is 250-500 mg twice daily for most conditions, with maximum daily dose of 1500 mg for limited periods. Lower doses are recommended for elderly patients and those with renal impairment.
Contraindications
- Known hypersensitivity to naproxen or any components
- History of asthma, urticaria, or allergic reactions to aspirin or other NSAIDs
- Coronary artery bypass graft (CABG) surgery period
Side Effects
- Gastrointestinal: nausea, dyspepsia, abdominal pain, GI bleeding
- Cardiovascular: edema, hypertension, heart failure
- Renal: acute kidney injury, hyperkalemia
- Hepatic: elevated liver enzymes, hepatitis
- Dermatological: rash, Stevens-Johnson syndrome
- Hematological: anemia, bleeding tendency
- Central nervous system: headache, dizziness
Interactions
- Anticoagulants (warfarin) - increased bleeding risk
- Aspirin - interference with antiplatelet effect
- ACE inhibitors/ARBs - reduced antihypertensive effect
- Diuretics - reduced efficacy
- Lithium - increased lithium levels
- Methotrexate - increased toxicity risk
- Cyclosporine - increased nephrotoxicity
- Other NSAIDs - increased GI toxicity
Counseling Points
- Take with food or milk to reduce GI upset
- Report signs of GI bleeding (black stools, abdominal pain)
- Monitor for signs of cardiovascular events
- Avoid alcohol consumption
- Do not exceed recommended dosage
- Report skin rash or allergic symptoms immediately
- Inform healthcare provider of all medications being taken