Naproxen

Naproxen Brand Names

Aflaxen | Aleve | Aleve Arthritis | All Day Pain Relief | All Day Relief | Anaprox | Anaprox DS | EC-Naprosyn | EnovaRX | Equipto Naproxen | Midol Extended Relief | Naprelan | Naprelan Dose Card | Naprosyn

What is Naproxen

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) of the propionic acid chemical class.

This medicine possesses antipyretic and analgesic properties. Naproxen is a propionic acid derivative related to ibuprofen, ketoprofen, flurbiprofen, and fenoprofen.

Many pharmacodynamic similarities exist among these agents, which are usually better tolerated than aspirin or indomethacin. All NSAIDs, including naproxen, carry an increased risk of serious gastrointestinal adverse effects including bleeding, ulceration, and perforation of the stomach or intestines, and may cause an increased risk of serious cardiovascular (CV) thrombotic events, myocardial infarction, and stroke.

The FDA approved labeling of both the OTC and prescription products stress dosing at the lowest effective dose for the shortest possible duration, as the risk for adverse effects may increase with increased use.

A retrospective review by FDA Advisory Committees of short-term efficacy trials of non-prescription strength naproxen indicated that an increase in CV events was not apparent during the studies.

However, it is important to note that CV risk was not the focus of the studies, and further information is needed to determine if a cause and effect relationship exists between non-prescription strength NSAID use and adverse cardiovascular outcomes.

Naproxen is available as the anion and as the sodium salt; all formulations liberate naproxen as the active drug.

Naproxen has been shown superior to ergotamine in the treatment of migraine.

Naproxen was approved by the FDA in 1976.

In January 1994, the FDA granted permission to market naproxen in a nonprescription form (e.g., Aleve).

Indications

1. ankylosing spondylitis
2. arthralgia
3. bone pain
4. bursitis
5. dental pain
6. dysmenorrhea
7. fever
8. gouty arthritis
9. headache
10. heterotopic ossification
11. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
12. migraine
13. migraine prophylaxis
14. mild pain
15. moderate pain
16. myalgia
17. osteoarthritis
18. rheumatoid arthritis
19. tendinitis

For the treatment of mild to moderately severe musculoskeletal inflammation including osteoarthritis, rheumatoid arthritis, or ankylosing spondylitis

Side Effects

1. abdominal pain
2. acne vulgaris
3. agranulocytosis
4. alopecia
5. amblyopia
6. amnesia
7. anaphylactic shock
8. anaphylactoid reactions
9. anemia
10. angina
11. angioedema
12. anorexia
13. anxiety
14. aplastic anemia
15. arrhythmia exacerbation
16. arthralgia
17. aseptic meningitis
18. asthenia
19. azotemia
20. back pain
21. bleeding
22. blurred vision
23. bone fractures
24. bone pain
25. bronchospasm
26. bullous rash
27. bundle-branch block
28. chest pain (unspecified)
29. chills
30. cholecystitis
31. cholelithiasis
32. colitis
33. coma
34. confusion
35. conjunctivitis
36. constipation
37. contact dermatitis
38. corneal opacification
39. cough
40. cystitis
41. dehydration
42. depression
43. diaphoresis
44. diarrhea
45. diplopia
46. dizziness
47. drowsiness
48. dysmenorrhea
49. dyspepsia
50. dysphagia
51. dyspnea
52. dysuria
53. ecchymosis
54. eczema vaccinatum
55. edema
56. elevated hepatic enzymes
57. emotional lability
58. eosinophilia
59. epistaxis
60. eructation
61. erythema multiforme
62. erythema nodosum
63. esophageal stricture
64. esophageal ulceration
65. esophagitis
66. exfoliative dermatitis
67. fever
68. flank pain
69. flatulence
70. gastritis
71. GI bleeding
72. GI perforation
73. glomerulonephritis
74. glossitis
75. glycosuria
76. hallucinations
77. headache
78. hearing loss
79. heart failure
80. hematemesis
81. hematuria
82. hemolytic anemia
83. hepatic failure
84. hepatic necrosis
85. hepatitis
86. hepatomegaly
87. hypercholesterolemia
88. hyperglycemia
89. hyperkalemia
90. hypertension
91. hypertonia
92. hyperuricemia
93. hypoglycemia
94. hypokalemia
95. hyponatremia
96. hypotension
97. increased urinary frequency
98. infection
99. infertility
100. influenza
101. insomnia
102. interstitial nephritis
103. jaundice
104. keratoconjunctivitis
105. lacrimation
106. leukopenia
107. lichen planus-like eruption
108. lupus-like symptoms
109. lymphadenopathy
110. malaise
111. melena
112. menorrhagia
113. metabolic alkalosis
114. migraine
115. muscle cramps
116. muscle paralysis
117. myalgia
118. myasthenia
119. myocardial infarction
120. nausea
121. nephrotic syndrome
122. neuritis
123. nocturia
124. ocular pain
125. odynophagia
126. oliguria
127. optic neuritis
128. oral ulceration
129. palpitations
130. pancreatitis
131. pancytopenia
132. papilledema
133. paresthesias
134. pelvic pain
135. peptic ulcer
136. peripheral edema
137. peripheral vasodilation
138. pharyngitis
139. phlebitis
140. photophobia
141. photosensitivity
142. platelet dysfunction
143. pneumonitis
144. polyuria
145. prolonged bleeding time
146. proteinuria
147. pruritus
148. pseudoporphyria
149. ptosis
150. pulmonary edema
151. purpura
152. pyrosis (heartburn)
153. pyuria
154. rash
155. renal failure (unspecified)
156. renal papillary necrosis
157. respiratory depression
158. rhinitis
159. seizures
160. sinus tachycardia
161. sinusitis
162. skin necrosis
163. skin ulcer
164. splenomegaly
165. Stevens-Johnson syndrome
166. stomatitis
167. stroke
168. subdural hematoma
169. syncope
170. thrombocytopenia
171. thromboembolism
172. tinnitus
173. toxic epidermal necrolysis
174. tremor
175. urinary incontinence
176. urinary retention
177. urticaria
178. vaginitis
179. vasculitis
180. vertigo
181. visual impairment
182. vomiting
183. weight loss
184. xerosis
185. xerostomia

Monitoring Parameters

• CBC
• LFTs
• serum creatinine/BUN

Contraindications

• acute bronchospasm
• acute myocardial infarction
• anemia
• angina
• anticoagulant therapy
• asthma
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• cardiomyopathy
• cerebrovascular disease
• coagulopathy
• coronary artery bypass graft surgery (CABG)
• coronary artery disease
• corticosteroid therapy
• dehydration
• ethanol ingestion
• geriatric
• GI bleeding
• GI perforation
• heart failure
• hepatic disease
• hypertension
• hypoalbuminemia
• hypovolemia
• infertility
• labor
• laboratory test interference
• myocardial infarction
• myocardial infarction or stroke
• nasal polyps
• NSAID hypersensitivity
• obstetric delivery
• peptic ulcer disease
• peripheral vascular disease
• pregnancy
• renal disease
• renal failure
• renal impairment
• reproductive risk
• salicylate hypersensitivity
• serious rash
• sodium restriction
• stroke
• tachycardia
• thromboembolism
• tobacco smoking
• urticaria

Interactions

• Abciximab
• Acebutolol
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetohexamide
• Acyclovir
• Adefovir
• Aldesleukin, IL-2
• Aliskiren
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aliskiren; Valsartan
• Alpha-blockers
• Alteplase
• Altretamine
• Ambenonium Chloride
• Amikacin
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
• Aminosalicylate sodium, Aminosalicylic acid
• Amiodarone
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Anagrelide
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Antacids
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• Antithymocyte Globulin
• Apixaban
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• Aprotinin
• Argatroban
• Arsenic Trioxide
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atazanavir
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• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendamustine
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• Beta-blockers
• Betamethasone
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• Bexarotene
• Bictegravir; Emtricitabine; Tenofovir Alafenamide
• Bismuth Subsalicylate
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• Bisoprolol
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• Bleomycin
• Brimonidine; Timolol
• Budesonide
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• Calcium Phosphate, Supersaturated
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• Captopril; Hydrochlorothiazide, HCTZ
• Carmustine, BCNU
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• Drospirenone; Ethinyl Estradiol
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• Elexacaftor; tezacaftor; ivacaftor
• Eltrombopag
• Elvitegravir
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Emtricitabine
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Emtricitabine; Tenofovir alafenamide
• Emtricitabine; Tenofovir disoproxil fumarate
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Enoxaparin
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• Ethacrynic Acid
• Ethanol
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• Fenofibric Acid
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• Fenoprofen
• Flavocoxid, Flavocoxid; Citrated Zinc Bisglycinate
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• Flurbiprofen
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• Fluvoxamine
• Fondaparinux
• food
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• Ginger, Zingiber officinale
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• Glimepiride
• Glimepiride; Pioglitazone
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• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Gold
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• H2-blockers
• Heparin
• Hyaluronidase, Recombinant; Immune Globulin
• Hydantoins
• Hydralazine
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydralazine; Isosorbide Dinitrate, ISDN
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Ibuprofen
• Hydrocortisone
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibritumomab Tiuxetan
• Ibuprofen
• Ibuprofen lysine
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Iloprost
• Imatinib
• Immune Globulin IV, IVIG, IGIV
• Indapamide
• Indomethacin
• Inotersen
• Interferon Alfa-2a
• Interferon Alfa-2b
• Interferon Alfa-2b; Ribavirin
• Iodipamide Meglumine
• Iohexol
• Ionic Contrast Media
• Iopamidol
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• Ioversol
• Ioxaglate Meglumine; Ioxaglate Sodium
• Irbesartan
• Isosulfan Blue
• Ivacaftor
• Ixabepilone
• Kanamycin
• Ketoprofen
• Ketorolac
• Labetalol
• Lamivudine; Tenofovir Disoproxil Fumarate
• Leflunomide
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• Levobetaxolol
• Levobunolol
• Levomefolate
• Levomilnacipran
• Lisinopril
• Lithium
• Lomustine, CCNU
• Losartan
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Macimorelin
• Magnesium Salicylate
• Magnesium Salts
• Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
• Mannitol
• Mecamylamine
• Mechlorethamine, Nitrogen Mustard
• Meclofenamate Sodium
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• Methylsulfonylmethane, MSM
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• Mitomycin
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• Nadolol
• Nebivolol
• Nebivolol; Valsartan
• Nelarabine
• Neomycin
• Neostigmine
• Nitroprusside
• Non-Ionic Contrast Media
• Olmesartan
• Omacetaxine
• Omeprazole; Sodium Bicarbonate
• Oritavancin
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• Paclitaxel
• Paroxetine
• Pegaspargase
• Penbutolol
• Pentamidine
• Pentosan
• Pentostatin
• Perindopril
• Perindopril; Amlodipine
• Phenoxybenzamine
• Phentermine; Topiramate
• Phentolamine
• Phenytoin
• Photosensitizing agents (topical)
• Physostigmine
• Pindolol
• Piroxicam
• Platelet Inhibitors
• Pneumococcal Vaccine, Polyvalent
• Polyethylene Glycol; Electrolytes
• Polyethylene Glycol; Electrolytes; Ascorbic Acid
• Polymyxin B
• Polymyxins
• Potassium
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• Prasugrel
• Prazosin
• Prednisolone
• Prednisone
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• Quinapril
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• Ramipril
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• Reteplase, r-PA
• Rivaroxaban
• Rivastigmine
• Romidepsin
• Sacubitril; Valsartan
• Salicylates
• Salsalate
• Selective serotonin reuptake inhibitors
• Sertraline
• Sodium Bicarbonate
• Sodium Hyaluronate, Hyaluronic Acid
• Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Sotalol
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• Streptokinase
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• Sucralfate
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• Tacrine
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• Telavancin
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• tobacco
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