Naproxen

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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
  • Antithrombin III
  • Antithymocyte Globulin
  • Apixaban
  • Aprepitant, Fosaprepitant
  • 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
  • Atazanavir; Cobicistat
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Edrophonium
  • Azathioprine
  • Azelastine; Fluticasone
  • Azilsartan
  • Azilsartan; Chlorthalidone
  • Bacitracin
  • Beclomethasone
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendamustine
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Beta-blockers
  • Betamethasone
  • Betaxolol
  • Betrixaban
  • Bexarotene
  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bisphosphonates
  • Bivalirudin
  • Bleomycin
  • Brimonidine; Timolol
  • Budesonide
  • Budesonide; Formoterol
  • Bumetanide
  • Busulfan
  • Calcium Chloride
  • Calcium Phosphate, Supersaturated
  • Calcium-channel blockers
  • Candesartan
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Cannabidiol
  • Capreomycin
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carmustine, BCNU
  • Carteolol
  • Carvedilol
  • Cefotaxime
  • Celecoxib
  • Chlorambucil
  • Chlorpropamide
  • Chlorthalidone; Clonidine
  • Cholestyramine
  • Choline Salicylate; Magnesium Salicylate
  • Cholinesterase inhibitors
  • Ciclesonide
  • Cidofovir
  • Cilostazol
  • Citalopram
  • Cladribine
  • Clofarabine
  • Clonidine
  • Clopidogrel
  • Colchicine; Probenecid
  • Colistimethate, Colistin, Polymyxin E
  • Corticosteroids
  • Cortisone
  • Cyclosporine
  • Cytarabine, ARA-C
  • Dabigatran
  • Dabrafenib
  • Dacarbazine, DTIC
  • Dactinomycin, Actinomycin D
  • Dalteparin
  • Danaparoid
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasatinib
  • Decitabine
  • Deferasirox
  • Deflazacort
  • Denileukin Diftitox
  • Desirudin
  • Desmopressin
  • Desvenlafaxine
  • Dexamethasone
  • Diazoxide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Digoxin
  • Diphenhydramine; Ibuprofen
  • Dipyridamole
  • Docetaxel
  • Donepezil
  • Donepezil; Memantine
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Dorzolamide; Timolol
  • Doxazosin
  • Drospirenone
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Drotrecogin Alfa
  • Duloxetine
  • Edoxaban
  • Edrophonium
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • 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
  • Entecavir
  • Eplerenone
  • Epoprostenol
  • Eprosartan
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Eptifibatide
  • Eribulin
  • Erlotinib
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esmolol
  • Estramustine
  • Ethacrynic Acid
  • Ethanol
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethotoin
  • Etodolac
  • Famotidine; Ibuprofen
  • Fenofibric Acid
  • Fenoldopam
  • Fenoprofen
  • Flavocoxid, Flavocoxid; Citrated Zinc Bisglycinate
  • Floxuridine
  • Fludarabine
  • Fludrocortisone
  • Flunisolide
  • Fluorouracil, 5-FU
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurbiprofen
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fluvoxamine
  • Fondaparinux
  • food
  • Formoterol; Mometasone
  • Foscarnet
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Furosemide
  • Gadoterate meglumine
  • Galantamine
  • Gallium Ga 68 Dotatate
  • Ganciclovir
  • Garlic, Allium sativum
  • Gemfibrozil
  • Gentamicin
  • Ginger, Zingiber officinale
  • Ginkgo, Ginkgo biloba
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Gold
  • Guanabenz
  • Guanfacine
  • 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
  • Iopromide
  • Ioversol
  • Ioxaglate Meglumine; Ioxaglate Sodium
  • Irbesartan
  • Isosulfan Blue
  • Ivacaftor
  • Ixabepilone
  • Kanamycin
  • Ketoprofen
  • Ketorolac
  • Labetalol
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Leflunomide
  • Lepirudin
  • 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
  • Mefenamic Acid
  • Meloxicam
  • Melphalan
  • Mesalamine, 5-ASA
  • Methotrexate
  • Methoxsalen
  • Methyldopa
  • Methylprednisolone
  • Methylsulfonylmethane, MSM
  • Metoprolol
  • Mifepristone
  • Milnacipran
  • Minoxidil
  • Mitomycin
  • Mitoxantrone
  • Moexipril
  • Mometasone
  • Nabumetone
  • Nadolol
  • Nebivolol
  • Nebivolol; Valsartan
  • Nelarabine
  • Neomycin
  • Neostigmine
  • Nitroprusside
  • Non-Ionic Contrast Media
  • Olmesartan
  • Omacetaxine
  • Omeprazole; Sodium Bicarbonate
  • Oritavancin
  • Oxaprozin
  • 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
  • Pralatrexate
  • Prasugrel
  • Prazosin
  • Prednisolone
  • Prednisone
  • Probenecid
  • Procarbazine
  • Propranolol
  • Pyridostigmine
  • Pyrimethamine; Sulfadoxine
  • Quinapril
  • Quinolones
  • Ramipril
  • Reserpine
  • 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
  • Spironolactone
  • Streptokinase
  • Streptomycin
  • Streptozocin
  • Sucralfate
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfinpyrazone
  • Sulfisoxazole
  • Sulfonamides
  • Sulfonylureas
  • Sulindac
  • Tacrine
  • Tacrolimus
  • Telavancin
  • Telbivudine
  • Telmisartan
  • Temozolomide
  • Tenecteplase
  • Teniposide
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Terazosin
  • Teriflunomide
  • Tezacaftor; Ivacaftor
  • Thiazide diuretics
  • Thioguanine, 6-TG
  • Thrombolytic Agents
  • Ticagrelor
  • Ticlopidine
  • Timolol
  • Tinzaparin
  • Tirofiban
  • tobacco
  • Tobramycin
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Topiramate
  • Torsemide
  • Tositumomab
  • Trandolapril
  • Trandolapril; Verapamil
  • Trazodone
  • Treprostinil
  • Tretinoin, ATRA
  • Triamcinolone
  • Triamterene
  • Urea
  • Urokinase
  • Valacyclovir
  • Valganciclovir
  • Valsartan
  • Vancomycin
  • Vasodilators
  • Vemurafenib
  • Venlafaxine
  • Verteporfin
  • Vigabatrin
  • Vilazodone
  • Vincristine
  • Vincristine Liposomal
  • Vorapaxar
  • Voriconazole
  • Vorinostat
  • Vortioxetine
  • Warfarin

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