NaproxenNaproxen/Naproxen Sodium

About Naproxen

Naproxen’s action, like that of other NSAIDs, is not completely understood but involves blocking the COX-1 and COX-2 enzymes that make prostaglandins, signals behind pain and inflammation. Naprosyn tablets, the suspension and Anaprox DS are labeled for rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, polyarticular juvenile idiopathic arthritis, tendonitis, bursitis, acute gout, pain and menstrual cramps. EC-Naprosyn is labeled for the four arthritis uses and, because its absorption is delayed, is not recommended to start treatment of acute pain or for gout; Naprelan has the uses of Naprosyn except juvenile arthritis, and its safety in children is not established. For arthritis, adults usually take 250 to 500 mg of naproxen, 275 to 550 mg of naproxen sodium or 375 to 500 mg of the delayed-release tablet twice a day, or Naprelan once a day. Children 2 and older with juvenile arthritis take about 10 mg/kg a day in two doses; tablets are not appropriate for children under 50 kg.

Its boxed warning says NSAIDs raise the risk of serious heart attacks and strokes, which can be fatal and may begin early in treatment and grow with longer use, and of bleeding, ulcers and perforation of the stomach or intestines, which can be fatal, can occur at any time without warning, and are more likely in older adults and people with past ulcers or bleeding. Naproxen must not be used in the setting of coronary artery bypass graft (CABG) surgery, by anyone allergic to it, or after asthma, hives or an allergic-type reaction to aspirin or another NSAID. Other warnings cover liver injury, high blood pressure, heart failure and swelling, kidney damage and high potassium, severe allergic and skin reactions including DRESS, anemia and masked signs of infection. The Naprosyn labels list indigestion, abdominal pain, nausea, headache, rash, bruising and swelling as the most common side effects.

NSAIDs used from about 20 weeks of pregnancy can cause rare but serious kidney problems in the unborn baby, leading to low amniotic fluid, and from about 30 weeks can close a fetal blood vessel (the ductus arteriosus) too early, so the labels limit use between about 20 and 30 weeks to the lowest dose for the shortest time and say to avoid NSAIDs from about 30 weeks; the over-the-counter label says not to use it at 20 weeks or later unless a doctor directs. Two naproxen products are not used together, and the suspension contains 39 mg of sodium per 5 mL. Over-the-counter naproxen sodium is labeled for minor aches, pains and fever from age 12, and its label says to stop and ask a doctor if pain lasts more than 10 days or fever more than 3 days.

Taking Naproxen

How to take it

Usually twice a day for arthritis, or once a day for Naprelan; for pain, as directed. Swallow delayed-release and controlled-release tablets whole, without splitting, chewing or crushing, and gently shake the suspension before each dose. Over-the-counter naproxen may be taken with food or milk.

If you miss a dose

Take a missed scheduled dose as soon as you remember, unless it is almost time for the next dose; then skip it and carry on as usual. Do not take a double dose.

Storage

At room temperature in the original, tightly closed container, away from excess heat and moisture, out of reach of children.

Interactions to know about

Pain-relieving aspirin doses are not generally recommended with it, and naproxen can interfere with low-dose aspirin’s antiplatelet effect; do not combine naproxen products or other NSAIDs. Blood thinners, SSRIs and SNRIs add to bleeding risk. It can weaken blood pressure medicines and diuretics and raises lithium levels and the risk of methotrexate toxicity; probenecid raises its levels, and some antacids, sucralfate and cholestyramine delay its absorption.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Naproxen differs from pharmacy to pharmacy

Plain naproxen tablets have many makers and the other forms fewer. A pharmacist fills the salt, strength and release form written, and a prescription that names a brand and blocks substitution is priced as a brand.

Ways to pay less for Naproxen without insurance

• Ask for a rated generic, and check that the prescription does not block substitution.
• If a delayed-release or controlled-release form is prescribed, ask the prescriber whether plain tablets would suit you.
• Ask whether naproxen is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Ask the prescriber whether an over-the-counter strength would suit you; never take it with prescription naproxen.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Naproxen

1. 1.Is my prescription for naproxen or naproxen sodium, and which release form?
2. 2.Is it safe with my heart, kidney or blood pressure conditions?
3. 3.Can I take it with my aspirin, blood thinner, antidepressant or water pill?
4. 4.Which stomach or bleeding symptoms mean I should stop it and get help?

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