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Prescription medication facts: Naproxen

Naproxen is an anti-inflammatory medication used in a wide range of conditions to treat pain and inflammation. Low doses are available over the counter for the relief of minor aches and pains; and higher doses are available on prescription from a doctor. Higher dose naproxen may be used in the management of chronic conditions such as rheumatoid arthritis, osteoarthritis, chronic pain and severe menstrual cramps.

How does naproxen work?

Naproxen belongs to a group of medications called NSAIDs – non-steroidal anti-inflammatory drugs. These drugs inhibit certain enzymes in the body that lead to the production of pain chemicals, called prostaglandins. When the production of prostaglandins is reduced, pain and inflammation is also reduced.

How is naproxen taken?

There are different types of prescription naproxen formulations available, which affects how it should be taken. On prescription there is a regular tablet, an enteric coated tablet; an extended release capsule designed for once daily dosing; and a suspension (liquid) formula is also available in some countries. The enteric coated tablet and extended release capsule should be swallowed whole, and not crushed or chewed. Naproxen should be taken at roughly the same time/s each day, exactly as prescribed by the doctor. If it is irritating to the stomach, it may be taken with food or a glass or milk.

Which people should avoid using naproxen?

Naproxen may not be suitable for use in some people. Naproxen should not be used in people with an aspirin allergy, due to the potential for people to also be sensitive to naproxen. Some pre-existing medical conditions may limit or prohibit the use of naproxen. The following is a list of some such conditions. It is not a complete list of all the conditions whereby your doctor may decide not to prescribe naproxen.

*Bleeding disorders

*Peptic ulcers (ulcers in the lining of the stomach)

*Liver disease

*Kidney disease or impairment

*Heart failure; High blood pressure; history of heart attack

*Asthma

*Nasal polyps

What are the side effects of naproxen?

Many people may use naproxen without experiencing any side effects at all. However, there are some less common but extremely serious side effects that all users of naproxen should be aware of. Naproxen may increase the risk of serious cardiovascular side effects, including heart attack and stroke. This risk generally increases with duration of use. People with pre-existing heart conditions are at increased risk of these complications, so great care must be taken before deciding to use naproxen in these patients, as the benefits must outweigh the risks.

Gastrointestinal ulceration and bleeding is another potentially life threatening side effect that can be associated with naproxen use. Elderly patients are most at risk of experiencing this side effect.

Some more common side effects of naproxen include abdominal pain, nausea, heartburn, headache, constipation, dizziness, drowsiness and ringing in the ears (tinnitus), rash and hives. This is not a complete list of side effects that may occur. If you experience any problems whilst taking naproxen, report back to your doctor for further review.

What drugs interact with naproxen?

A range of medications can potentially interact with naproxen. Some combinations are best avoided all together, whilst some medications may require a dose adjustment when being used with naproxen to prevent side effects occurring. Some medications that interact with naproxen include (but are not limited to) the following:

Other NSAIDs – including ibuprofen, ketoprofen, indomethacin, celecoxcib, diclofenac, meloxicam and others

Methotrexate

Blood pressure medications called ACE inhibitors (including captopril, ramipril, enalapril, fosinopril, trandolapril and perindopril and others)

Blood pressure medications called angiotensin II receptor antagonists (angiotensin receptor blockers; ARBs) – (including candesartan, irbesartan, valsartan, eprosartan, telmisartan and others)

Selective Serotonin Reuptake Inhibitors (SSRIs) – including fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline and paroxetine. Combining these medications with naproxen may increase the risk of bleeding.

Fluid tablets -diuretics, eg. frusemide

Lithium

Warfarin

Steroids eg. prednisone, prednisolone

This is not a complete list of medications that may interact with naproxen. There may be other drugs that interact with naproxen including over the counter medications, vitamins and herbal preparations. Always seek advice from your pharmacist or doctor regarding drug interactions.

Naproxen is a useful anti-inflammatory for many people in treating a range of conditions. However, close monitoring for side effects and drug interactions is required, particularly in elderly patients and those using naproxen on a continuous basis. For further advice, always consult your doctor.

General Note:

This article is of a general nature and in no way should be seen as a substitute for your own doctor’s or health professional’s advice. The author accepts no responsibility for loss occasioned to any person acting on or refraining from action as a result of the published information. Before commencing any health treatment, always consult your doctor.