Dosing & Uses
Dosage Forms & Strengths
tablet
- 220mg (OTC)
- 250mg
- 275mg
- 375mg
- 500mg
- 550mg
tablet delayed release
- 375mg
- 500mg
tablet extended release
- 375mg
- 500mg
- 750mg
capsule
- 220mg
oral suspension
- 25mg/mL
Pain
500 mg PO initially, then 250 mg PO q6-8hr or 500 mg PO q12hr PRN; not to exceed 1250 mg/day naproxen base on day 1; subsequent daily doses should not exceed 1000 mg naproxen base
Extended release: 750-1000 mg PO qDay; may temporarily increase to 1500 mg/day if tolerated well and clinically indicated
Rheumatoid Arthritis, Osteoarthritis, Ankylosing Spondylitis
500-1000 mg/day PO divided q12hr; may increase to 1500 mg/day if tolerated well for limited time
Extended release: 750-1000 mg PO qDay; may temporarily increase to 1500 mg/day if tolerated well and clinically indicated
Dysmenorrhea
500 mg PO initially, then 250 mg PO q6-8hr or 500 mg PO q12hr (long-acting formula); not to exceed 1250 mg/day on first day; subsequent doses should not exceed 1000 mg/day naproxen base
Gout, Acute
750 mg PO initially, followed by 250 mg q8hr until attack subsides
Extended release: 1000-1500 mg qDay, followed by 1000 mg qDay until attack subsides
Migraine (Off-label)
750 mg PO initially, may give additional 250-500 mg if necessary; not to exceed 1250 mg in 24 hr
Dosing Considerations
220 mg of naproxen sodium contains 200 mg of naproxen
Delayed-release formulation not recommended for acute pain
Take with food or 8-12 oz of water to avoid gastrointestinal (GI) effects
Dosing Modifications
CrCl <30 mL/min: Use not recommended
Dosage Forms & Strengths
tablet
- 220mg (OTC)
- 250mg
- 275mg
- 375mg
- 500mg
- 550mg
tablet delayed release
- 375mg
- 500mg
tablet extended release
- 375mg
- 500mg
- 750mg
capsule
- 220mg
oral suspension
- 25mg/mL
Pain
>2 years
>12 years
- 500 mg PO initially, then 250 mg PO q6-8hr or 500 mg PO q12hr PRN; not to exceed 1250 mg/day naproxen base on day 1; subsequent daily doses should not exceed 1000 mg naproxen base
- Extended release: 750-1000 mg PO qDay; may temporarily increase to 1500 mg/day if tolerated well and clinically indicated
Juvenile Idiopathic Arthritis
>2 years: 10 mg/kg/day oral suspension PO divided q12hr; not to exceed 15 mg/kg/day
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (21)
- aminolevulinic acid oral
aminolevulinic acid oral, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.
- aminolevulinic acid topical
naproxen, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- apixaban
naproxen and apixaban both decrease anticoagulation. Avoid or Use Alternate Drug.
- benazepril
naproxen, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- captopril
naproxen, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- enalapril
naproxen, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- fosinopril
naproxen, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- ibuprofen
ibuprofen will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. Therapeutic duplication
ibuprofen and naproxen both increase anticoagulation. Avoid or Use Alternate Drug. Therapeutic duplication
ibuprofen and naproxen both increase serum potassium. Avoid or Use Alternate Drug. Therapeutic duplication - ibuprofen IV
ibuprofen IV will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Avoid or Use Alternate Drug. therapeutic duplication; increased risk of gastric ulceration
ibuprofen IV and naproxen both increase anticoagulation. Avoid or Use Alternate Drug. Therapeutic duplication
ibuprofen IV and naproxen both increase serum potassium. Avoid or Use Alternate Drug. Therapeutic duplication - ketorolac
naproxen, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- ketorolac intranasal
naproxen, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- lisinopril
naproxen, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- methotrexate
naproxen increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Concomitant administration of NSAIDs with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and GI toxicity. NSAIDs may reduce tubular secretion of methotrexate and enhance toxicity.
- methyl aminolevulinate
naproxen, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- moexipril
naproxen, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- pemetrexed
naproxen increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Interrupt dosing in all patients taking NSAIDs with long elimination half-lives for at least 5d before, the day of, and 2d following pemetrexed administration. If coadministration of an NSAID is necessary, closely monitor patients for toxicity, especially myelosuppression, renal toxicity, and GI toxicity.
- perindopril
naproxen, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- quinapril
naproxen, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- ramipril
naproxen, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- tacrolimus
naproxen, tacrolimus. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Concomitant administration increases risk of nephrotoxicity.
- trandolapril
naproxen, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (235)
- acebutolol
acebutolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aceclofenac
aceclofenac and naproxen both increase anticoagulation. Use Caution/Monitor.
aceclofenac and naproxen both increase serum potassium. Use Caution/Monitor. - acemetacin
acemetacin and naproxen both increase anticoagulation. Use Caution/Monitor.
acemetacin and naproxen both increase serum potassium. Use Caution/Monitor. - agrimony
naproxen and agrimony both increase anticoagulation. Use Caution/Monitor.
- albuterol
naproxen increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfalfa
naproxen and alfalfa both increase anticoagulation. Use Caution/Monitor.
- alfuzosin
naproxen decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- aliskiren
naproxen will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.
- alteplase
naproxen and alteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
- American ginseng
naproxen and American ginseng both increase anticoagulation. Use Caution/Monitor.
- amiloride
amiloride and naproxen both increase serum potassium. Modify Therapy/Monitor Closely.
- antithrombin alfa
antithrombin alfa and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- antithrombin III
antithrombin III and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- arformoterol
naproxen increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- argatroban
argatroban and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- asenapine
naproxen decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- aspirin
aspirin and naproxen both increase anticoagulation. Use Caution/Monitor.
aspirin and naproxen both increase serum potassium. Use Caution/Monitor. - aspirin rectal
aspirin rectal and naproxen both increase anticoagulation. Use Caution/Monitor.
aspirin rectal and naproxen both increase serum potassium. Use Caution/Monitor. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate and naproxen both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and naproxen both increase serum potassium. Use Caution/Monitor. - atenolol
atenolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - azilsartan
naproxen, azilsartan. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
naproxen decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. - bemiparin
bemiparin and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- benazepril
benazepril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- bendroflumethiazide
naproxen increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- betaxolol
betaxolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - betrixaban
naproxen, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.
- bimatoprost
bimatoprost, naproxen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- bisoprolol
bisoprolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - bivalirudin
bivalirudin and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- budesonide
naproxen, budesonide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- bumetanide
naproxen increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
naproxen decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis. - candesartan
candesartan and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
candesartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - captopril
captopril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- carbenoxolone
naproxen increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carvedilol
carvedilol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - celecoxib
celecoxib and naproxen both increase anticoagulation. Use Caution/Monitor.
celecoxib and naproxen both increase serum potassium. Use Caution/Monitor. - celiprolol
celiprolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - chlorothiazide
naproxen increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpropamide
naproxen increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- chlorthalidone
naproxen increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- choline magnesium trisalicylate
naproxen and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
naproxen and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor. - cinnamon
naproxen and cinnamon both increase anticoagulation. Use Caution/Monitor.
- ciprofloxacin
naproxen, ciprofloxacin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Mechanism: unknown. Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- citalopram
citalopram, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.
- clomipramine
clomipramine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.
- clopidogrel
clopidogrel, naproxen. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.
- cordyceps
naproxen and cordyceps both increase anticoagulation. Use Caution/Monitor.
- cortisone
naproxen, cortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- cyclopenthiazide
naproxen increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclosporine
naproxen, cyclosporine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- dabigatran
dabigatran and naproxen both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.
- dalteparin
dalteparin and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- deferasirox
deferasirox, naproxen. Other (see comment). Use Caution/Monitor. Comment: Combination may increase GI bleeding, ulceration and irritation. Use with caution.
- defibrotide
defibrotide increases effects of naproxen by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.
- deflazacort
naproxen, deflazacort. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- dexamethasone
naproxen, dexamethasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- dichlorphenamide
dichlorphenamide and naproxen both decrease serum potassium. Use Caution/Monitor.
- diclofenac
diclofenac and naproxen both increase anticoagulation. Use Caution/Monitor.
diclofenac and naproxen both increase serum potassium. Use Caution/Monitor. - diflunisal
diflunisal and naproxen both increase anticoagulation. Use Caution/Monitor.
diflunisal and naproxen both increase serum potassium. Use Caution/Monitor. - digoxin
naproxen and digoxin both increase serum potassium. Use Caution/Monitor.
- dobutamine
naproxen increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dong quai
naproxen and dong quai both increase anticoagulation. Use Caution/Monitor.
- dopexamine
naproxen increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxazosin
naproxen decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- drospirenone
drospirenone and naproxen both increase serum potassium. Modify Therapy/Monitor Closely.
- duloxetine
duloxetine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- edoxaban
edoxaban, naproxen. Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.
- eltrombopag
eltrombopag increases levels of naproxen by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF, naproxen. Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
- emtricitabine
emtricitabine, naproxen. Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
- enalapril
enalapril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- enoxaparin
enoxaparin and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- ephedrine
naproxen increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
naproxen increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
naproxen increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epoprostenol
naproxen and epoprostenol both increase anticoagulation. Use Caution/Monitor.
- eprosartan
eprosartan and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
eprosartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - escitalopram
escitalopram, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- esmolol
esmolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ethacrynic acid
naproxen increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- etodolac
etodolac and naproxen both increase anticoagulation. Use Caution/Monitor.
etodolac and naproxen both increase serum potassium. Use Caution/Monitor. - fennel
naproxen and fennel both increase anticoagulation. Use Caution/Monitor.
- fenoprofen
fenoprofen and naproxen both increase anticoagulation. Use Caution/Monitor.
fenoprofen and naproxen both increase serum potassium. Use Caution/Monitor. - feverfew
naproxen and feverfew both increase anticoagulation. Use Caution/Monitor.
- fish oil triglycerides
fish oil triglycerides will increase the level or effect of naproxen by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.
- fludrocortisone
naproxen, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- fluoxetine
fluoxetine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- flurbiprofen
flurbiprofen and naproxen both increase anticoagulation. Use Caution/Monitor.
flurbiprofen and naproxen both increase serum potassium. Use Caution/Monitor. - fluvoxamine
fluvoxamine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- fondaparinux
fondaparinux and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- formoterol
naproxen increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- forskolin
naproxen and forskolin both increase anticoagulation. Use Caution/Monitor.
- fosinopril
fosinopril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- furosemide
naproxen increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- garlic
naproxen and garlic both increase anticoagulation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin, naproxen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- gentamicin
naproxen increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ginger
naproxen and ginger both increase anticoagulation. Use Caution/Monitor.
- ginkgo biloba
naproxen and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- glimepiride
naproxen increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glipizide
naproxen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glyburide
naproxen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- green tea
green tea, naproxen. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.
- heparin
heparin and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- horse chestnut seed
naproxen and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
- hydralazine
naproxen decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- hydrochlorothiazide
naproxen increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocortisone
naproxen, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- ibrutinib
ibrutinib will increase the level or effect of naproxen by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.
- imatinib
imatinib, naproxen. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents.
- indapamide
naproxen increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indomethacin
indomethacin and naproxen both increase anticoagulation. Use Caution/Monitor.
indomethacin and naproxen both increase serum potassium. Use Caution/Monitor. - irbesartan
irbesartan and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
irbesartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - isoproterenol
naproxen increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketoprofen
ketoprofen and naproxen both increase anticoagulation. Use Caution/Monitor.
ketoprofen and naproxen both increase serum potassium. Use Caution/Monitor. - ketorolac
ketorolac and naproxen both increase anticoagulation. Use Caution/Monitor.
ketorolac and naproxen both increase serum potassium. Use Caution/Monitor. - ketorolac intranasal
ketorolac intranasal and naproxen both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and naproxen both increase serum potassium. Use Caution/Monitor. - labetalol
labetalol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - latanoprost
latanoprost, naproxen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- latanoprostene bunod ophthalmic
latanoprostene bunod ophthalmic, naproxen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- levalbuterol
naproxen increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levofloxacin
levofloxacin, naproxen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
- levomilnacipran
levomilnacipran, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.
- lisinopril
lisinopril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- lithium
naproxen increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.
- lornoxicam
lornoxicam and naproxen both increase anticoagulation. Use Caution/Monitor.
lornoxicam and naproxen both increase serum potassium. Use Caution/Monitor. - losartan
losartan and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
losartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - meclofenamate
meclofenamate and naproxen both increase anticoagulation. Use Caution/Monitor.
meclofenamate and naproxen both increase serum potassium. Use Caution/Monitor. - mefenamic acid
mefenamic acid and naproxen both increase anticoagulation. Use Caution/Monitor.
mefenamic acid and naproxen both increase serum potassium. Use Caution/Monitor. - melatonin
melatonin increases effects of naproxen by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.
- meloxicam
meloxicam and naproxen both increase anticoagulation. Use Caution/Monitor.
meloxicam and naproxen both increase serum potassium. Use Caution/Monitor. - mesalamine
mesalamine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.
- metaproterenol
naproxen increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methyclothiazide
naproxen increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- methylprednisolone
naproxen, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- metolazone
naproxen increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoprolol
metoprolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - milnacipran
milnacipran, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- mipomersen
mipomersen, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
- mistletoe
naproxen increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- moexipril
moexipril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- moxifloxacin
moxifloxacin, naproxen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- moxisylyte
naproxen decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- mycophenolate
naproxen will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- nabumetone
nabumetone and naproxen both increase anticoagulation. Use Caution/Monitor.
nabumetone and naproxen both increase serum potassium. Use Caution/Monitor. - nadolol
nadolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nebivolol
nebivolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nefazodone
nefazodone, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- nettle
naproxen increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- norepinephrine
naproxen increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- olmesartan
olmesartan and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
olmesartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - ospemifene
naproxen, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.
- oxaprozin
naproxen and oxaprozin both increase anticoagulation. Use Caution/Monitor.
naproxen and oxaprozin both increase serum potassium. Use Caution/Monitor. - panax ginseng
naproxen and panax ginseng both increase anticoagulation. Use Caution/Monitor.
- parecoxib
naproxen and parecoxib both increase anticoagulation. Use Caution/Monitor.
naproxen and parecoxib both increase serum potassium. Use Caution/Monitor. - paroxetine
paroxetine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- pau d'arco
naproxen and pau d'arco both increase anticoagulation. Use Caution/Monitor.
- pegaspargase
pegaspargase increases effects of naproxen by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.
- peginterferon alfa 2b
peginterferon alfa 2b decreases levels of naproxen by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. When patients are administered peginterferon alpha-2b with CYP2C9 substrates, the therapeutic effect of these drugs may be altered.
- penbutolol
penbutolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - perindopril
perindopril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- phenindione
phenindione and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- phenoxybenzamine
naproxen decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phentolamine
naproxen decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phytoestrogens
naproxen and phytoestrogens both increase anticoagulation. Use Caution/Monitor.
- pindolol
pindolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - pirbuterol
naproxen increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- piroxicam
naproxen and piroxicam both increase anticoagulation. Use Caution/Monitor.
naproxen and piroxicam both increase serum potassium. Use Caution/Monitor. - pivmecillinam
pivmecillinam, naproxen. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
pivmecillinam, naproxen. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - potassium acid phosphate
naproxen and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
naproxen and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate
naproxen and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium iodide
potassium iodide and naproxen both increase serum potassium. Use Caution/Monitor.
- pralatrexate
naproxen increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor. NSAIDs may delay pralatrexate clearance, increasing drug exposure. Adjust the pralatrexate dose as needed.
- prasugrel
naproxen, prasugrel. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.
- prazosin
naproxen decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- prednisolone
naproxen, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- prednisone
naproxen, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- probenecid
naproxen will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- propranolol
propranolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - protamine
protamine and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- quinapril
quinapril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- ramipril
ramipril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- reishi
naproxen and reishi both increase anticoagulation. Use Caution/Monitor.
- reteplase
naproxen and reteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
- rivaroxaban
rivaroxaban, naproxen. Other (see comment). Use Caution/Monitor. Comment: NSAIDs are known to increase bleeding. Bleeding risk may be increased when NSAIDs are used concomitantly with rivaroxaban. Monitor for signs/symptoms of blood loss.
- rivastigmine
rivastigmine increases toxicity of naproxen by pharmacodynamic synergism. Use Caution/Monitor. Monitor patients for symptoms of active or occult gastrointestinal bleeding.
- sacubitril/valsartan
sacubitril/valsartan and naproxen both increase serum potassium. Use Caution/Monitor.
sacubitril/valsartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
naproxen decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. - salicylates (non-asa)
naproxen and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.
naproxen and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor. - salmeterol
naproxen increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salsalate
naproxen and salsalate both increase anticoagulation. Use Caution/Monitor.
naproxen and salsalate both increase serum potassium. Use Caution/Monitor. - saw palmetto
saw palmetto increases toxicity of naproxen by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- sertraline
sertraline, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- Siberian ginseng
naproxen and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.
- silodosin
naproxen decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
naproxen, sodium picosulfate/magnesium oxide/anhydrous citric acid. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May be associated with fluid and electrolyte imbalances.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of naproxen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of naproxen by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
naproxen, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.
- sotalol
sotalol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - sparsentan
naproxen and sparsentan both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Coadministration of NSAIDS, including selective COX-2 inhibitors, may result in deterioration of kidney function (eg, possible kidney failure). Monitor for signs of worsening renal function with concomitant use with NSAIDs.
- spironolactone
spironolactone and naproxen both increase serum potassium. Modify Therapy/Monitor Closely.
- succinylcholine
naproxen and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfasalazine
naproxen and sulfasalazine both increase anticoagulation. Use Caution/Monitor.
naproxen and sulfasalazine both increase serum potassium. Use Caution/Monitor. - sulindac
naproxen and sulindac both increase anticoagulation. Use Caution/Monitor.
naproxen and sulindac both increase serum potassium. Use Caution/Monitor. - tafluprost
tafluprost, naproxen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- telmisartan
telmisartan and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
telmisartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - temocillin
temocillin, naproxen. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
temocillin, naproxen. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - tenecteplase
naproxen and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
- tenofovir DF
tenofovir DF, naproxen. Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of tenofovir DF with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
- terazosin
naproxen decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- terbutaline
naproxen increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ticarcillin
ticarcillin, naproxen. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
ticarcillin, naproxen. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - timolol
timolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tobramycin inhaled
tobramycin inhaled and naproxen both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity
- tolazamide
naproxen increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolbutamide
naproxen increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolfenamic acid
naproxen and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.
naproxen and tolfenamic acid both increase serum potassium. Use Caution/Monitor. - tolmetin
naproxen and tolmetin both increase anticoagulation. Use Caution/Monitor.
naproxen and tolmetin both increase serum potassium. Use Caution/Monitor. - tolvaptan
naproxen and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
naproxen increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trandolapril
trandolapril, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- travoprost ophthalmic
travoprost ophthalmic, naproxen. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- trazodone
trazodone, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- triamcinolone acetonide injectable suspension
naproxen, triamcinolone acetonide injectable suspension. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .
- triamterene
triamterene and naproxen both increase serum potassium. Modify Therapy/Monitor Closely.
- valsartan
valsartan and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
valsartan, naproxen. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - venlafaxine
venlafaxine, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- vitamin K1 (phytonadione)
naproxen increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- voclosporin
voclosporin, naproxen. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- vorapaxar
naproxen, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.
- vortioxetine
naproxen, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.
- warfarin
naproxen, warfarin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Drugs with antiplatelet properties may increase anticoagulation effect of warfarin.
- zanubrutinib
naproxen, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.
- zotepine
naproxen decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Minor (73)
- aceclofenac
aceclofenac will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acemetacin
acemetacin will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acyclovir
naproxen will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- alendronate
naproxen, alendronate. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.
- amikacin
naproxen increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- aminohippurate sodium
naproxen will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- anamu
naproxen and anamu both increase anticoagulation. Minor/Significance Unknown.
- aspirin
aspirin will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin rectal
aspirin rectal will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- balsalazide
naproxen will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefadroxil
cefadroxil will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefamandole
cefamandole will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefpirome
cefpirome will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ceftibuten
ceftibuten will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- celecoxib
celecoxib will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cephalexin
cephalexin will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorpropamide
naproxen will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorthalidone
chlorthalidone will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- choline magnesium trisalicylate
naproxen will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- creatine
creatine, naproxen. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.
- cyclopenthiazide
cyclopenthiazide will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- danshen
naproxen and danshen both increase anticoagulation. Minor/Significance Unknown.
- devil's claw
naproxen and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- diclofenac
diclofenac will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- diclofenac topical
diclofenac topical, naproxen. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.
- diflunisal
diflunisal will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- eplerenone
naproxen decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- etodolac
etodolac will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- fenoprofen
fenoprofen will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- feverfew
naproxen decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.
- flurbiprofen
flurbiprofen will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- furosemide
naproxen decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- ganciclovir
naproxen will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- gentamicin
naproxen increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- hydrochlorothiazide
hydrochlorothiazide will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- imidapril
naproxen decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- indapamide
indapamide will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indomethacin
indomethacin will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketoprofen
ketoprofen will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac
ketorolac will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac intranasal
ketorolac intranasal will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- lornoxicam
lornoxicam will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meclofenamate
meclofenamate will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mefenamic acid
mefenamic acid will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meloxicam
meloxicam will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mesalamine
naproxen will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- metolazone
metolazone will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nabumetone
nabumetone will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- neomycin PO
naproxen increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- nitazoxanide
nitazoxanide, naproxen. Either increases levels of the other by Mechanism: plasma protein binding competition. Minor/Significance Unknown.
- noni juice
naproxen and noni juice both increase serum potassium. Minor/Significance Unknown.
- ofloxacin
ofloxacin, naproxen. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
- oxaprozin
naproxen will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- parecoxib
naproxen will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- paromomycin
naproxen increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- piroxicam
naproxen will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- rose hips
rose hips will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salicylates (non-asa)
naproxen will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salsalate
naproxen will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- streptomycin
naproxen increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- sulfasalazine
naproxen will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulindac
naproxen will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tobramycin
naproxen increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- tolfenamic acid
naproxen will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tolmetin
naproxen will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- triamterene
triamterene, naproxen. Other (see comment). Minor/Significance Unknown. Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.
naproxen increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity. - valganciclovir
naproxen will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- vancomycin
naproxen increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.
- willow bark
naproxen will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Adverse Effects
1-10%
Abdominal pain (3-9%)
Constipation (3-9%)
Dizziness (3-9%)
Drowsiness (3-9%)
Headache (3-9%)
Heartburn (3-9%)
Nausea (3-9%)
Edema (3-9%)
GI bleeding (1-4%)
GI perforation (1-4%)
Lightneadedness (<3%)
GI ulcers (1-4%)
Fluid retention (3-9%)
Diarrhea (1-3%)
Stomatitis (<3%)
Diverticulitis (1-3%)
Dyspnea (3-9%)
Hearing disturbances (<3%)
<1%
Meaningful (3 × upper limit of normal) elevation of serum alanine aminotransferase or aspartate aminotransferase
Warnings
Black Box Warnings
Cardiovascular risk
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase risk of serious cardiovascular thrombotic events, myocardial infarction (MI), and stroke, which can be fatal
- Risk may increase with duration of use
- Patients with existing cardiovascular disease or risk factors for such disease may be at greater risk
- NSAIDs are contraindicated for perioperative pain in setting of coronary artery bypass graft (CABG) surgery
Gastrointestinal risk
- NSAIDs increase risk of serious GI adverse events, including bleeding, ulceration, and gastric or intestinal perforation, which can be fatal
- GI adverse events may occur at any time during use and without warning symptoms
- Elderly patients are at greater risk for serious GI events
Contraindications
Absolute: Aspirin allergy; perioperative pain in setting of coronary artery bypass graft (CABG) surgery
Relative: Bleeding disorders, delayed esophageal transit, hepatic disease, peptic ulcer, renal impairment, stomatitis, late pregnancy (may cause premature closure of ductus arteriosus)
Cautions
Use caution in congestive heart failure (CHF), hypertension, renal/hepatic impairment, or aspirin sensitive asthma
May increase risk of aseptic meningitis, especially in patients with systemic lupus erythematosis and mixed connective tissue disorders
Prolonged use may increase risk of adverse cardiovascular events
May cause anaphylactoid reactions, even in patients with no prior exposure to NSAIDs
Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include elderly individuals, those with impaired renal function, hypovolemia, heart failure, liver dysfunction, or salt depletion, and those taking diuretics, angiotensin-converting enzyme inhibitors, or angiotensin-receptor blockers
May cause drowsiness, dizziness, and blurred vision
Platelet aggregation and adhesion may be decreased; may prolong bleeding time; monitor closely patients with coagulation disorders
Patient should ask a doctor or pharmacist, before taking this medication, if under a doctor's care for any serious condition, taking aspirin for heart attack or stroke (drug may decrease benefit of aspirin), or if taking any other drug
May increase risk of hyperkalemia in the elderly, renal disease, or diabetics, especially when used concomitantly with drugs that increase hyperkalemia
May cause serious skin reactions including exfoliative dermatitis, toxic epidermal syndrome, Stevens-Johnson syndrome, and toxic epidermal necrolysis; discontinue therapy at first sign of skin rash
May cause new-onset of hypertension; monitor blood pressure closely throughout therapy
OTC use not for children <12 years
Withhold for at least 4-6 half-lives prior to surgery or dental procedure
Heart failure risk
- NSAIDS have the potential to trigger HF by prostaglandin inhibition that leads to sodium and water retention, increased systemic vascular resistance, and blunted response to diuretics
- NSAIDS should be avoided or withdrawn whenever possible
- Heart failure: risk is higher if you administer more than directed or for longer than directed
- AHA/ACC Heart Failure Guidelines; Circulation. 2016; 134
Drug reaction with eosinophilia and systemic symptoms
- Drug Reaction reported in patients taking NSAIDs; some of these events have been fatal or life-threatening; DRESS typically, although not exclusively, presents with fever, rash, lymphadenopathy, and/or facial swelling
- Other clinical manifestations may include hepatitis, nephritis, hematological abnormalities, myocarditis, or myositis; sometimes symptoms of DRESS may resemble an acute viral infection
- Eosinophilia is often present; because this disorder is variable in its presentation, other organ systems not noted here may be involved
- Early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident; if such signs or symptoms are present, discontinue therapy and evaluate the patient immediately
Pregnancy & Lactation
Pregnancy
When self-medicating, if pregnant or breast-feeding, ask a health professional before use; it is especially important not to take medication at 20 weeks or later in pregnancy unless definitely directed to do so by a doctor because it may cause problems in unborn child or complications during delivery
Use of NSAIDs can cause premature closure of fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment
Because of these risks, limit dose and duration of use between about 20 and 30 weeks of gestation, and avoid use at about 30 weeks of gestation and later in pregnancy
Use of NSAIDs at about 30 weeks gestation or later in pregnancy increases risk of premature closure of fetal ductus arteriosus
If an NSAID is necessary at about 20 weeks gestation or later in pregnancy, limit use to lowest effective dose and shortest duration possible; if treatment extends beyond 48 hours, consider monitoring with ultrasound for oligohydramnios; if oligohydramnios occurs, discontinue therapy and follow up according to clinical practice
Data from observational studies regarding other potential embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive
Animal data
- In animal reproduction studies in rats, rabbits, and mice no evidence of teratogenicity or fetal harm when naproxen was administered during the period of organogenesis at doses 0.13, 0.26, and 0.6 times maximum recommended human daily dose of 1500 mg/day, respectively
- Based on animal data, prostaglandins have been shown to have an important role in endometrial vascular permeability, blastocyst implantation, and decidualization
- In animal studies, administration of prostaglandin synthesis inhibitors resulted in increased pre-and post-implantation loss; prostaglandins also have been shown to have an important role in fetal kidney development; in published animal studies, prostaglandin synthesis inhibitors have been reported to impair kidney development when administered at clinically relevant doses
- There are no studies on effects of therapy during labor or delivery; in animal studies, NSAIDS inhibit prostaglandin synthesis, cause delayed parturition, and increase incidence of stillbirth
Lactation
Based on available published clinical data, drug may be present in human milk; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclooxygenase (COX) isoenzymes, COX-1 and COX-2
May inhibit chemotaxis, alter lymphocyte activity, decrease proinflammatory cytokine activity, and inhibit neutrophil aggregation; these effects may contribute to anti-inflammatory activity
Absorption
Bioavailability: 95%
Onset: 30-60 min
Duration: < 12 hr
Peak serum time: 1-4 hr (tablets); 2-12 hr (delayed release empty stomach); 4-24 hr (delayed relase with food)
Peak plasma concentration: 62-96 mcg/mL
Distribution
Protein bound: <99%
Vd: 0.16 L/kg
Metabolism
Metabolized in liver via conjugation
Metabolites: 6-Desmethylnaproxen, glucuronide conjugates
Enzymes inhibited: COX-1, COX-2
Elimination
Half-life: 12-17 hr
Dialyzable: No value
Clearance: 0.13 mL/min/kg
Excretion: Urine (95%), feces (<3%)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| EC-Naproxen oral - | 375 mg tablet |  | |
| EC-Naproxen oral - | 500 mg tablet |  | |
| Naprosyn oral - | 500 mg tablet |  | |
| Naprosyn oral - | 500 mg tablet |  | |
| Naprosyn oral - | 125 mg/5 mL suspension |  | |
| EC-Naprosyn oral - | 500 mg tablet | | |
| EC-Naprosyn oral - | 375 mg tablet | | |
| EC-Naprosyn oral - | 500 mg tablet |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 250 mg tablet |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 250 mg tablet |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 250 mg tablet |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 250 mg tablet |  | |
| naproxen oral - | 250 mg tablet |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 125 mg/5 mL suspension |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 250 mg tablet |  | |
| naproxen oral - | 125 mg/5 mL suspension |  | |
| naproxen oral - | 500 mg tablet |  | |
| naproxen oral - | 375 mg tablet |  | |
| naproxen oral - | 125 mg/5 mL suspension |  | |
| naproxen oral - | 250 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
naproxen oral
NAPROXEN ENTERIC-COATED TABLET - ORAL
(nah-PROX-en)
COMMON BRAND NAME(S): EC-Naprosyn
WARNING: Nonsteroidal anti-inflammatory drugs (including naproxen) may rarely increase the risk for a heart attack or stroke. This effect can happen at any time while taking this drug but is more likely if you take it for a long time. The risk may be greater in older adults or if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Do not take this drug right before or after heart bypass surgery (CABG).This drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning at any time while taking this drug. Older adults may be at higher risk for this effect.Stop taking naproxen and get medical help right away if you notice any of these rare but serious side effects: stomach/abdominal pain that doesn't go away, black/tarry stools, vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating, confusion, weakness on one side of the body, trouble speaking, sudden vision changes.Talk to your doctor or pharmacist about the benefits and risks of taking this drug.
USES: Naproxen is used to relieve mild to moderate pain from various conditions. It also reduces pain, swelling, and joint stiffness from arthritis. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation.If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.This form of naproxen is absorbed slowly and should not be used for pain that needs quick relief (such as during a gout attack). Ask your doctor or pharmacist about using a different form of this drug or other medications for quick relief of pain.
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start using naproxen and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually twice daily with or without food. Swallow this medication whole. Do not break, crush, or chew the tablets. Doing so can release the drug too quickly, increasing the risk of side effects. Take this medication with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise. Do not lie down for at least 10 minutes after taking this drug.The dosage is based on your medical condition and response to treatment. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose or take this drug more often than directed. For ongoing conditions such as arthritis, continue taking this medication as directed by your doctor.For certain conditions (such as arthritis), it may take up to two weeks of taking this drug regularly until you get the full benefit.Tell your doctor if your condition does not improve or if it worsens.
SIDE EFFECTS: See also Warning section.Upset stomach, nausea, heartburn, headache, drowsiness, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, difficult/painful swallowing, hearing changes (such as ringing in the ears), mental/mood changes, signs of kidney problems (such as change in the amount of urine), unexplained stiff neck, vision changes, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: nausea/vomiting that doesn't stop, loss of appetite, dark urine, stomach/abdominal pain, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking naproxen, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before taking this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), blood disorders (such as anemia, bleeding/clotting problems), growths in the nose (nasal polyps), heart disease (such as previous heart attack), high blood pressure, liver disease, stroke, throat/stomach/intestinal problems (such as bleeding, heartburn, ulcers).Kidney problems can sometimes occur with the use of NSAID medications, including naproxen. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana (cannabis).This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be at greater risk for stomach/intestinal bleeding, kidney problems, heart attack, and stroke while using this drug.Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks. Tell your doctor if you are pregnant or if you plan to become pregnant. This medication may harm an unborn baby and cause problems with normal labor/delivery. It is not recommended for use in pregnancy from 20 weeks until delivery. If your doctor decides that you need to use this medication between 20 and 30 weeks of pregnancy, you should use the lowest effective dose for the shortest possible time. You should not use this medication after 30 weeks of pregnancy.This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), cidofovir, corticosteroids (such as prednisone), lithium, "water pills" (diuretics such as furosemide).Do not take this medication with antacids or other drugs that decrease stomach acid (including famotidine, ranitidine, proton pump inhibitors such as omeprazole). These products may affect the enteric coating of this drug, causing the medication to be released too quickly and increasing the risk of side effects.This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to naproxen and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Daily use of naproxen may decrease aspirin's ability to prevent heart attack/stroke. Talk with your doctor about the risks and benefits. Ask about other medications that can be used to treat pain/fever.This medication can affect the results of certain laboratory tests, possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach pain, extreme drowsiness, seizures.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood pressure, complete blood count, liver/kidney function) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.If you have arthritis, lifestyle changes (such as weight loss if needed, strengthening/conditioning exercises) may help improve your flexibility and joint function. Consult your doctor for specific instructions.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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