Naproxen
ALEVE
Pronunciation: na-PROX-en
“Nap-rocks on a levee”
“The N said... NSAID”
What it isNonselective COX-1 and COX-2 inhibitor; pain and inflammation, notably gout and inflammatory arthritis.
Why this oneTwice-daily dosing from a long half-life, and the least cardiovascular signal among the traditional NSAIDs.
What limits itGI bleeding and kidney injury remain; it raises lithium exposure and can worsen hypertension or edema.
Naproxen prescription history
Animated chart of estimated U.S. prescriptions per year, NSAIDs (1914–2026). Naproxen enters in 1976 (estimated).
FDA-approved for
- pain/inflammation (1976)
Classes and tags
Clinical profile
Legacy pregnancy categoryMultiple / indication-, trimester- or formulation-dependent
Defining liabilityGI bleeding, kidney injury, hypertension and fluid retention; many agents increase lithium concentrations.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Minor aches/pains (arthritis, muscular aches, backache, menstrual cramps, headache, toothache, common cold); fever | Adults and children ≥12 y | 1 caplet q8–12h while symptoms last (first dose: may take 2 caplets within the first hour) | 1 caplet q8–12h PRN | 2 caplets per 8–12 h; 3 caplets per 24 h |
| Same uses | Children <12 y | Ask a doctor | Ask a doctor | Undefined |
Renal Undefined (not addressed on OTC label; kidney disease: ask a doctor before use)
Hepatic Undefined (not addressed on OTC label; liver cirrhosis: ask a doctor before use)
Each caplet: naproxen sodium 220 mg (naproxen 200 mg); sodium 21 mg
Instructions
- Do not take more than directed; use smallest effective dose
- Drink a full glass of water with each dose
- Take with food or milk if stomach upset occurs
Available strengths
- tab 220, 250, 375, 500 mg
- cap 200 mg
- DR tab 375, 500 mg
- ER tab 375, 500, 750 mg
- susp 25 mg/mL
Contraindications
- Ever had an allergic reaction to any other pain reliever/fever reducer
- Right before or after heart surgery
Cautions
- Allergy alert: severe allergic reaction, especially if allergic to aspirin (hives, facial swelling, asthma, shock)
- Stomach bleeding warning: higher risk if age 60+, prior ulcers/bleeding, anticoagulant/steroid, other NSAIDs, 3+ drinks/day, or longer/more than directed
- Heart attack and stroke warning: NSAIDs (except aspirin) increase risk of heart attack, heart failure, stroke
- Ask a doctor: history of stomach problems; high blood pressure, heart disease, liver cirrhosis, kidney disease, asthma, or prior stroke; taking a diuretic
- Ask a doctor/pharmacist: taking aspirin for heart attack/stroke (naproxen may decrease its benefit); any other drug
- Stop use: signs of stomach bleeding or heart problems/stroke; pain >10 days or fever >3 days; difficulty swallowing; redness/swelling in painful area; new symptoms
Pregnancy Ask a healthcare professional before use; do not use at 20 weeks or later unless directed by a doctor (problems in unborn child or complications during delivery).
Lactation If breast-feeding, ask a healthcare professional before use.
Cost
Generic entry1993
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Self-check
- How can naproxen affect lithium exposure?
Raises it. - What dosing frequency does naproxen’s long half-life permit?
Twice daily.