Naproxen
Brand Names: Naprosyn, EC-Naprosyn
Generic Available
Common Dosage Forms:
Tablets (Naprosyn): 250 mg, 375 mg, 500 mg
Delayed-release, enteric-coated tablets (EC-Naprosyn): 375 mg, 500 mg
Suspension: 125 mg/5 mL
FDA Indications:
Mild to moderate pain, primary dysmenorrhea, acute tendinitis, and bursitis (delayed-release tablets are not recommended for initial treatment of acute pain because the absorption of naproxen is delayed compared to absorption from other naproxen-containing products): 500 mg initially followed by 250 mg every 6-8 hours, as needed.
Rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis: 250-500 mg twice a day.
Acute gout: 750 mg initially followed by 250 mg every 8 hours until attack is under control.
Not recommended for use in pediatrics.
Monitor: RFT
Pharmacology/Pharmacokinetics: Naproxen’s mechanism of action is probably due to inhibition of cyclooxygenase resulting in a decreased biosynthesis of prostaglandins. Naproxen achieves an analgesic action slightly later than naproxen sodium. Peak plasma levels are reached in 2-4 hours with a half-life of 13 hours. Protein binding to albumin equals 99%. Metabolism and unchanged drug is excreted in the urine.
Drug Interactions: May increase the pharmacological effects of oral anticoagulants, lithium, and methotrexate. Do not use with other nonsteroidal anti-inflammatory agents.
Contraindications/Precautions: Contraindicated in patients hypersensitive to nonsteroidal anti-inflammatory agents. Use with caution in patients with renal impairment, hypertension, fluid retention, heart failure, bleeding disorders or a peptic ulcer, or in the elderly. NSAIDS MAY CAUSE AN INCREASED RISK OF SERIOUS CARDIOVASCULAR THROMBOTIC EVENTS, MYOCARDIAL INFARCTION, AND STROKE. NSAIDS HAVE BEEN INVOLVED IN RARE CASES OF GI BLEEDING INCIDENTS. Pregnancy Category B.
Adverse Effects: Shortness of breath, indigestion, tinnitus, edema, itching, constipation, dizziness, drowsiness, headache, nausea, and vomiting.
Patient Consultation:
May require up to 2 weeks to see noticeable improvement in arthritic conditions.
Take on an empty stomach for better absorption, may take with food to reduce GI upset.
Concurrent ingestion of alcohol may increase ulcerogenic effect.
Avoid aspirin or products containing aspirin without first consulting a physician.
May cause drowsiness. Use caution when operating machinery or when mental alertness is required.
Store in a cool, dry place away from sunlight and children.
To maintain the integrity of enteric coating, the delayed-release tablets should not be broken, chewed, or crushed during ingestion.
If a dose is missed, take it as soon as possible. If it is closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule.
Contact a physician if the above side effects are severe or persistent.