Naproxen belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). Its mechanism of action is based on blocking cyclooxygenase 1 and 2 (COX-1 and COX-2), which inhibits the synthesis of prostaglandins and prostacyclins responsible for inflammation, pain sensation and an increase in body temperature. Therefore, this mechanism indicates the activity of naproxen: anti-inflammatory, analgesic and antipyretic.

Naproxen: indications

Naproxen can be used orally and rectally to treat:

  • rheumatoid arthritis (RA),
  • gout attacks,
  • acute pain conditions related to: migraine, tension headache, postoperative pain, postpartum pain,
  • dysmenorrhea,
  • muscle and joint pains: sprain, post-exercise damage, tendinitis, bursitis, lumbar pain.

It is also used topically, e.g. in the form of a gel, in the treatment of muscle and joint pain and osteoarthritis.

Naproxen: dosage

Dosage depends on the indication for use. In adults (oral and rectal):

  • in rheumatic diseases:500 mg to 1 g daily in 2 doses divided every 12 hours or in a single dose. It is recommended to use a loading dose of 750 mg or 1 g daily in acute conditions,
  • In acute musculoskeletal disorders and dysmenorrhea:starting dose is 500 mg once, then 250 mg every 6 to 8 hours as needed. The maximum daily dose is 1250 mg,
  • in acute gout:starting dose is 750 mg, then 250 mg every eight hours until the seizure is over.

Naproxen can be in free form or as the sodium s alt, which dissolves faster in the stomach, so it reaches high blood levels more quickly. The maximum concentration is reached after 2-4 hours.

The lowest effective dose should be used for the shortest possible period of time in order to minimize the risk of side effects. This is especially important in the case of elderly patients, who are at a much higher risk of developing side effects. Naproxen in this group of patients is found into a greater extent in a form unbound with proteins, and therefore in a pharmacodynamically active form.

Naproxen can also be used in children over 5 years of age in juvenile rheumatoid arthritis in the dose of 10 mg / kg bw twice a day. This is the only indication for the use of naproxen in children under 16 years of age.

Topical naproxen should be used 4-5 times a day for a maximum of 4 weeks. Be aware that substances may be absorbed into the bloodstream and cause systemic effects.

Naproxen: contraindications and precautions

The main contraindications to the use of naproxen are:

  • hypersensitivity to the active substance,
  • history of any allergy symptoms such as runny nose, urticaria or bronchial asthma during treatment with acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (NSAIDs),
  • severe liver failure,
  • severe kidney failure,
  • severe heart failure,
  • peptic ulcer of the stomach and / or duodenum (history of or active activity), perforation or bleeding, also with NSAIDs,
  • third trimester of pregnancy,
  • hemorrhagic diathesis.

Take special care with concomitant use of naproxen with:

  • drugs that lower blood pressure and diuretics - their effect decreases,
  • cardiac glycosides - increasing their toxicity,
  • anticoagulants (warfarin) - increasing their effect, and therefore the risk of bleeding,
  • corticosteroids,
  • antiplatelet drugs and selective serotonin reuptake inhibitors (SSRIs) - increasing the risk of gastrointestinal ulceration and bleeding,
  • with tacrolimus and cyclosporine - increasing the nephrotoxicity of naproxen.

Naproxen should not be used together with other drugs from the NSAID group, as it increases the risk of side effects (especially the risk of gastrointestinal bleeding), and at the same time we do not obtain increased potency.

Due to the occurrence of side effects such as drowsiness, dizziness, fatigue and even visual disturbances, you should not drive or operate machinery after taking naproxen.

Naproxen: side effects

The side effects of naproxen are:

  • dizziness,
  • sleepiness,
  • visual disturbance,
  • peptic ulcer,
  • gastrointestinal perforation,
  • stomach bleeding,
  • nausea,
  • vomiting,
  • diarrhea,
  • hypersensitivity reactions,
  • a slight increase in the risk of arterial blockage (e.g. heart attack or stroke) - when taking long-term high doses of NSAIDs,
  • nephrotoxic effect.

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