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Naproxen

Sounds like 'nah-PROX-en'

Key points about naproxen

Naproxen is an anti-inflammatory used to treat pain and inflammation.
Naproxen is commonly called Noflam, Naprosyn Naprogesic® and Sonaflam®.
Find out how to take it safely and possible side effects.

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Naproxen belongs to a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs). It's used to treat different types of pain such as period pain and pain from injury or after surgery.

NSAIDs are also used to ease pain, swelling and stiffness associated with flare-ups of gout, osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. NSAIDs block the inflammation process and in this way ease swelling and pain.

In New Zealand naproxen is available as tablets.

Tablets comes as immediate release and slow release (SR).
The immediate release tablets are useful where immediate pain relief is required, and the slow release tablets are more useful in reducing long term inflammation.
Lower strengths of naproxen tablets (Naprogesic® and Sonaflam®) can be bought over-the-counter from a pharmacy.

The dose of naproxen will be different for different people. As a guide:

For a long-term condition (such as arthritis), the usual dose is 500 mg to 1 gram per day, taken as either a single dose, or divided into 2 doses during the day.
For short-term conditions (such as muscle/tendon pain or sprains/strains), the usual dose is 250 mg, 3 or 4 times a day when needed. It is often recommended that a double dose (500 mg) be taken for the first dose.
For gout pain, the usual dose is 750 mg for the first dose, and then 250 mg every 8 hours until the flare has passed.
For period pain, the usual dose is 250 mg or 275 mg 3 to 4 times a day for up to 5 days.

Always take your naproxen exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions.

Take naproxen with food or immediately after food, to prevent stomach upset. Take naproxen with a full glass of water. Swallow the tablets whole, don't crush or chew them.
Avoid or limit alcohol while you are taking naproxen. Alcohol can increase the risk of side effects such as stomach upset.
Missed dose: If you forget to take a dose, take it when you next need pain relief and then continue as before. Don't take 2 doses together to make up for a forgotten dose.

For most people taking naproxen is safe but extra care is needed in some situations, for example if:

you have high blood pressure
you have heart or kidney problems or asthma
you're aged 65 years or older
you smoke.

It can also be harmful to take naproxen when you are dehydrated or have been sick with diarrhoea (runny poos) or vomiting (being sick). Read more about the risks of NSAIDs.

When you should NOT take naproxen
Naproxen should NOT be used in some situations as it can be harmful. For example, if you: have current or previous stomach problems such as ulcers or bleeding are pregnant have heart failure or chest pain (angina) have had a stroke or heart attack have chronic kidney disease have had an allergic reaction (such as hives or trouble breathing) to ibuprofen, aspirin, or other similar medications (discuss with your healthcare provider) are taking medicines to reduce blood clots (anticoagulants) such as warfarin, dabigatran and rivaroxaban are also taking other anti-inflammatory medicines, eg, diclofenac (Voltaren®), ibuprofen (Brufen) or celecoxib (Celebrex) are taking some blood pressure medicines such as ACE inhibitors, ARBs, diuretics. Always check with your healthcare provider before taking NSAIDs. Read more about the risks associated with NSAIDs.

When you should NOT take naproxen

Naproxen should NOT be used in some situations as it can be harmful. For example, if you:

have current or previous stomach problems such as ulcers or bleeding
are pregnant
have heart failure or chest pain (angina)
have had a stroke or heart attack
have chronic kidney disease
have had an allergic reaction (such as hives or trouble breathing) to ibuprofen, aspirin, or other similar medications (discuss with your healthcare provider)
are taking medicines to reduce blood clots (anticoagulants) such as warfarin, dabigatran and rivaroxaban
are also taking other anti-inflammatory medicines, eg, diclofenac (Voltaren®), ibuprofen (Brufen) or celecoxib (Celebrex)
are taking some blood pressure medicines such as ACE inhibitors, ARBs, diuretics. Always check with your healthcare provider before taking NSAIDs.

Read more about the risks associated with NSAIDs.

Don't take other anti-inflammatory medicines such as diclofenac, ibuprofen or celecoxib while taking naproxen. This can increase your risk of side effects.

It's safe to take naproxen with paracetamol because they work differently.

Naproxen interacts with some medicines, especially those used for high blood pressure, so check with your doctor or pharmacist before you start taking naproxen.

Image credit: University of Otago, NZ

Taking NSAIDs together with blood pressure medicines can be harmful to your kidneys. This is called the ‘triple whammy’. If you are taking blood pressure medicines (ACE inhibitors or ARBs and diuretics) tell your doctor or pharmacist before starting naproxen.

Examples of ACE inhibitors are captopril, cilazapril, enalapril, lisinopril, perindopril and quinapril.
Examples of ARBs are candesartan, irbesartan and losartan.
Examples of diuretics are furosemide, bumetanide, bendroflumethiazide, chlortalidone, indapamide, spironolactone, eplerenone and metolazone.

Read more about the triple whammy.(external link)

Side effects	What should I do?
Heartburn Indigestion Stomach discomfort Runny poo (diarrhoea)	These are common and should settle within a few days. Take naproxen with food. Talk to your doctor if they're ongoing.
Serious stomach problems such as really bad stomach pain, blood in the stool or black stools, cough or vomit up blood or dark coloured vomit.	Stop taking naproxen. Tell your doctor immediately or ring Healthline on 0800 611 116.
Chest pain Shortness of breath or trouble breathing Weakness in one part or side of the body Slurred speech	Stop taking naproxen. Tell your doctor immediately or ring Healthline on 0800 611 116.
Swollen ankles, blood in your pee or not peeing at all – these can be signs of a kidney problem.	Stop taking naproxen. Tell your doctor immediately or ring Healthline on 0800 611 116.
Signs of an allergic reaction such as skin rash, itching, swelling of your lips, face and mouth or difficulty breathing	Stop taking naproxen. Tell your doctor immediately or ring Healthline on 0800 611 116.
Read more about medicines and side effects and reporting a reaction you think might be a side effect.

Types of pain
NSAIDs
Gout | Mate waikawa kai kōiwi
Painful periods

The following links have more information about naproxen.

Naproxen(external link) (te reo Māori(external link)) NZ Formulary Patient Information

Medsafe Consumer Information Sheets: