Naproxen

Aka: Naproxen, Naprosyn, Anaprox, Aleve, Naprelan, Prevacid NepraPAC, Vimovo

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II. Indications

  1. FDA approved indications in adults
    1. Rheumatoid Arthritis
    2. Osteoarthritis
    3. Ankylosing Spondylitis
    4. Mild to moderate pain
    5. Dysmenorrhea
    6. Acute Tendinitis or Bursitis
    7. Fever
    8. Acute Gouty Arthritis
  2. FDA approved indications in children
    1. Juvenile Rheumatoid Arthritis
    2. Mild to moderate pain

III. Mechanism

  1. See NSAID
  2. Naproxen is an NSAID in the propionic acid class

IV. Medications: Naproxen

  1. Naproxen Base Immediate Release (Naprosyn): 250 mg, 375 mg, 500 mg
  2. Naproxen Sodium Immediate Release: 200 mg (OTC Aleve), 275 mg, 550 mg (Anaprox)
    1. Naproxen Sodium 275 mg is equivalent to 250 mg Naproxen base
    2. Naproxen Sodium has faster absorption, and faster action onset (1-2 hours) than Naproxen (2-4 hours)
  3. Naproxen Delayed Release Enteric Coated (EC-Naprosyn): 375 mg, 500 mg
  4. Naproxen Controlled Release (Naprelan): 375 mg, 500 mg, 750 mg
  5. Naproxen Suspension: 125 mg/ml

V. Medications: Naproxen Combinations with Antacids

  1. Naproxen 375 mg or 500 mg combined with Lansoprazole 15 mg (Prevacid NepraPAC)
  2. Naproxen 375 mg or 500 mg combined with Esomeprazole 20 mg (Vimovo)
    1. Onset of action is delayed compared with other Naproxen preparations

VI. Dosing: Adult

  1. Naproxen (Naprosyn)
    1. Dose: 250 to 500 mg orally twice daily as needed
    2. Acute gout: 750 mg for one dose, then 250 mg orally every 8 hours until acute flare resolves
  2. Naproxen Sodium (Anaprox, Aleve)
    1. Dose: 275 mg to 550 mg orally twice daily as needed
    2. Naproxen Sodium 275 mg is equivalent to 250 mg Naproxen base
    3. Naproxen Sodium 550 mg is equivalent to 500 mg Naproxen base
  3. Naproxen delayed release Enteric Coated (EC-Naprosyn)
    1. Dose: 375 to 500 mg orally twice daily (do not chew or crush)
  4. Naproxen controlled release (Naprelan)
    1. Dose: 750 to 1000 mg orally daily
    2. Acute gout: 1000 to 1500 mg for one dose, then 1000 mg orally daily until acute flare resolves

VII. Dosing: Child

  1. For age >=2 years old
  2. Juvenile Rheumatoid Arthritis
    1. Give 10 to 20 mg/kg/day (max 1250 mg/day) orally divided twice daily
  3. Mild to moderate pain
    1. Give 5 to 7 mg/kg/dose orally every 8 to 12 hours

VIII. Adverse Effects

  1. See NSAID
  2. See NSAID Gastrointestinal Adverse Effects
  3. See NSAID Renal Adverse Effects
  4. Bleeding risk (inhibits Platelet aggregation)
    1. Naproxen increases risk almost as much as Aspirin

IX. Safety

  1. See NSAID
  2. Considered safe in Lactation
  3. Avoid NSAIDs in pregnancy outside the first part of the second trimester (13 to 20 weeks)
    1. Teratogenic in first trimester
    2. Risk of premature ductus arteriosus closure in the fetus in third trimester
    3. Most NSAIDs carry a legacy system Pregnancy Category B or C designation (aside from third trimester)
      1. However, many obstetricians avoid NSAIDs entirely in pregnancy (even in second trimester)

X. Resources

  1. Naproxen (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bff5df5-d856-4237-b6a8-ae445b454844
  2. Naproxen (StatPearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK525965/

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Related Studies

Cost: Medications

naproxen (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
NAPROXEN 125 MG/5 ML SUSPEN Generic $0.59 per ml
NAPROXEN 250 MG TABLET Generic $0.05 each
NAPROXEN 375 MG TABLET Generic $0.07 each
NAPROXEN 500 MG TABLET Generic $0.07 each
NAPROXEN DR 375 MG TABLET Generic $0.23 each
NAPROXEN DR 500 MG TABLET Generic $2.88 each
NAPROXEN SODIUM 220 MG CAPSULE Generic OTC $0.16 each
NAPROXEN SODIUM 220 MG TABLET Generic OTC $0.06 each
NAPROXEN SODIUM 550 MG TAB Generic $0.29 each
NAPROXEN-ESOMEPRAZ DR 500-20 MG Generic $13.92 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Ontology: Naproxen (C0027396)

Definition (CHV) a drug that relieves pain, inflammation, and fever
Definition (NCI_NCI-GLOSS) A drug used to treat mild pain and the symptoms of arthritis and several other conditions. It is also being studied in the treatment of bone pain in patients with cancer. Naprosyn stops the body from making substances that cause pain and inflammation. It is a type of nonsteroidal anti-inflammatory drug (NSAID) and a type of cyclooxygenase inhibitor.
Definition (NCI) A propionic acid derivative and a non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, antipyretic and analgesic activities. Naproxen inhibits the activity of the enzymes cyclo-oxygenase I and II, resulting in a decreased formation of precursors of prostaglandins and thromboxanes. The resulting decrease in prostaglandin synthesis is responsible for the therapeutic effects of naproxen. Naproxen also causes a decrease in the formation of thromboxane A2 synthesis, by thromboxane synthase, thereby inhibiting platelet aggregation.
Definition (MSH) An anti-inflammatory agent with analgesic and antipyretic properties. Both the acid and its sodium salt are used in the treatment of rheumatoid arthritis and other rheumatic or musculoskeletal disorders, dysmenorrhea, and acute gout.
Definition (CSP) 6-methoxy-alpha-methyl-2-naphthaleneacetic acid; nonsteroidal antiinflammatory drug (NSAID); acts by inhibiting cyclooxygenase and thus prostaglandin synthesis; tocolytic oxytocin antagonist.
Definition (PDQ) A propionic acid derivative and a non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, antipyretic and analgesic activities. Naproxen inhibits the activity of the enzymes cyclo-oxygenase I and II, resulting in a decreased formation of precursors of prostaglandins and thromboxanes. The resulting decrease in prostaglandin synthesis is responsible for the therapeutic effects of naproxen. Naproxen also causes a decrease in the formation of thromboxane A2 synthesis, by thromboxane synthase, thereby inhibiting platelet aggregation. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40222&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40222&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C680" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009288
SnomedCT 363614005, 11847009, 372588000
LNC LP16215-3, MTHU015374
English Methoxypropiocin, MNPA, Naproxen, 2-Naphthaleneacetic acid, 6-methoxy-alpha-methyl-, (S)-, d-2-(6-Methoxy-2-naphthyl)propionic Acid, 6-Methoxy-alpha-methyl-2-naphthaleneacetic Acid, naproxen, NAPROXEN, naproxen (medication), non-prescription naproxen, non-prescription naproxen (medication), Naproxen [Chemical/Ingredient], Naproxen product, Naproxen product (substance), Naproxen (product), Naproxen (substance)
Swedish Naproxen
Czech naproxen
Finnish Naprokseeni
Russian NAPROKSEN, НАПРОКСЕН
Japanese ナプロキセン
Spanish Naproxeno, Naproxen, naproxeno (producto), naproxeno (sustancia), naproxeno
Polish Naproksen
French Naproxène
German Naproxen
Italian Naproxene
Portuguese Naproxeno
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Anaprox (C0699095)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009288
English anaprox, Anaprox
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Naprosyn (C0700017)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009288
English naprosyn, naprosin, Naprosin, Naprosyn
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Aleve (C0718343)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009288
English aleve, Aleve
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Analgesic Medications

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