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naproxen
Apo-Naproxen†, EC-Naprosyn, Naprosyn, Naprosyn-E†, Naprosyn-SR, Naxen†, Novo-Naprox†, Nu-Naprox†, Nycopren§

naproxen sodium
AleveOTC, Anaprox, Anaprox DS, Apo-Napro-Na†, Naprelan, Naprogesic‡, Novo-Naprox Sodium†, Synflex†

Pregnancy Risk Category B

How supplied
naproxen

Tablets:
250 mg, 375 mg, 500 mg
Tablets (delayed-release):
375 mg, 500 mg
Tablets (extended-release):
750 mg, 1,000 mg
Oral suspension:
125 mg/5 ml
Suppositories:
500 mg‡
naproxen sodium

Tablets (controlled-release):
421.5 mg, 550 mg
Tablets (film-coated):
220 mgOTC, 275 mg, 550 mg
Note:
275 mg of naproxen sodium contains 250 mg of naproxen.

Action
Unknown. Produces anti-inflammatory, analgesic, and antipyretic effects, possibly by inhibiting prostaglandin synthesis.

Indications & dosage
Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, pain, dysmenorrhea, tendinitis, bursitis--

Adults:
250 to 500 mg (naproxen) b.i.d.; maximum is 1.5 g daily for a limited time. Or, 375 to 500 mg delayed-release (EC-Naprosyn) b.i.d.; or 750 to 1,000 mg controlled-release (Naprelan) daily; or 275 to 550 mg naproxen sodium b.i.d.
Juvenile arthritis--

Children:
10 mg/kg P.O. in two divided doses.
Acute gout
--
Adults:
750 mg (naproxen) P.O.; then 250 mg q 8 hours until attack subsides. Or, 825 mg naproxen sodium; then 275 mg q 8 hours until attack subsides. Or, 1,000 to 1,500 mg/day controlled-release (Naprelan) on first day; then 1,000 mg daily until attack subsides.
Mild to moderate pain, primary dysmenorrhea--

Adults:
500 mg (naproxen) P.O.; then 250 mg q 6 to 8 hours up to 1.25 g/day. Or, 550 mg naproxen sodium; then 275 mg q 6 to 8 hours up to 1,375 mg/
day. Or, 1,000 mg controlled-release (Naprelan) once daily.
Elderly:
for patients over age 65, don't exceed 400 mg/day.

Adverse reactions
CNS:
headache, drowsiness, dizziness, vertigo.
CV:
edema, palpitations.
EENT:
visual disturbances, tinnitus, auditory disturbances.
GI:
epigastric distress, occult blood loss, nausea, peptic ulceration, constipation, dyspepsia, heartburn, diarrhea, stomatitis, thirst.
GU:
elevated BUN and creatinine levels.
Hematologic:
increased bleeding time.
Hepatic:
elevated liver enzyme levels.
Metabolic:
hyperkalemia.
Respiratory:
dyspnea.
Skin:
pruritus, rash, urticaria, ecchymosis, diaphoresis, purpura.

Interactions
Drug-drug:
ACE inhibitors: may increase risk of renal impairment. Use together cautiously.
Antihypertensives, diuretics:
decreased effect of these drugs. Monitor patient closely.
Aspirin, corticosteroids:
increased risk of adverse GI reactions. Avoid concomitant use.
Methotrexate:
increased risk of toxicity. Monitor patient closely.
Oral anticoagulants, other sulfonylureas, highly protein-bound drugs:
increased risk of toxicity. Monitor patient closely.
Probenecid:
decreased elimination of naproxen. Monitor for toxicity.
Drug-lifestyle.
Alcohol use: increased risk of adverse GI reactions. Avoid concomitant use.

Effects on diagnostic tests
Drug and its metabolite may interfere with urinary 5-hydroxyindoleacetic acid and 17-hydroxycorticosteroid determinations.

Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with the syndrome of asthma, rhinitis, and nasal polyps.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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