naproxen sodium
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