Is Naproxen a strong painkiller?

Naproxen is a mild to moderate painkiller belong to the family of Non-Steroidal Anti Inflammatories (NSAIDs), the same family as Ibuprofen and Diclofenac.

It is used to treat pain and inflammation in a variety of conditions such as:

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Acute gout attacks
• Headaches
• Muscle aches
• Headaches
• Back aches 

Naproxen generally has a longer duration of action than Ibuprofen and can stay active in the body from 8-12 hours.

Naproxen is not as strong as opioid based painkillers such as codeine or morphine, and hence is not suitable for post-surgical pain relief, especially after major surgery.

Naproxen can come in both; Over the Counter (OTC) and Prescription forms. Over the counter forms can be used for mild conditions such as headaches, back aches or muscle aches. Prescription forms are prescribed for more chronic conditions like arthritis or gout, and their flare ups.

Naproxen also comes in the form of Naproxen sodium which helps it be better absorbed into the bloodstream.  The doses of Naproxen sodium and Naproxen are similar whereas the doses of Prescription Naproxen are slightly higher.  Please speak to your healthcare advisor about the right form and dose of Naproxen for you.

Naproxen like all medications has some side effects and these can range from mild or moderate to severe. Check out the list of the prominent side effects on our website below and the full list in the patient information leaflet provided in the medicine pack. 

What is naproxen?

Naproxen is a Non-Steroidal Anti Inflammatory (NSAID) that works to reduce inflammation and pain in the body.  The NSAID class has other well-known medicines such as Ibuprofen, Celecoxib and Diclofenac. It reduces the production of inflammatory substances in the body like Prostaglandins that otherwise cause inflammation, pain and fever. 

What is naproxen used for?

Naproxen can be used to treat a range of health issues such as rheumatoid arthritis, osteoarthritis, gout flare ups, period pains, tendonitis, bursitis or ankylosing spondylitis. Due to being non-steroidal, it can also be used to treat muscle and bone disorders such as sprains or back pain. 

How to take naproxen?

You should take Naproxen as advised by your GP or alternative suitable healthcare provider. This usually involves the following guidelines:

If taking Over the Counter (OTC) Naproxen:

• Take the usual dose tablet (220 mg) every 8-12 hours for pain relief
• You can take 2 tablets for the first dose if needed but do not exceed 440 mg of Naproxen (2 tablets) in a 12-hour period or 660mg (3 tablets) in a 24 hour period.

If taking prescription naproxen:

Prescription doses can range from 250 mg to 500 mg and can come in 3 tablet forms;  standard, effervescent and gastro-resistant as well as in a liquid.

The standard tablet form should be swallowed with milk or food, this helps lower the risk of stomach irritation.

Effervescent tablets should be completely dissolved in a glass of water and swallowed with food or soon after food to reduce the risk of stomach irritation.

Gastro-resistant tablets should be swallowed whole (It is not advisable to chew these) alongside or shortly after food. The Gastro-resistant form is coated to avoid being digested by the stomach and is instead digested in the bowels. This helps reduce the risk of stomach irritation.

If taking the liquid forms of Naproxen, use the syringe provided to measure out the prescribed amount. Liquid naproxen should also be taken with or shortly after food.

When considering how long Naproxen takes to kick in; it’s important to consider that it takes around 30 minutes to 1 hour to work depending on factors such as the food its taken with, the condition being treated and individual response.

After taking Naproxen, avoid lying down for 10-15 minutes, this reduces the risk that the medicine will irritate your oesophagus (the tube that connects the mouth to the stomach). 

With Naproxen the foods to avoid are mainly alcohol as it can increase the risk of stomach irritation.

Please take Naproxen as prescribed or advised by your healthcare provider, alternatively please follow the instructions in the patient information leaflet provided. 

Can anyone take naproxen?

Most people over the age of 18 can take naproxen and most children over the age of 15 can buy Naproxen from a pharmacy for period pains.

Naproxen can be taken by children under 15 in the following circumstances:

• For Period pains
• For children aged 2 years and above who have muscle or joint problems
• For children aged 1 month who have muscle or bone disorders.

Naproxen isn’t the appropriate medication for everyone, due to its side effect profile, this is particularly for people who have underlying medical conditions. Please speak to your healthcare advisor about whether Naproxen is right for you.

Naproxen is generally not advised in people who are pregnant, trying to conceive or breastfeeding.

Naproxen is also not advisable for people who have

• Allergies to other NSAID’s like Ibuprofen or diclofenac
• Kidney Failure
• Liver failure
• High blood pressure
• Stomach ulcers
• Blood-clotting disorder
• Conditions like lupus, Chron’s or ulcerative colitis

Why is it important to use naproxen as directed? 

Naproxen is meant as a short-term treatment and not taking it as directed can increase the risks of harmful side effects.

It is important to take naproxen as advised by your healthcare provider.

Do not take naproxen for longer than is recommended by your healthcare provider. This can cause an overdose in the body. If you think you have taken too much Naproxen, call 999 or go to Accident and Emergency as soon as possible.

You should avoid missing doses or not sticking to the prescribed schedule as this may mean Naproxen will not work as well or at all.

If you miss a dose, you should take it as soon as possible. Do not take a missed dose if it’s almost time for your next dose. You should not double up to make up for a mixed dose. 

Side effects of Naproxen 

Like all medications, there are side effects of Naproxen, however these don’t necessarily affect everyone:

 Common side effects:  

• Stomach pains
• Nausea
• Vomiting
• Dizziness
• Confusion
• Constipation
• Swelling in the hands or feet due to fluid build up
• Ringing in the ears
• Vision changes

These common side effects should settle after a few days of use, if they continue, please bring this up to your healthcare provider so they can appropriately alter your dose or provide an alternative treatment option.

Serious side effects:

• Chest Pain
• Issues with breathing
• Weakness in one area or side of the body
• Difficulty speaking
• Chest pain which spreads to your left neck or arm
• High blood pressure
• Irregular slow heartbeat
• Frequent sore throat, infection or nose bleed

If you experience any of these side effects, seek medical attention immediately.

Allergic reactions 

If you experience any allergic side effects to Naproxen, such as the following, call 999 or go to A&E immediately:

• Red, blistered or itchy skin
• Tight chest or throat
• Wheezing
• Swelling around the mouth, face, lips, tongue or throat 

Long-term side effects

One of the most common side effects of taking Naproxen long term is an ulcer/break in the stomach lining. This can cause internal bleeding. 

The most common symptom of an ulcer is a burning sensation in the centre of the stomach. However other symptoms include nausea, heartburn or indigestion. 

If you have a previous history of a stomach ulcer, please disclose this to your healthcare provider in your discussions about whether to take naproxen. 

Naproxen dosage

Mild to moderate pain

For mild to moderate pain, the dosage of Over the counter (OTC) naproxen is as follows:

• 1 tablet (220mg) every 8-12 hours
• 2 tablets (440 mg) can be taken for the first dose but do not take more than 2 tablets in the first 12 hours and more than 3 in the first 24 hours
• The typical dose of prescription Naproxen taken for mild to moderate pain can range from 250mg to 500mg taken twice daily.

Do not exceed the 1000mg (maximum dose of naproxen) a day of prescription naproxen.

For conditions like osteoarthritis, rheumatoid arthritis or ankylosing spondylitis:

• Take an initial dose of 250mg to 500mg twice daily of prescription Naproxen followed by a maintenance dose of 250mg to 500mg every 12 hours depending on the levels of pain or inflammation.
• In most cases, the maximum dose per day is 1000mg of Naproxen, however it can be raised to 1500 mg during flare ups under medical supervision.

Please speak to your healthcare provider about the recommended dose and prescribed scheduled of Naproxen for arthritis or ankylosing spondylitis.

Acute gout attacks 

Acute gout attacks is usually treated with prescription naproxen.

• Take 750 mg of Naproxen at the onset of the act and follow up, every 8 hours with 250 mg of follow up Naproxen for the first few days after the attack, depending on how severe the attack is.
• Do not exceed more than 1500mg of Naproxen on the first day of the attack or more than 1000mg on subsequent days.

Please speak to your healthcare provider about the appropriate dose of Naproxen for acute gout attacks.

Juvenile rheumatoid arthritis 

For Juvenile rheumatoid arthritis (JRA), naproxen is given to manage pain and inflammation for children older than 2 yrs.

JRA occurs in children and the typical dose of naproxen prescribed is based on the child’s weight and the specific treatment plan made by a healthcare provider.

The usual dose of naproxen for JRA is 10mg/kg/day depending on the child’s body weight. For example, a child who weighs 40 kg would be given 400mg a day. This daily dosage is divided into 2 and taken twice a day.

Please speak to your healthcare provider about the correct dose of Naproxen for your child’s JRA. 

Headaches

Naproxen can be taken both over the counter (OTC) and via prescription for headaches.

For mild to moderate headaches, OTC doses of naproxen can be used:

• An initial dose of 220 – 440mg followed by another dose of 220mg Naproxen every 8-12 hours.
• When taking OTC naproxen for headaches, Do not use more than 440mg (2 tablets) in a 12 hour time period or more than 660mg (3 tablets) in a 24 hour time period
• For moderate to severe headaches, you may be prescribed Naproxen by your healthcare provider. This is typically an initial dose of 500mg, with follow up doses of 250 mg every 6-8 hours as needed.
• The maximum dose on the first day of use should not be more than 1250mg and 1000mg on subsequent days.

The naproxen dosage of migraine and headaches is similar, however its important to consult your healthcare advisor to determine the right dosage for you.

Please speak to your healthcare provider about the appropriate naproxen dosage for your headaches and a plan for when and how to take your medicines.