Naproxen: Difference between revisions

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| generic = Naproxen

| generic = Naproxen (sodium; free acid)

| brand = Aleve, Naprosyn

| brand = Aleve (OTC), Naprosyn (Rx), Anaprox (Rx), Naprelan (ER), EC-Naprosyn (enteric-coated), Vimovo (with esomeprazole)

| classes = NSAID

| structure =

| ~~intro~~ = ~~Naproxen is a non~~-selective ~~non~~-~~steroidal anti~~-~~inflammatory drug~~ (~~NSAID~~) with a ~~relatively long duration of action~~.

| classes = [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID)]], [[:Category:Analgesics|Analgesic]], [[:Category:Antipyretics|Antipyretic]]

| uses = <vote slug="mild-moderate-pain-use">Mild-to-moderate pain (FDA)</vote>, <vote slug="fever-use">Fever (FDA)</vote>, <vote slug="osteoarthritis-use">Osteoarthritis (FDA)</vote>, <vote slug="rheumatoid-arthritis-use">Rheumatoid arthritis (FDA)</vote>, <vote slug="ankylosing-spondylitis-use">Ankylosing spondylitis (FDA)</vote>, <vote slug="dysmenorrhea-use">Primary dysmenorrhea (FDA)</vote>, <vote slug="tendinitis-bursitis-use">Tendinitis and bursitis (FDA)</vote>, <vote slug="acute-gout-use">Acute gout (FDA)</vote>

| starting_dose = OTC: 220 mg PO every 8-12 hours, max 660 mg/24h. Rx: 250-500 mg PO BID. Acute gout: 750 mg loading then 250 mg every 8 hours

| preparations = OTC tablets 220 mg; Rx tablets 250, 375, 500 mg; ER tablets 375, 500, 750 mg (Naprelan); oral suspension 125 mg/5 mL; enteric-coated tablets (EC-Naprosyn)

| fda_max = 1500 mg/day (Rx); 660 mg/24h (OTC, without provider direction)

| pill_id =

| routes = Oral

| onset = 30-60 minutes

| duration = 8-12 hours (the long-duration feature relative to ibuprofen)

| halflife = 12-17 hours<ref name="naprosyn-label">FDA Prescribing Information, Naprosyn (naproxen), Roche/Atnahs, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/017581s113lbl.pdf</ref>

| bioavailability = ~95% (oral)<ref name="naprosyn-label" />

| pregnancy = Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)<ref name="naprosyn-label" />

| legal = [[USLegal:Over-the-counter|OTC]] in US at ≤220 mg/tablet and ≤660 mg/day; [[USLegal:Prescription only|Rx-only]] at higher strengths

| mechanism = <vote slug="naproxen-mech-claim">Non-selective inhibitor of both COX-1 and COX-2, with slight COX-1 preference at therapeutic doses (in contrast to ibuprofen's roughly balanced profile). Anti-inflammatory and analgesic effect derives from reduced prostaglandin synthesis.</vote> Among the '''lower-cardiovascular-risk NSAIDs''' per PRECISION-trial-era data, the basis for the guideline preference of naproxen over other NSAIDs in patients with elevated cardiovascular risk who still require NSAID therapy. The long half-life allows twice-daily dosing, a clinical advantage over ibuprofen's QID-to-q8h requirements. Same GI bleeding, renal impairment, and Boxed-Warning class effects as other NSAIDs<ref name="naprosyn-label" />.

}}

== References ==

[[Category:NSAIDs]]

[[Category:Analgesics]]

[[Category:Antipyretics]]

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