Apo-Naproxen

Brand Names: Apo-Naproxen

Common Name: naproxen

What is this drug used for?

Naproxen belongs to the class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It is used to treat the symptoms of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and juvenile rheumatoid arthritis. It is also used for the relief of minor aches and pains in muscles, bones, and joints; mild-to-moderate pain accompanied by inflammation in injuries (e.g., sprains and strains); and menstrual cramps.

It relieves pain and reduce swelling and inflammation by reducing a substance in the body that leads to inflammation and pain. If immediate relief of pain is desired, the long-acting forms of naproxen (such as the enteric-coated forms) are not recommended as they release the medication over a longer period of time.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Is there any reason not to take this drug?

Naproxen should not be taken by anyone who:

• is or may be allergic to naproxen or to any of the ingredients of the medication
• is breast-feeding
• is in the third trimester of pregnancy
• is under 2 years of age
• has an active ulcer or bleeding in the gastrointestinal tract
• has active liver disease or severely impaired liverhas active liver disease or severely impaired liver
• has bleeding disorders including bleeding in the brain
• has had an allergic reaction to ASA or any other anti-inflammatory medications
• has high blood potassium
• has inflammatory bowel disease
• has recent or scheduled heart bypass surgery
• has severely impaired kidney or kidney disease
• has uncontrolled heart failure

Naproxen suppositories should not be used by anyone who:

• is under 12 years of age
• has any inflammatory lesions of the rectum or anus
• has recently had rectal or anal bleeding

What about possible side effects?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal or stomach cramps, pain, or discomfort (mild to moderate)
• constipation
• diarrhea
• dizziness
• drowsiness
• headache (mild to moderate)
• heartburn or indigestion
• itchy skin
• lightheadedness
• nausea
• skin rash
• spinning sensation (vertigo)
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

bleeding from cuts or scratches that lasts longer than usual bleeding or crusting sores on lips bleeding from rectum (with suppositories) blurred vision or other changes in vision depression difficulty hearing feeling tired heartburn (persistent) increased sensitivity to light increased sweating

rectal irritation (with suppositories) ringing or buzzing sound in the ears sores, ulcers, or white spots on lips or in mouth swelling of feet, lower legs, arms, and hands weight gain thirst (continuing) unusual tiredness or weakness without any other symptom urinating problems (e.g., bladder pain, painful urination, frequent urination)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• bloody or black, tarry stools
• chest pain
• convulsions (seizures)
• fainting
• fast or irregular breathing
• fast, irregular heartbeat or pulse
• pinpoint-sized red spots on skin
• shortness of breath, troubled breathing, wheezing, or tightness in chest
• spitting up of blood
• swelling of face, eyelids, mouth, lips, or tongue
• unusual bleeding or bruising
• vomiting of blood or material that looks like coffee grounds

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

There may be an interaction between naproxen and any of the following:

 

ASA (acetylsalicylic acid) or salicylates alcohol angiotensin converting enzyme (ACE) inhibitors (e.g., enalapril, ramipril) angiotensin receptor blockers (e.g., candesartan, losartan, telmisartan) antacids beta-blockers (e.g., atenolol, metoprolol) cholestyramine clopidogrel corticosteroids (e.g., cortisone, prednisone) cyclosporine digoxin

diuretics (water pills; e.g., furosemide, hydrochlorothiazide) heparin lithium methotrexate other NSAIDs (e.g., celecoxib, diclofenac, ibuprofen, ketorolac) permetrexed potassium supplements probenecid selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, sertraline) warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: People taking naproxen should not drive a car or perform hazardous tasks until they determine that this medication does not impair their ability to perform these tasks safely..

Fluid and electrolyte balance: Fluid retention and swelling (edema) have been reported by people taking this medication. People with heart failure, high blood pressure, reduced heart function, any condition that might lead to fluid retention, and seniors should be closely monitored by their doctor while taking naproxen.

There is a risk of high blood potassium (an electrolyte) with naproxen treatment. People most at risk are seniors; people with conditions such as diabetes or kidney failure; and those taking beta-adrenergic blockers, angiotensin converting enzyme (ACE) inhibitors, or some diuretics (water pills). People with known high blood potassium should not take naproxen.

Gastrointestinal: Stomach ulcers, perforation, and bleeding from the stomach have been known to occur during therapy with naproxen. These complications can occur at any time, and are sometimes severe enough to require immediate medical attention. The risk of ulcers and bleeding increase for people taking higher doses of naproxen for longer periods of time.

People prone to irritation of the stomach and intestines, particularly those who have had a stomach ulcer, bloody stools, or diverticulosis or other inflammatory disease of the stomach or intestines (such as ulcerative colitis or Crohn's disease) should be closely monitored by their doctor while taking naproxen.

Stop taking the medication and contact your doctor immediately if you experience symptoms or signs suggestive of stomach ulcers or bleeding in the stomach (black, tarry stools). These reactions can occur at any time during treatment without warning.

Heart attack and stroke: People who take NSAIDs have a higher risk of experiencing a heart attack or stroke. The risk for these side effects is higher with larger total daily doses and longer treatment periods. People with heart disease, high blood pressure, or risk factors for heart disease may be at a higher risk. These people, along with people with blood vessel disorders and heart failure, should be closely monitored by their doctors while taking this medication. This medication should not be taken by people who have had or are planning to have open heart (bypass) surgery.

Infection: Like other NSAIDs, taking naproxen may mask the signs and symptoms of an underlying infection. If you experience any new symptoms, including severe headache, fever, or stiff neck while taking naproxen, see your doctor as soon as possible.

Kidney function: Long-term use of naproxen may lead to a higher risk of reduced kidney function. This is most common for people who already have kidney disease, liver disease, or heart failure; for people who are take diuretics (water pills); and for seniors. These people should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severely impaired kidney or kidney disease should not take this medication.

Liver function: Naproxen may cause liver function tests to be abnormal. People with a history of liver disease, discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with active liver disease or severely impaired liver function should not take this medication.

Medical tests: Your doctor may ask you to get medical tests, such as a complete blood count or eye exam, while you are taking naproxen, especially if you are taking it for a long period of time.

Pregnancy: This medication should not be used during pregnancy, especially during the third trimester. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication should not be used by breast-feeding mothers.

Children: Naproxen is not recommended for children under 2 years of age. The safety and effectiveness of this medication have not been established for this age group. Naproxen suppositories should not be used by children under 12 years of age.

Seniors: Seniors appear to have a higher risk of side effects. They should use the lowest effective dosage under close medical supervision.

Special Instructions:

The recommended adult dose of naproxen tablets for osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis ranges from 500 mg to 1,000 mg per day in divided doses (either 2 or 3 times a day). Take naproxen with food or milk. The maximum daily dose is 1,500 mg and this dose should only be taken for limited periods of time. The suppository form of naproxen is usually used once daily to replace one of the oral doses.

For those taking naproxen on a continual basis, the long-acting (sustained-release) form of the medication may be substituted for the immediate-release form after the most appropriate daily dose of the medication has been found (i.e., the dose that controls pain and inflammation without side effects). In many cases, this will allow the medication to be taken only once daily. The sustained-release form of the medication should be swallowed whole.

The dose of naproxen for children treated for juvenile rheumatoid arthritis is based on body weight. Naproxen suspension is often used for young children who have difficulty swallowing tablets. Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons. Naproxen should not be used by children under the age of 2 years, as the safety and effectiveness of the medication for this age group have not been established.

When used to treat pain or muscle and skeletal injuries, the usual recommended adult dose of naproxen is 750 mg divided into 2 or 3 daily doses.

For treatment of menstrual pain and cramps, the recommended first dose is 500 mg followed by 250 mg every 6 to 8 hours as needed. No more than 5 tablets (1,250 mg) should be taken in one day. Alternatively, one 500 mg tablet may be taken twice daily as recommended by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

This medication is available under multiple brand names and in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under "What form(s) does this medication come in?"

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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