Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Naprelan (controlled-release tablets): 375 and 500 mg.
STORAGE: Naproxen should be stored at room temperature: 15 C to 30 C (59 F to 86 F).
DOSING: The usual adult dose for pain is 250 every 6 to 8 hours or 500 mg twice daily using regular naproxen tablets. The usual dose for Naprelan controlled release tablets is 750 to 1000 mg given once daily. For EC-Naprosyn, the usual dose is 375-500 mg twice daily.
Naproxen should be given with food to reduce upset stomach. The dose for rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis is 500 to 1000 mg every 12 hours. Dysmenorrhea is treated with 250 mg every 6 to 8 hours after an initial dose of 500 mg.
Naproxen is associated with several suspected or probable interactions that affect the action of other drugs. The following examples are the most common suspected interactions.
Naproxen may increase the blood levels of
Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.
Naproxen may reduce the blood pressure lowering effects of
blood pressure medications. This may occur because prostaglandins play a role in the regulation of blood pressure.
When naproxen is used in combination with
(Rheumatrex, Trexall) or aminoglycosides (for example, gentamicin) the blood levels of the methotrexate or aminoglycoside may increase, presumably because the elimination from the body of these drugs is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.
Individuals taking anticoagulants, for example,
warfarin, (Coumadin), should avoid naproxen because naproxen also thins the blood, and excessive blood thinning may lead to bleeding.
Naproxen increases the negative effect of cyclosporine on kidney function and reduces the effect of
(Lasix) and thiazide diuretics because of prostaglandin inhibition.
Naproxen should be avoided by patients with a history of asthma attacks,
hives or other allergic reactions to
aspirin or other NSAIDs.
If aspirin is taken with naproxen there may be an increased risk for developing an ulcer.
Persons who have more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking naproxen or other NSAIDs.