Does Daypro (oxaprozin) cause side effects?

Daypro (oxaprozin) is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve the signs and symptoms of osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis.

NSAIDs work by reducing the levels of prostaglandins, chemicals that are responsible for pain, fever, and inflammation. Daypro blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced. 

Common side effects of Daypro include

Serious side effects of include

Drug interactions of Daypro include lithium, because Daypro may increase the blood levels of lithium by reducing the excretion of lithium by the kidneys, which may lead to lithium toxicity.

Daypro may reduce the blood pressure lowering effects of blood pressure medications.

  • When Daypro is used in combination with methotrexate or aminoglycoside antibiotics the blood levels of those drugs may increase, presumably because their elimination is reduced. This may lead to more side effects from methotrexate or aminoglycoside.
  • Individuals taking oral blood thinners or anticoagulants should avoid Daypro because Daypro also thins the blood, and excessive blood thinning may lead to bleeding. Daypro increases the negative effect of cyclosporine on kidney function.
  • If aspirin is taken with Daypro 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 Daypro or other NSAIDs.

Taking Daypro during the last three months of pregnancy may harm a fetus and interfere with normal labor/delivery. Tell your doctor if you are pregnant or plan to become pregnant.

It is unknown if Daypro is excreted in breast milk. Consult your doctor before breastfeeding

What are the important side effects of Daypro (oxaprozin)?

The most common side effects from oxaprozin are

NSAIDs reduce the ability of blood to clot and therefore increase bleeding after an injury. Oxaprozin also may cause bleeding in the stomach and intestine as well as ulcers.

Sometimes, stomach ulceration and intestinal bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of the bleeding.

People who are allergic to other NSAIDs should not use oxaprozin. NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of NSAIDs in these patients should be done cautiously.

Individuals with asthma are more likely to experience allergic reactions to oxaprozin and other NSAIDs. Fluid retention, blood clots, heart attacks, hypertension, and heart failure also have been associated with the use of NSAIDs.

Daypro (oxaprozin) side effects list for healthcare professionals

The following adverse reactions are discussed in greater detail in other sections of the labeling:

  • Cardiovascular Thrombotic Events
  • GI Bleeding, Ulceration and Perforation
  • Hepatotoxicity
  • Hypertension
  • Heart Failure and Edema
  • Renal Toxicity and Hyperkalemia
  • Anaphylactic Reactions
  • Serious Skin Reactions
  • Hematologic Toxicity

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

  • Adverse reaction data were derived from patients who received Daypro in multidose, controlled, and open-label clinical trials.
  • Rates for events from clinical trial experience are based on 2253 patients who took 1200 mg to 1800 mg Daypro per day in clinical trials.
  • Of these, 1721 patients were treated for at least 1 month, 971 patients for at least 3 months, and 366 patients for more than 1 year.
Incidence Greater Than 1%

In clinical trials of Daypro or in patients taking other NSAIDs, the following adverse reactions occurred at an incidence greater than 1%.

Cardiovascular system: edema.

Digestive system: abdominal pain/distress, anorexia, constipation, diarrhea, dyspepsia, flatulence, gastrointestinal ulcers (gastric/duodenal), gross bleeding/perforation, heartburn, liver enzyme elevations, nausea, vomiting.

Hematologic system: anemia, increased bleeding time.

Nervous system: CNS inhibition (depression, sedation, somnolence, or confusion), disturbance of sleep, dizziness, headache.

Skin and appendages: pruritus, rash.

Special senses: tinnitus.

Urogenital system: abnormal renal function, dysuria or frequency.

Incidence Greater Than 1%

The following adverse reactions were reported in clinical trials or in patients taking other NSAIDs.

Body as a whole: appetite changes, death, drug hypersensitivity reactions including anaphylaxis, fever, infection, sepsis.

Cardiovascular system: arrhythmia, blood pressure changes, congestive heart failure, hypertension, hypotension, myocardial infarction, palpitations, tachycardia, syncope, vasculitis.

Digestive system: alteration in taste, dry mouth, eructation, esophagitis, gastritis, glossitis, hematemesis, jaundice, liver function abnormalities including liver failure, stomatitis, hemorrhoidal or rectal bleeding.

Hematologic system: aplastic anemia, ecchymoses, eosinophilia, hemolytic anemia, lymphadenopathy, melena, purpura, thrombocytopenia, leukopenia. Metabolic system: hyperglycemia, weight changes.

Nervous system: anxiety, asthenia, coma, convulsions, dream abnormalities, drowsiness, hallucinations, insomnia, malaise, meningitis, nervousness, paresthesia, tremors, vertigo, weakness.

Respiratory system: asthma, dyspnea, pulmonary infections, pneumonia, sinusitis, symptoms of upper respiratory tract infection, respiratory depression.

Skin: alopecia, angioedema, urticaria, photosensitivity, sweat.

Special senses: blurred vision, conjunctivitis, hearing decrease.

Urogenital: cystitis, hematuria, increase in menstrual flow, oliguria/ polyuria, proteinuria, renal insufficiency, decreased menstrual flow.

Postmarketing Experience

The following adverse reactions have been identified during post approval use of Daypro. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Body as a whole: serum sickness.

Digestive system: hepatitis, pancreatitis.

Hematologic system: agranulocytosis, pancytopenia.

Skin: pseudoporphyria, exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell’s syndrome).

Urogenital: acute interstitial nephritis, nephrotic syndrome, acute renal failure.

What drugs interact with Daypro (oxaprozin)?

See Table 2 for clinically significant drug interactions with oxaprozin.

Table 2: Clinically Significant Drug Interactions with Oxaprozin

Drugs That Interfere with Hemostasis
Clinical Impact:
  • Oxaprozin and anticoagulants such as warfarin have a synergistic effect on bleeding. The concomitant use of oxaprozin and anticoagulants have an increased risk of serious bleeding compared to the use of either drug alone.
  • Serotonin release by platelets plays an important role in hemostasis. Case-control and cohort epidemiological studies showed that concomitant use of drugs that interfere with serotonin reuptake and an NSAID may potentiate the risk of bleeding more than an NSAID alone.
Intervention:Monitor patients with concomitant use of Daypro with anticoagulants (e.g., warfarin), antiplatelet drugs (e.g., aspirin), SSRIs, and SNRIs for signs of bleeding.
Clinical Impact:Controlled clinical studies showed that the concomitant use of NSAIDs and analgesic doses of aspirin does not produce any greater therapeutic effect than the use of NSAIDs alone. In a clinical study, the concomitant use of an NSAID and aspirin was associated with a significantly increased incidence of GI adverse reactions as compared to use of the NSAID alone.
Intervention:Concomitant use of Daypro and analgesic doses of aspirin is not generally recommended because of the increased risk of bleeding.

Daypro is not a substitute for low dose aspirin for cardiovascular protection.

ACE Inhibitors, Angiotensin Receptor Blockers, and Beta-Blockers
Clinical Impact:
  • NSAIDs may diminish the antihypertensive effect of ACE inhibitors, ARBs, or beta-blockers (including propranolol).
  • In patients who are elderly, volume-depleted (including those on diuretic therapy), or have renal impairment, co-administration of an NSAID with ACE inhibitors or ARBs may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible.
  • During concomitant use of Daypro and ACE inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained.
  • During concomitant use of Daypro and ACE inhibitors or ARBs in patients who are elderly, volume-depleted, or have impaired renal function, monitor for signs of worsening renal function.
  • When these drugs are administered concomitantly, patients should be adequately hydrated. Assess renal function at the beginning of the concomitant treatment and periodically thereafter.
Clinical Impact:Clinical studies, as well as post-marketing observations, showed that NSAIDs reduced the natriuretic effect of loop diuretics (e.g., furosemide) and thiazide diuretics in some patients. This effect has been attributed to the NSAID inhibition of renal prostaglandin synthesis.
Intervention:During concomitant use of Daypro with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects.
Clinical Impact:The concomitant use of oxaprozin with digoxin has been reported to increase the serum concentration and prolong the half-life of digoxin.
Intervention:During concomitant use of Daypro and digoxin, monitor serum digoxin levels.
Clinical Impact:NSAIDs have produced elevations in plasma lithium levels and reductions in renal lithium clearance. The mean minimum lithium concentration increased 15%, and the renal clearance decreased by approximately 20%. This effect has been attributed to NSAID inhibition of renal prostaglandin synthesis.
Intervention:During concomitant use of Daypro and lithium, monitor patients for signs of lithium toxicity.
Clinical Impact:Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity (e.g., neutropenia, thrombocytopenia, renal dysfunction) because NSAID administration may result in increased plasma levels of methotrexate, especially in patients receiving high doses of methotrexate.
Intervention:During concomitant use of Daypro and methotrexate, monitor patients for methotrexate toxicity.
Clinical Impact:Concomitant use of Daypro and cyclosporine may increase cyclosporine’s nephrotoxicity.
Intervention:During concomitant use of Daypro and cyclosporine, monitor patients for signs of worsening renal function.
NSAIDs and Salicylates
Clinical Impact:Concomitant use of oxaprozin with other NSAIDs or salicylates (e.g., diflunisal, salsalate) increases the risk of GI toxicity, with little or no increase in efficacy.
Intervention:The concomitant use of oxaprozin with other NSAIDs or salicylates is not recommended.
Clinical Impact:Concomitant use of Daypro and pemetrexed may increase the risk of pemetrexed-associated myelosuppression, renal, and GI toxicity (see the pemetrexed prescribing information).
Intervention:During concomitant use of Daypro and pemetrexed, in patients with renal impairment whose creatinine clearance ranges from 45 to 79 mL/min, monitor for myelosuppression, renal and GI toxicity.

NSAIDs with short elimination half-lives (e.g., diclofenac, indomethacin) should be avoided for a period of two days before, the day of, and two days following administration of pemetrexed.

In the absence of data regarding potential interaction between pemetrexed and NSAIDs with longer half-lives (e.g., meloxicam, nabumetone), patients taking these NSAIDs should interrupt dosing for at least five days before, the day of, and two days following pemetrexed administration.
Clinical Impact:Concomitant use of corticosteroids with Daypro may increase the risk of GI ulceration or bleeding.
Intervention:Monitor patients with concomitant use of Daypro with corticosteroids for signs of bleeding.
Clinical Impact:While oxaprozin does alter the pharmacokinetics of glyburide, coadministration of oxaprozin to type II non-insulin dependent diabetic patients did not affect the area under the glucose concentration curve nor the magnitude or duration of control.
Intervention:During concomitant use of Daypro and glyburide, monitor patient’s blood glucose in the beginning phase of cotherapy.

Laboratory Test Interactions

False-positive urine immunoassay screening tests for benzodiazepines have been reported in patients taking Daypro. This is due to lack of specificity of the screening tests.

False-positive test results may be expected for several days following discontinuation of Daypro therapy. Confirmatory tests, such as gas chromatography/mass spectrometry, will distinguish Daypro from benzodiazepines.

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Medically Reviewed on 8/12/2020
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Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.