Naproxen

1. About naproxen

Naproxen is a medicine that reduces inflammation and pain in joints and muscles.

It's used to treat diseases of joints, such as rheumatoid arthritis, osteoarthritis and gout.

It's also used for period pain and muscle and bone disorders, such as back pain and sprains and strains.

Naproxen is available on prescription as tablets or as a liquid that you drink. You can buy it without a prescription from a pharmacy for period pain.

Brands include Feminax Ultra, Period Pain Reliever and Boots Period Pain Relief.

Naproxen can only be taken by children when it's prescribed for them.

2. Key facts

  • Take naproxen tablets with or just after a meal or snack.
  • Take the lowest dose of naproxen for the shortest time to control your symptoms.
  • The most common side effects of naproxen are confusion, headache, ringing in the ears, changes in vision, tiredness, drowsiness, dizziness and rashes.
  • For strains and sprains, some doctors and pharmacists recommend waiting 48 hours before taking naproxen as it may slow down healing. If you're unsure, speak to a pharmacist.
  • Naproxen is also called by the brand names Naprosyn or Stirlescent. Naproxen tablets you buy to treat period pain are called Feminax Ultra, Period Pain Reliever and Boots Period Pain Relief.
  • If you're taking naproxen for a long time or at risk of getting a stomach ulcer, your doctor may prescribe a medicine to protect your stomach.

3. Who can and can't take naproxen

Naproxen can be taken by adults.

It can also be taken under medical supervision by children to treat:

  • muscle and bone disorders for babies from 1 month
  • diseases of the joints for children from 2 years
  • period pain - for girls of any age

Naproxen isn't suitable for certain people. Tell your doctor or pharmacist if you:

  • have had an allergic reaction to naproxen or any other medicines in the past
  • have had an allergic reaction to aspirin or other non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen
  • have or have had stomach ulcers, bleeding in the stomach or intestines, or a hole in your stomach
  • have high blood pressure
  • have severe liver or kidney failure
  • have severe heart failure or other heart problems
  • have Crohn's disease or ulcerative colitis
  • have lupus
  • have a blood clotting disorder
  • are pregnant, planning to become pregnant, or breastfeeding

4. How and when to take it

Always take your naproxen tablets with or just after a meal so you don't get an upset stomach.

As a general rule in adults, the dose to treat:

  • diseases of joints is 500mg to 1,000mg a day in 1 or 2 doses
  • muscle, bone disorders and painful periods is 500mg at first, then 250mg every 6 to 8 hours as required
  • attacks of gout is 750mg, then 250mg every 8 hours until the attack has passed

Doses are usually lower for elderly people and people with heart, liver or kidney problems.

The doctor will use your child's weight to work out the right dose.

If you get naproxen on prescription, the dose depends on the reason why you're taking it, your age, how well your liver and kidneys work, and how well it helps your symptoms.

If you buy naproxen from a pharmacy for painful menstrual periods:

  • on the first day - take 2 tablets when the pain starts, then after 6 to 8 hours take 1 more tablet that day if you need to
  • on the second and following days - take 1 tablet every 6 to 8 hours if needed

Important

Do not take more than 3 tablets in 24 hours for period pain.

How to take it

Naproxen on prescription comes as 2 different tablets: effervescent and gastro-resistant tablets.

Effervescent tablets are dissolved in water before you take them.

Gastro-resistant tablets have a coating to protect them from being broken down by the acid in your stomach. Instead, the medicine is released further down the gut in your intestine.

If you take gastro-resistant tablets, swallow them whole with or after food. Do not crush or chew them.

If you take effervescent tablets, dissolve 1 to 2 tablets in a glass (150ml) of water and drink.

Doses of 3 tablets should be dissolved in 300ml. To make sure there's no medicine left, rinse the empty glass with a small amount of water and drink it. Take with or after food.

What if I forget to take it?

Take your forgotten dose as soon as you remember, unless it's nearly time for your next dose.

Do not take a double dose to make up for a forgotten dose.

If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

If you take too many naproxen tablets by accident, you're more likely to get some of the common side effects. Contact your doctor straight away.

5. Taking naproxen with other painkillers

Do not take naproxen with ibuprofen or other NSAIDs.

It's OK to take naproxen with paracetamol or co-codamol that you buy over the counter, but this should just be for short periods of time.

If you often need to take extra painkillers with naproxen or for more than a few days, you should talk to your doctor or pharmacist.

Sometimes taking different painkillers together is a good way to relieve pain, but there may be other treatments you can try.

It's OK to take other painkillers with naproxen for longer if your doctor has given them to you on prescription and told you to take them together.

If you're unsure, talk to your pharmacist or doctor.

6. Side effects

Like all medicines, naproxen can cause side effects, although not everyone gets them.

Common side effects

Common side effects of naproxen happen in more than 1 in 100 people.

They include:

  • confusion
  • headaches
  • ringing in the ears
  • changes in vision
  • tiredness and feeling sleepy
  • dizziness
  • rashes

Talk to your doctor or pharmacist if these side effects bother you or don't go away.

Serious side effects

Call your doctor straight away if you have:

  • severe indigestion, heartburn, pains in your stomach, feeling or being sick (nausea or vomiting) or diarrhoea - these can be signs of an ulcer or inflammation in the stomach or gut
  • vomiting blood or dark particles that look like coffee grounds, blood in your poo, or black, tarry-looking poo - these could be signs of bleeding and perforation of the stomach or gut
  • a frequent sore throat, nose bleeds, and infections - these can be signs of abnormalities in your blood cells, known as agranulocytosis
  • fainting, chest pain, or breathlessness - these can be signs of anaemia
  • fever, feeling or being sick, confusion, headache, neck stiffness and sensitivity to light - these can be signs of aseptic meningitis
  • blood in your pee, a decrease in how much pee is passed, feeling or being sick - these can be signs of kidney damage or infection
  • yellow skin or the whites of your eyes turn yellow - these can be signs of jaundice or inflammation of the liver
  • irregular, slow heartbeats caused by high levels of potassium in the blood
  • fever, stomach pain and being sick - these can be signs of inflammation of the pancreas

You can read more about some of these side effects in our common questions.

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction to naproxen.

Contact a doctor straight away if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

These are warning signs of a serious allergic reaction. A serious allergic reaction is an emergency.

A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

Information:

You can report any suspected side effect to the UK safety scheme.

7. How to cope with side effects

What to do about:

  • confusion - if naproxen makes you feel confused, speak to your doctor.
  • headache - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking naproxen. Talk to your doctor if they last longer than a week or are severe.
  • ringing in the ears - if this lasts for more than a day or two, speak to your doctor as they may need to change your treatment.
  • changes in vision - do not drive until this side effect has worn off.
  • feeling sleepy, tired or dizzy - as your body gets used to naproxen, these side effects should wear off.
  • dizziness - if naproxen makes you feel dizzy, stop what you're doing and sit or lie down until you feel better.
  • rashes - it may help to take an antihistamine, which you can buy from a pharmacy. Check with the pharmacist to see what type is suitable for you.

8. Pregnancy and breastfeeding

Naproxen isn't normally recommended in pregnancy - especially if you're 30 or more weeks - unless it's prescribed by a doctor.

This is because there might be a link between taking naproxen in pregnancy and some birth defects, in particular damage to the baby's heart and blood vessels.

There may also be a link between taking naproxen in early pregnancy and miscarriage.

Talk to your doctor about the benefits and possible harms of taking naproxen.

It'll depend on how many weeks pregnant you are and the reason you need to take the medicine. There may be other treatments that are safer for you.

Paracetamol is usually recommended as the first choice of painkiller for pregnant women.

For more information about how naproxen can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.

Naproxen and breastfeeding

Naproxen isn't usually recommended during breastfeeding. Other anti-inflammatory medicines, such as ibuprofen, are safer.

But if your baby is premature, had a low birth weight, or has an underlying medical condition, talk to your doctor before taking any painkillers.

Tell your doctor if you're:

  • trying to get pregnant
  • pregnant
  • breastfeeding

9. Cautions with other medicines

There are some medicines that interfere with the way naproxen works.

Tell your doctor if you're taking:

  • other anti-inflammatory medicines, such as aspirin or ibuprofen
  • medicines that thin the blood, such as warfarin or rivaroxaban
  • steroids, such as prednisolone
  • medicines that make you pee more (diuretics), such as furosemide
  • medicines used to treat heart problems and high blood pressure
  • antidepressants, such as citalopram
  • medicine used to treat rheumatoid arthritis, such as methotrexate

Important

Tell your doctor and pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

10. Common questions

How does naproxen work?

Naproxen is a non-steroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.

Paracetamol is usually the best treatment for most types of pain, but naproxen is better for some types, such as period pain or back pain.

When will I feel better?

You should start to feel better 1 hour after taking naproxen.

But it might take up to 3 days for naproxen to work properly if you take it regularly twice a day.

How long will I take naproxen for?

Depending on why you're taking naproxen, you may only need to take it for a short time.

For example, if you have a sore back or period pain, you may only need to take naproxen for a day or two.

You may need to take it for longer if you have a long-term condition, such as rheumatoid arthritis.

If you need to take naproxen for a long time, your doctor may prescribe a medicine to protect your stomach from side effects.

It's best to take the lowest dose of naproxen for the shortest time to control your symptoms.

Talk to your doctor if you're unsure how long you need to take naproxen for.

Can I take naproxen for a long time?

Naproxen can cause an ulcer in your stomach or gut if you take it for a long time or in big doses.

There's also a small risk that people taking very big doses for a long time may get heart failure or kidney failure.

It's best to take the lowest dose that works for the shortest possible time.

If you need to take naproxen very often or you're taking a big dose, talk to your doctor about your pain.

Is naproxen addictive?

No, naproxen is not addictive, but it's important to always take it as prescribed.

Are there other painkillers I can try?

The type of painkiller that's best depends on what type of pain you have and the cause of your pain.

If naproxen doesn't get rid of your pain, you can try painkillers that you can buy from shops and pharmacies, such as paracetamol or co-codamol (paracetamol combined with low-dose codeine).

If the medicine you buy isn't controlling your pain, your doctor may recommend another type of treatment to help your pain, such as exercise or physiotherapy.

Your doctor may also be able to prescribe a stronger painkiller, such as higher dose co-codamol or codeine.

Naproxen doesn't work for some types of pain, such as nerve pain.

Your doctor will have to prescribe a different medicine if your pain is related to your nerves.

Why do I need to be careful of stomach ulcers?

Naproxen can cause an ulcer in your stomach or gut if you take it for a long time or in big doses, or if you're elderly or in poor general health.

Your doctor may tell you not to take naproxen if you have a stomach ulcer or you have had one in the past.

If you need to take naproxen but you're at risk of getting a stomach ulcer, your doctor may prescribe another medicine for you to take alongside naproxen to protect your stomach.

The most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the stomach.

But stomach ulcers aren't always painful and some people may have other symptoms, such as indigestion, heartburn and feeling sick.

If you're prone to stomach ulcers or have had one before, take paracetamol instead of naproxen as it's gentler on your stomach.

Important

If you think you may have symptoms of a stomach ulcer, stop taking naproxen and contact your doctor.

Can naproxen cause heart failure?

It's been said that taking anti-inflammatory medicines increases the chances of getting heart failure.

But the risk is very small for most people.

If you find you need to take naproxen very often or you're taking doses higher than recommended, talk to your doctor about your pain.

Some anti-inflammatory medicines are less risky than others. Your doctor will be able to help you decide which is the best one for you.

Does naproxen cause kidney failure?

Naproxen is safe for occasional use when taken as advised by a doctor.

If you have problems with your kidney function, talk to your doctor about the best anti-inflammatory to take.

NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage.

Does naproxen cause an irregular heartbeat?

It's thought some anti-inflammatory medicines, including naproxen, can increase the chance of you getting an irregular heartbeat (such as atrial fibrillation or atrial flutter).

But the chances of getting an irregular heartbeat is small and not enough to recommend people stop taking these medicines.

If you're prescribed naproxen for a long-term condition, keep taking it and talk to your doctor if you're worried.

If you buy naproxen from a shop, occasional doses or short courses (2 or 3 days) are safe.

Does naproxen cause hearing loss?

It's been reported that women taking some anti-inflammatory medicines, including naproxen, twice a week for more than a year have a higher chance of losing their hearing.

But there's no proof that naproxen and similar anti-inflammatory medicines cause hearing loss.

Hearing loss is common as people get older.

There are ways to protect your hearing - for example, limiting your exposure to loud noise, wearing hearing protection in noisy places, and keeping the volume down on personal headphones.

If you find you have to take naproxen several days a week, talk to your doctor about what's causing your pain and whether there are better ways to manage it.

Will it affect my fertility?

Taking anti-inflammatory medicines, like naproxen, in large doses or for a long time can affect ovulation in women. This may make it more difficult to get pregnant.

Do not take naproxen if you're trying to get pregnant or you're having tests for infertility.

Paracetamol is a better painkiller in these situations.

There's no firm evidence to suggest that taking naproxen will reduce fertility in men.

Will it affect my contraception?

Naproxen doesn't affect any type of contraception, including the combined pill or emergency contraception.

Can I drink alcohol with it?

Yes, you can drink alcohol while taking naproxen. But drinking too much alcohol may irritate your stomach.

Page last reviewed: 24/10/2018
Next review due: 24/10/2018