Dosage Forms. Tablet: 250 mg, 375 mg, 500 mg; Tablet, Extended Release: 375 mg, 500 mg, 750 mg; Tablet, Enteric Coated, Delayed Release: 375 mg, 500 mg; Capsule: 220 mg; Suspension: 25 mg/mL
Common FDA Label Indication, Dosing, and Titration.
1. Osteoarthritis: 250-500 mg po bid
2. Rheumatoid arthritis: 250-500 mg po bid
3. Gout, acute: 250 mg po tid
4. Fever: Adults and Children over 12 y, 200-400 mg po bid prn, to a max of 600 mg daily
Off-Label Uses. None
MOA. Nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2), and reversibly alters platelet function, and prolongs bleeding time.
Drug Characteristics: Naproxen
Medication Safety Issues: Naproxen
Drug Interactions: Naproxen
Adverse Reactions: Naproxen
Efficacy Monitoring Parameters. Decreased pain and improved range of motion.
Toxicity Monitoring Parameters. Severe skin rash, black tarry stools, chest pains, yellowing of eyes or skin, change in urination; monitor CBC, LFTs, SCr, fecal occult blood tests if chronic use.
Key Patient Counseling Points. Take with food or milk to decrease GI upset.
Clinical Pearls. Elderly patients are at increased risk of GI ulceration. Patients with underlying cardiac dysfunction are at increased risk of cardiovascular effects. Use lowest dose for shortest period of time to minimize toxicity. Naproxen is also available over the counter as a 220 mg tablet. If taken as OTC for fever, do not take longer than 10 d unless directed by physician. Medication guide required at dispensing.