Naproxen

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 22, 2022

Warnings

Naproxen Risks, Warnings, and Complications

Naproxen can cause serious health problems, especially in certain high-risk patients. Some of the risks of naproxen use include:

HEART ATTACK AND STROKE: Naproxen can increase the risk of a blood clot and a fatal heart attack or stroke. The risk is higher in people with pre-existing heart problems and those who have had or plan to have a coronary artery bypass graft (heart bypass surgery). The risk is also higher in people taking high doses of naproxen or on long-term treatment with naproxen.
You should take the lowest effective dose of naproxen for the shortest possible time to relieve pain. If you have heart disease, talk to your doctor before starting naproxen. Do not take naproxen if you have had or are planning to have a coronary artery bypass graft (heart bypass surgery). Call 911 or seek immediate medical help if you experience chest pain, difficulty breathing, weakness or numbness on one side of the body, or problems with walking or talking.
STOMACH BLEEDING AND STOMACH ULCERS: Naproxen can cause potentially dangerous stomach ulcers, stomach bleeding, and intestinal bleeding. Risk factors for this complication include a previous history of stomach bleeding, older age, drinking alcohol, smoking, taking naproxen for a long time, and taking other medications such as blood thinners, other NSAIDs including aspirin, and oral corticosteroids. Call your doctor immediately if you notice blood in your vomit, dark-colored stools, or experience severe and persistent stomach pain.
SEVERE ALLERGIC REACTION: Rarely, a severe allergic reaction to naproxen can lead to life-threatening problems like anaphylaxis (closing of the throat) and serious skin reactions like Stevens-Johnson syndrome. Call 911 if you develop painful skin blisters, hives, skin rash, skin pain, swelling of the throat, tongue, or lips, or difficulty breathing. Before starting naproxen, tell your doctor if you have an aspirin allergy, an allergy to other non-steroidal anti-inflammatory drugs, or if you ever had an asthma attack that got worse after taking aspirin.
KIDNEY DAMAGE: Naproxen can cause damage to the kidneys. Risk factors include certain medical conditions, including renal impairment or pre-existing renal disease, liver disease, heart problems, and dehydration. Other risk factors are older age, taking certain medications to treat high blood pressure, and taking naproxen for a long time. Call your doctor if you develop any signs and symptoms, such as changes in urinary frequency after starting naproxen.
LIVER DAMAGE: Very rarely, naproxen can lead to potentially life-threatening liver damage. Call your doctor if you have unexplained stomach pain, nausea, vomiting, pale stools, dark urine, or yellowing of the skin or eyes. Your doctor may order certain medical tests to check liver function.
HARM TO UNBORN BABIES: The use of naproxen in the last 3 months of pregnancy can increase the risk of heart problems in an unborn baby. Do not take naproxen without talking to your healthcare provider if you are pregnant.
If you are at a high risk of complications from naproxen use, your doctor or pharmacist can help you find other medicines for your condition.

Precautions Before Starting Naproxen

Tell your healthcare provider if you have ever had an allergic reaction to naproxen, any of the ingredients in naproxen products, other NSAIDs, or other medications. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Naproxen may not be right for people with certain medical conditions such as anemia, asthma, kidney disease, heart failure, a low-sodium diet, and frequent stuffy nose or nasal polyps.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between naproxen and other drugs.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Naproxen can cause a temporary decrease in fertility in women. Talk to your doctor about this if you are planning a pregnancy in the near future.

Talk to your doctor about the appropriate dose of naproxen if you are over the age of 65. You may need to take a lower dose because higher doses of naproxen can cause serious side effects without being more effective in older individuals.

Precautions During Use of Naproxen

Keep all your medical and lab appointments while on naproxen. Your doctor may want to order frequent medical tests while you are on this medication.

Tell your doctors you take naproxen before any surgery, including dental procedures.

Call your doctor if you become pregnant while on naproxen

Naproxen Drug Interactions

Taking naproxen with other medicines can affect how each medication works. Interactions between medications can also increase the risk of serious side effects. Your physician may choose a different drug combination, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between naproxen and your other medications.

There can be possible drug interactions between naproxen and the following medications:

Medications used to treat high blood pressure called angiotensin-converting enzymes (ACE) inhibitors, such as captopril, benazepril (Lotensin, in Lotrel), enalapril (Vasotec, in Vaseretic), lisinopril (Zestril, in Zestoretic), fosinopril, moexipril (Univasc), quinapril (Accupril, in Accuretic, in Quinaretic), perindopril (Aceon, in Prestalia), ramipril (Altace), and trandolapril (Mavik, in Tarka)
Medications used to treat high blood pressure called angiotensin receptor blockers (ARBs) such as candesartan (Atacand, in Atacand HCT), azilsartan (Edarbi, in Edarbyclor), eprosartan (Teveten), losartan (Cozaar, in Hyzaar), irbesartan (Avapro, in Avalide), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), valsartan (in Exforge HCT), and telmisartan (Micardis, in Micardis HCT, in Twynsta)
Medications used to treat high blood pressure and heart disease called beta-blockers such as labetalol (Trandate), atenolol (Tenormin, in Tenoretic), metoprolol (Lopressor, Toprol XL, in Dutoprol), propranolol (Hemangeol, Inderal, InnoPran), and nadolol (Corgard, in Corzide)
Cholestyramine (Prevalite), a medication used to treat high cholesterol
Cyclosporine (Gengraf, Neoral, Sandimmune), an immunosuppressive drug
Heart medications like digoxin (Lanoxin)
Diuretics or water pills
Medications used to treat diabetes
Sulfa medications such as sulfamethoxazole (in Bactrim, in Septra)
Lithium (Lithobid)
Phenytoin (Dilantin, Phenytek)
Pemetrexed (Alimta, Pemfexy)
Methotrexate (Otrexup, Rasuvo, Trexall)
Probenecid (Probalan; in Col-Probenecid)

This list does not describe all possible naproxen interactions. Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.

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