Naproxen

What is Naproxen?

Naproxen belongs to the class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) and is used to manage and relieve pain and inflammation. Naproxen is often used in the treatment of migraine headaches or muscle and joint pain. Doctors at Medzino can issue a prescription of Naproxen for migraine relief if you are suitable. Migraine is a complex disorder. While for some people, migraines are an occasional problem that can be effectively managed, for many, it is a frequent occurrence that leaves them incapacitated. Most patients who suffer from episodic migraines (only occurring once in a while) have recourse to medications like Naproxen to help relieve mild to moderate pain. However, NSAIDs like Naproxen can also be administrated as part of preventive treatment, otherwise known as prophylactic therapy, for chronic migraines. Prophylactic therapy is warranted when migraine attacks occur more than 2 to 3 times per month for more than 48h. It can also be prescribed if migraine attacks cause substantial functional impairment or if conventional treatments for migraine relief are ineffective or cause serious side effects.

How does Naproxen work?

NSAIDs like Naproxen work by blocking the mechanisms of pain. When you suffer from a condition such as arthritis, or have an injury, an enzyme in your body called cyclo-oxygenase (COX) produces substances called prostaglandins, which cause pain, swelling and inflammation. When you take Naproxen, it stops the COX from working and producing the prostaglandins, thereby reducing pain and inflammation. If you are pregnant, Naproxen is usually not recommended as it may be linked to birth defects and miscarriage in early pregnancy. The preferred painkiller for pregnant women is usually Paracetamol which is not a NSAID. If you are breastfeeding, other medicines such as Ibuprofen (an over the counter NSAID) might be safer. Talk to your doctor about the possible risks of taking Naproxen.

How long does Naproxen take to work?

Naproxen works immediately once it is absorbed in the GI tract. This means you should start feeling relief after about 30 minutes to one hour. Relief lasts up to 4-6 hours. 

Active ingredients

Naproxen contains the active ingredient naproxen at a concentration of 500mg.

Inactive ingredients

Naproxen contains the following inactive ingredients: magnesium stearate, microcrystalline cellulose, povidone and talc. The coating suspension may contain hydroxypropyl methylcellulose 2910, Opaspray K-1-4227, polyethylene glycol 8000 or Opadry YS-1-4216.

Please note: inactive ingredients can vary across different manufacturers. 

Which ingredients can cause an allergic reaction?

Severe allergic reactions to naproxen are rare, unless you have a known allergy to the medication. If you have previously had an allergic reaction (any severity) to this medication, please refrain from taking this again. Let your doctor know to ensure he does not prescribe you the same medication. Symptoms of a severe allergic reaction are: hives/rash, chest tightness, lips/face swelling and dizziness. This is a medical emergency. If you experience any of these symptoms, you should visit your nearest emergency department as soon as possible.

The recommended dosage of Naproxen will vary depending on your condition. For the management of acute pain such as migraine, it is usually recommended that you take a starting dose of 500mg (one tablet) followed by 250mg (half of a 500mg tablet) every 6-8 hours as required. Take Naproxen orally (by mouth) with or after your meal in order to prevent upsetting your stomach.

The maximum recommended dose per day is 1250mg of naproxen. Do not exceed this limit.

If you forget to take a dose, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the dose you forgot and take the one that is due soon. Do not take your dose twice in order to make up for the forgotten dose.

How should I take Naproxen for migraine relief?

For the treatment of acute migraine, it is recommended that you take a starting dose of 750 mg (1 1/2 tablets). An additional 250 mg (1/2 tablet) or 500 mg (1 tablet) may be given if needed in 4-6 hours after the initial dosage. For prophylactic therapy to prevent migraines, the dose is 250 mg to 500 mg twice a day for 3 to 6 months. Take Naproxen orally (by mouth) with or after your meal in order to prevent upsetting your stomach. The maximum recommended dose per day is 1250mg of Naproxen. Do not exceed this limit. If you forget to take a dose, take it as soon as you remember unless it’s almost time for your next dose. In that case, skip the dose you forgot and take the one that is due soon. Do not take your dose twice in order to make up for the forgotten dose. It is advised to use medications for acute migraines with moderation as they might cause side effects such as nausea, vomiting, rebound headaches and progression to chronic headache disorders. Often, anti-nausea and other symptom-preventing medications are given alongside the migraine medication to prevent such side effects.

Naproxen side effects

Get immediate medical help if you experience an allergic reaction to Naproxen. Symptoms of an allergic reaction include: rash (itchy, red, swollen blistered or peeling skin), wheezing, swelling/itching of the face/tongue/throat, severe dizziness, difficulty breathing.

General side effects include:

• Nausea (feeling sick)
• Upset stomach
• Heartburn
• Tiredness
• Dizziness
• Headache

It is advised to use medications for acute migraine with moderation as they might cause side effects such as nausea, vomiting, rebound headaches and progression to chronic headache disorders. Often, anti-nausea and other symptom-preventing medications are given alongside the migraine medication to prevent such side effects. If any of these symptoms persist or cause distress, talk to your doctor.

Serious side effects

• Easy bruising/bleeding
• Difficult swallowing
• Severe indigestion, heartburn, stomach pain, nausea, vomiting or diarrhea (may be signs of an ulcer or inflammation in the stomach or gut)
• Hearing changes (ringing in the ears)
• Kidney problems (change in the amount of urine, or blood in your pee)
• Changes in vision
• Fainting, chest pain, breathlessness (may be signs of anaemia)
• Yellowish skin or the white of your eyes turn yellow (signs of jaundice or inflammation of the liver)
• Swelling ankles/feet, unusual tiredness, unusual/sudden weight gain /may be signs of heart failure)
• Vomiting blood or blood in your faeces (poo) (signs of bleeding and perforation of the stomach or gut)
• Fever, nausea, vomiting, confusion, headache, neck stiffness, sensitivity to light (may be signs of aseptic meningitis)

If you experience any of these rare but very serious side effects, get medical help right away.

Contraindications

Naproxen is contraindicated in the following cases:

• If you are allergic to naproxen sodium or any of the ingredients in Naproxen
• If you have previously experienced allergic reactions (rash, wheezing, swelling/itching of the face/tongue/throat, severe dizziness, difficulty breathing) to other painkillers such as Ibuprofen or Aspirin
• If you suffer from liver, kidney or heart failure
• If you are pregnant
• If you have or have had acute peptic ulcer (open sores that develop on the inside of your stomach and the upper portion of your small intestine)
• If you have a history of upper gastrointestinal (stomach and intestines) bleeding or perforation related to previous therapy using painkillers
• If you are already taking another painkiller. Different painkillers must not be taken at the same time.  

Drug interactions

Always inform your doctor of all the medications you take as these may interfere with the effects of Naproxen. Medications that may interfere with Naproxen include: drugs called ‘steroids’ such as Prednisolone, other painkillers such as Aspirin or Ibuprofen, blood-thinners such as Warfarin or Rivaroxaban, antidepressants such as Citalopram, medicines for heart disease and high blood pressure, diuretics (drugs to make you pee more) such as Furosemide, medicine for rheumatoid arthritis such as Methotrexate.