Naproxen is one of the most commonly used anti-inflammatory drugs (NSAIDS) to relieve pain from various health problems such as arthritis, headaches, and menstrual cramps. Around 29 million Americans use over-the-counter NSAIDS such as naproxen sodium for pain relief [1].
Naproxen is not considered addictive, but long-term use can increase tolerance and reduce effectiveness. Understanding how to take naproxen safely is also essential to reduce serious side effects such as kidney problems or stomach ulcers.
What is Naproxen?
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve symptoms of inflammation and chronic pain conditions, such as swelling, stiffness, and joint pain. It is not a cure, but when taken correctly, it can effectively reduce pain levels, working as an adjunctive therapy.
It was initially approved in 1976 for prescription use until it received FDA approval in 1994 as an over-the-counter drug (Aleve). It is currently FDA-approved to treat several health conditions, including[1]:
- Acute gout
- Ankylosing Spondylitis
- Bursitis
- Osteoarthritis, rheumatoid arthritis, and juvenile idiopathic arthritis
- Tendonitis
- Menstrual cramps
Off-label naproxen is used to treat acute migraines and is sometimes used in chronic migraine relief as a prevention. Naproxen can also reduce fevers by inhibiting the COX-1 and COX-2 enzymes. These reduce the production of prostaglandins, chemical messengers in the brain’s temperature regulation center that play a role in inflammation, pain, and fever [2].
Prescription vs OTC Naproxen
Naproxen is both an OTC and a prescription medication in the US, depending on its dose and usage.
Prescription: Sold as Naprosyn, Anaprox, or generic “naproxen”. It comes in tablet or liquid capsule form in varying doses of 250 mg, 375 mg, and 500 mg. It is typically prescribed for chronic conditions such as arthritis, gout, tendonitis, or bursitis.
OTC: Sold over the counter as Aleve (generic name is Naproxen sodium). These come in 220 mg tablets and are approved for short-term pain relief, such as from minor arthritis, menstrual cramps, or headaches.
Naproxen vs Other NSAIDS?
There are several NSAIDS on the market used to treat similar symptoms, and they are often confused with one another; however, they differ in their duration of action and effect profiles [3].
| Drug | Aleve (Naproxen Sodium) | Aspirin | Advil, Motrin (Ibuprofen) | Tylenol (Acetamino- phen) |
| Type | NSAID | NSAID | NSAID | Non-NSAID Analgesic |
| Primary Use | Pain, inflammation, arthritis | Pain, inflammation, and blood thinner | Pain, inflammation, and fever | Fever, pain |
| Duration of Action | 8 to 12 hours | 4 to 6 hours | 4 to 6 hours | 4 to 6 hours |
| Max Dose | 660 mg | 4,000 mg | 1200 mg | 3,000-4,000 mg |
Can You Get Addicted to Naproxen? Tolerance vs Addiction
Naproxen is not addictive. It works by reducing inflammation without affecting the brain’s reward pathways or producing euphoria. Naproxen does not cause cravings, physical dependence, or withdrawal symptoms.
However, it is possible to develop a tolerance to naproxen when taking it for a long time. This means over time, your body requires more of the drug to feel the same relief.
Increasing the amount of naproxen you take without medical advice can lead to serious health risks such as stomach bleeding, kidney damage, and heart problems. If you have been on naproxen long-term and it is no longer providing you with pain relief, talk to your doctor about other options.
Side Effects of Taking Too Much Naproxen
Too much naproxen can cause dangerous consequences to one’s physical health and increase the risk of allergic reactions. Common side effects of taking too much Naproxen include:
- Heartburn
- Stomach pain, vomiting, nausea, and intestinal bleeding
- Headache
- Dizziness
- Naproxen overdoses are rare but not impossible, and often occur when mixed with other substances such as opioid painkillers. This can cause life-threatening symptoms such as seizures, coma, or respiratory distress.
How to Safely Use Naproxen
If you are thinking about taking naproxen or are already taking it, it’s important to follow the recommendation of your doctor or the instructions listed on the package. A few tips to take naproxen safely and avoid adverse side effects include:
- Do not take naproxen for more than 10 days for pain or 3 days for fever without talking to your doctor.
- Swallow tablets whole with a glass of water, do not crush or chew
- If taking liquid naproxen, shake before use and use the provided dosing cup, not a household measuring spoon
- Avoid combining naproxen with other NSAIDS
- Avoid alcohol or illicit drugs such as opioids
- Watch for any side effects and get medical attention if you notice any serious complications
- Do not give to children under 2 years of age. For dosing, follow instructions on the package or speak with your child’s pediatrician
- No known safety concerns for breastfeeding women, but it’s best to talk with your doctor
- Naproxen has several drug interactions. Speak with a healthcare professional before taking anything new
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Sources
[1] Brutzkus, J. et al. 2023. Naproxen. National Library of Medicine.
[2] Svetoslav, Nikolaev. Et al. 2021. Naproxen in Pain and Inflammation – A Review. International Journal of Pharmaceutical and Phytopharmacological Research.
[3] Doyle, S. 2024. What’s The Difference Between Tylenol, Advil, and Aleve? Hospital for Special Surgery.