Naproxen
A long-acting propionic acid NSAID used for arthritis, ankylosing spondylitis, gout attacks, period pain and other pain.
Drug card
- Class
- NSAID
- How it works
- Blocking COX-1 and COX-2, so less prostaglandin is made
- Used for
- Osteoarthritis
- Rheumatoid arthritis
- Acute gout attacks
- Ankylosing spondylitis
- Known for
- Stomach and duodenal ulcers
- Bleeding from the stomach or gut
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does naproxen work?
Naproxen, a propionic acid derivative like ibuprofen, blocks COX-1 and COX-2 and so lowers prostaglandin and thromboxane A2 production. Its half-life of 12 to 17 hours is far longer than ibuprofen's, so each dose lasts longer.
Like other non-steroidal anti-inflammatory drugs: NSAIDs block the cyclooxygenase enzymes COX-1 and COX-2, which turn arachidonic acid into prostaglandins and thromboxane. With less prostaglandin, nerve endings are less sensitized, inflammation settles and fever falls. Losing COX-1 products in the stomach and platelets, and the prostaglandins that keep blood flowing through the kidney, explains their ulcers, bleeding and kidney harm.
Uses
What is naproxen used for?
- Osteoarthritis
- Rheumatoid arthritis
- Acute gout attacks
- Ankylosing spondylitis
- Period pain (primary dysmenorrhea)
- Pain, such as tendonitis and bursitis
Side effects
Side effects of naproxen
- Stomach and duodenal ulcersKnown forSerious
- Bleeding from the stomach or gutKnown forSerious
- Indigestion and stomach pain
- Constipation
- Headache
- Ringing in the ears (tinnitus)
- Easy bruising
- Swelling from fluid retention
- Acute kidney injurySerious
- Heart attack and strokeSerious
- Blistering skin reactions to sunlight
- Severe skin reactions (SJS, TEN)Serious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Avoid with a past ulcer or GI bleeding; steroids, anticoagulants or SSRIs taken alongside raise the bleeding risk.
- It raises lithium levels and the risk of methotrexate toxicity; monitor both when used together.
- Pregnancy: limit use from about 20 weeks and avoid from 30 weeks, as with all NSAIDs.
Good to know: Its half-life of 12 to 17 hours makes it longer-acting than ibuprofen (about 2 hours).
Remember it
A way to remember it
NSAID
- N
- Nephrotoxicity: acute kidney injury
- S
- Stomach ulcers and bleeding
- A
- Asthma attacks in aspirin-sensitive people
- I
- Increased risk of heart attack and stroke
- D
- Ductus arteriosus closing early in late pregnancy
Written for biofideX
Its class
Non-steroidal anti-inflammatory drugs
Other non-steroidal anti-inflammatory drugs with a card:
Easily mixed up with selective COX-2 inhibitors, paracetamol and glucocorticoids.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Naproxen tablets: label (DailyMed)
- Naproxen (NCI Thesaurus)
- Naproxen (NHS)
- Ibuprofen tablets: label (DailyMed)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Pain, fever and inflammation
Naproxen is one of 15 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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