Naproxen

Naproxen is a non-steroidal anti-inflammatory drug (NSAID). It is sold under the brand names Aleve, Anaprox, Anaprox DS, EC-Naprosyn, Naprelan, and Naprosyn.

What It's Prescribed For
"Prescription naproxen is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), juvenile arthritis (a form of joint disease in children), and ankylosing spondylitis (arthritis that mainly affects the spine). Prescription naproxen tablets, extended-release tablets, and suspension are also used to relieve shoulder pain caused by bursitis (inflammation of a fluid-filled sac in the shoulder joint), tendinitis (inflammation of the tissue that connects muscle to bone), gouty arthritis (attacks of joint pain caused by a build-up of certain substances in the joints), and pain from other causes, including menstrual pain (pain that happens before or during a menstrual period)."

Over the Counter Uses
"Nonprescription naproxen is used to reduce fever and to relieve mild pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches."

Form, Route, and Dosage
In its prescription forms, naproxen is available as a tablet, an enteric coated tablet (delayed-release tablet), an extended-release (long-acting) tablet, and a suspension (liquid) to take orally. Strengths available include 125mg/5ml (suspension), 250mg, 375mg, and 500mg. Patients may be prescribed up to 1000mg every 12 hours, to be taken with food.

The over-the-counter brand Aleve is available in the strength 220mg. Patients ages 12 to 65 taking naproxen over the counter are instructed to take 1 tablets (220mg) every 8 to 12 hours, with the option of taking 2 tablets (440mg) for the first dose. Patients over age 65 are instructed to take no more than 1 tablet every 12 hours. Patients under age 12 are instructed to ask their doctors before taking the drug.

Side Effects
Patients taking naproxen may experience side effects. Possible side effects include:
 * constipation
 * diarrhea
 * gas
 * sores in mouth
 * excessive thirst
 * headache
 * dizziness
 * lightheadedness
 * drowsiness
 * difficulty falling asleep or staying asleep
 * burning or tingling in the arms or legs
 * cold symptoms
 * ringing in the ears
 * hearing problems
 * changes in vision
 * feeling that the tablet is stuck in your throat
 * unexplained weight gain
 * sore throat, fever, chills, and other signs of infection
 * blisters
 * rash
 * skin reddening
 * itching
 * hives
 * swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs
 * difficulty breathing or swallowing
 * hoarseness
 * excessive tiredness
 * pain in the upper right part of the stomach
 * nausea
 * loss of appetite
 * yellowing of the skin or eyes
 * flu-like symptoms
 * bruises or purple blotches under the skin
 * pale skin
 * fast heartbeat
 * cloudy, discolored, or bloody urine
 * back pain
 * difficult or painful urination

Overdoses
Patients may overdose if they take too much naproxen. Symptoms of overdose include:
 * dizziness
 * extreme tiredness
 * confusion
 * drowsiness
 * stomach pain
 * heartburn
 * nausea
 * vomiting
 * slow or difficult breathing
 * decreased urination

Warnings
Taking NSAIDs like naproxen might increase risk of heart attack or stroke. This risk may increase in patients who take NSAIDs for a long time. Therefore, patients are instructed to alert their doctor if they have any of the following risk factors: someone in the patient's immediate family has ever had heart disease, a heart attack, or a stroke; smoking; high blood pressure or a history of high blood pressure; high cholesterol or a history of high cholesterol; or diabetes.

Patients are instructed to avoid taking naproxen before or after any coronary artery bypass graft (CABG) surgery.

Additionally, NSAIDs may cause ulcers, bleeding, or holes in the stomach or intestines. The risk of this may increase if patients take NSAIDs for a long time, are older in age, have poor health, or drink more than three alcoholic beverages per day.

As a Pollutant
Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.

In Sewage Sludge
Naproxen has been detected in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found naproxen in 44 samples (52%) in concentrations ranging from 20.9 to 1,020 parts per billion. There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

In Drinking Water
An Associated Press investigation found that, of 62 metropolitan areas in the U.S., only 28 tested for pharmaceuticals, and 24 found pharmaceuticals in the drinking water when they tested it. New Orleans, Philadelphia, and Washington, DC all tested positive for naproxen.

Related SourceWatch articles

 * Biosolids
 * Sewage sludge
 * Food Rights Network
 * Pharmaceuticals

External resources

 * PubMed Health - Naproxen