Dr. Andrea Middleton - Is It Bad For You? Approved by Dr. Andrea Middleton

Is Naproxen Bad For You?

Also Known As: Aleve, Naprosyn



Short answer

Naproxen, a nonsteroidal anti-inflammatory drug, is effective for treating pain, inflammation, and fever but may pose risks of gastrointestinal issues, cardiovascular problems, kidney and liver health concerns, and drug interactions. Appropriate use, considering individual risk factors and under medical guidance, is crucial to minimize potential side effects and ensure its benefits outweigh the risks.



Long answer

Overview of Naproxen and Its Therapeutic Use

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that has been widely used for its analgesic, antipyretic, and anti-inflammatory properties. It works by inhibiting the enzymes responsible for producing prostaglandins, compounds that contribute to inflammation, pain, and fever in the body. By reducing prostaglandin synthesis, naproxen effectively alleviates symptoms associated with a variety of conditions.

Naproxen is often prescribed for the management of pain and inflammation resulting from:

  • Osteoarthritis and rheumatoid arthritis
  • Ankylosing spondylitis
  • Tendinitis
  • Bursitis
  • Menstrual cramps (dysmenorrhea)
  • Acute gout
  • Other musculoskeletal disorders and acute injuries

Available in several forms, including tablets, capsules, liquid suspensions, and extended-release formulations, naproxen offers flexibility in dosing schedules to meet individual patient needs. The medication is typically taken twice daily with a glass of water, with or without food, though dosages can vary based on the specific condition being treated and the patient's response to therapy.

While naproxen is effective for short-term relief of pain and inflammation, long-term use requires careful consideration due to potential side effects and interactions with other drugs. It is imperative for patients to follow their healthcare provider's guidance regarding the dosage and duration of treatment with naproxen.

Numerous studies have validated the efficacy of naproxen in relieving pain and reducing inflammation. A review published in the Journal of Pain Research highlighted its effectiveness in treating acute postoperative pain, demonstrating comparable or superior results to other NSAIDs. Another significant study in the Annals of the Rheumatic Diseases concluded that naproxen effectively relieves symptoms of rheumatoid arthritis, including stiffness, swelling, and pain, underscoring its importance in managing chronic inflammatory conditions.

While naproxen is a valuable tool in the management of a range of conditions, it is not without its risks. Patients are advised to discuss their full medical history with their healthcare provider to ensure naproxen is a safe option for them. This includes disclosing any history of cardiovascular disease, gastrointestinal issues, kidney or liver function impairment, and any other medications or supplements currently being taken, to avoid adverse reactions or interactions.

Common Side Effects of Naproxen

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for reducing inflammation, pain, and fever. While it is effective for these purposes, it is not without its potential side effects. Understanding the common side effects associated with naproxen can help users make informed decisions about its use and when to seek medical advice.

Gastrointestinal Issues: One of the most frequently reported side effects of naproxen involves the gastrointestinal (GI) system. These can range from mild discomfort to serious, life-threatening conditions. Common GI symptoms include:

  • Heartburn
  • Nausea
  • Vomiting
  • Indigestion (dyspepsia)
  • Stomach pain
  • Constipation
  • Diarrhea
  • Gastric ulcers, which may lead to bleeding – a more serious side effect necessitating immediate medical attention

Cardiovascular Risks: Long-term use of naproxen, like other NSAIDs, has been linked to an increased risk of heart attack or stroke. This risk is higher for people who have existing heart disease or risk factors for cardiovascular disease.

Renal Effects: Kidney function can also be adversely affected by naproxen, especially with long-term use or in individuals with pre-existing kidney conditions. Symptoms related to kidney issues might include:

  • Fluid retention and swelling (edema)
  • Decreased urine output
  • Blood in urine

It's crucial for patients with kidney problems to consult a healthcare professional before starting naproxen.

Central Nervous System Effects: Naproxen may cause certain side effects related to the central nervous system, such as:

  • Headaches
  • Dizziness
  • Drowsiness
  • Fatigue
  • Cognitive disturbances in rare cases

These symptoms can impact the ability to perform tasks that require attention, such as driving or operating machinery.

Other Possible Side Effects: Although less common, some people may experience:

  • Skin rashes or itching
  • Ringing in the ears (tinnitus)
  • Shortness of breath
  • Anemia
  • Allergic reactions, which in rare cases can be severe and involve swelling of the face or throat, difficulty breathing, and anaphylaxis

It's important to note that individual reactions to naproxen can vary, and not everyone will experience these side effects. However, if side effects are severe, persistent, or worsen, it is crucial to seek medical advice promptly. For those with chronic conditions or taking other medications, consulting with a healthcare professional before starting naproxen is advisable to avoid potential drug interactions or exacerbation of existing conditions.

While this overview covers common side effects, it does not include all possible side effects of naproxen. For the most comprehensive and personalized advice, discuss with a healthcare provider or pharmacist.

Naproxen and Risk of Gastrointestinal Problems

Naproxen is a commonly used nonsteroidal anti-inflammatory drug (NSAID) that helps reduce inflammation, pain, and fever. Despite its effectiveness, one of the significant concerns associated with naproxen—and NSAIDs in general—is its impact on the gastrointestinal (GI) tract. The risk of GI problems ranges from mild disturbances to severe complications, including ulcers and bleeding.

Mechanism of Action and GI Distress

The principal mechanism through which naproxen operates can also lead to gastrointestinal issues. By inhibiting the enzyme cyclooxygenase (COX), naproxen reduces the production of prostaglandins, which play a key role in inflammation and pain but also protect the stomach lining by stimulating the production of mucus and bicarbonate. Reduced prostaglandin production diminishes this protective layer, making the GI tract more susceptible to damage from stomach acid.

Common GI Symptoms Associated with Naproxen

  • Dyspepsia (indigestion)
  • Heartburn
  • Nausea
  • Bloating
  • Abdominal pain

Severe GI Complications

  • Gastric ulcers: Open sores on the stomach lining
  • Duodenal ulcers: Open sores on the lining of the upper part of the small intestine (duodenum)
  • Gastrointestinal bleeding: Can range from minor to severe bleeding
  • Perforations: Holes in the stomach or intestinal wall

Studies have shown that long-term or high-dose use of NSAIDs like naproxen increases the risk of developing serious gastrointestinal complications. A systematic review published in the Archives of Internal Medicine highlighted that NSAIDs are associated with a two- to four-fold increase in the risk of GI complications such as bleeding or perforation compared to non-users.

Risk Factors for GI Problems

The risk of experiencing GI issues while taking naproxen varies among individuals, influenced by several factors:

  • Age: Older adults are at a higher risk.
  • History of ulcers or GI bleeding
  • Use of other medications (e.g., corticosteroids, anticoagulants) that can increase GI risk
  • High doses or prolonged use of NSAIDs
  • Smoking and alcohol use

Minimizing the Risk

There are several strategies to minimize the risk of GI complications when taking naproxen:

  • Use the lowest effective dose for the shortest duration necessary.
  • Consider concurrent use of gastroprotective agents (e.g., proton pump inhibitors or misoprostol) if you're at high risk for GI problems.
  • Maintain good communication with your healthcare provider, especially if you have a history of GI issues or other risk factors.
  • Avoid combining naproxen with other NSAIDs or medications that increase GI risk.
  • Limit alcohol consumption and quit smoking.

It's crucial for individuals considering naproxen for pain or inflammation relief to be aware of these potential gastrointestinal risks. By understanding the factors that increase the likelihood of GI complications and taking appropriate precautions, patients and their healthcare providers can work together to ensure the benefits of naproxen use outweigh the risks.

Cardiovascular Concerns with Long-Term Naproxen Use

Naproxen, a popular nonsteroidal anti-inflammatory drug (NSAID), is commonly used for its pain-relieving and anti-inflammatory properties. While it offers significant benefits for managing conditions like arthritis, menstrual cramps, and general pain relief, long-term use raises concerns, particularly regarding cardiovascular health. Understanding these risks is crucial for both patients and healthcare providers to make informed decisions about its use.

Evidence of Increased Risks

Several studies have linked long-term NSAID use, including naproxen, with elevated risks for cardiovascular events. A meta-analysis published in the British Medical Journal (BMJ) highlighted that certain NSAIDs may increase the risk of heart attacks and strokes, especially when taken in high doses or for prolonged periods. While naproxen has been suggested to have a somewhat lower risk compared to other NSAIDs, the risk cannot be discounted entirely, particularly in individuals with pre-existing cardiovascular conditions or those at high risk of cardiovascular disease.

Possible Mechanisms

The exact mechanisms through which NSAIDs like naproxen could increase cardiovascular risk are not fully understood but are believed to involve the inhibition of prostaglandin synthesis. This action can lead to adverse effects on blood pressure, atherothrombosis, and kidney function, all of which are factors in cardiovascular health. Increased blood pressure is a known risk factor for heart attacks and strokes, while impaired kidney function can exacerbate heart failure.

Risk Factors

  • Pre-existing cardiovascular disease
  • Hypertension (high blood pressure)
  • Chronic kidney disease
  • Diabetes
  • Smoking and other lifestyle factors

Patients with these risk factors should exercise caution and consult healthcare providers before taking naproxen, especially for long-term pain management.

Recommendations for Patients and Healthcare Providers

For those considering the use of naproxen for pain management, especially on a long-term basis, the following steps are recommended:

  • Assessment of individual risk factors for cardiovascular disease before initiating treatment.
  • Limiting the dose and duration of naproxen use to the minimum effective for managing symptoms.
  • Regular monitoring of blood pressure, kidney function, and signs of heart disease.
  • Considering alternative pain management strategies, particularly for individuals at high risk of cardiovascular events.

In conclusion, while naproxen is an effective medication for pain and inflammation, awareness, and management of potential cardiovascular risks are essential, especially for long-term users. Individual risk factors and potential benefits should be carefully weighed against the risks, with regular health monitoring for those who opt to use this medication.

Naproxen Interaction with Other Medications

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to relieve pain, reduce inflammation, and lower fever. While effective, its interactions with other medications can pose risks, necessitating cautious use and thorough understanding of potential complications. This sub-section delves into the notable drug interactions with naproxen, aiming to provide clarity and guidance on safely managing these combinations.

1. Anticoagulants and Antiplatelet Drugs

Concurrent use of naproxen with anticoagulants (like warfarin) or antiplatelet drugs (such as aspirin and clopidogrel) can significantly increase the risk of bleeding. A study published in the Journal of Thrombosis and Haemostasis suggests that NSAIDs like naproxen may impair platelet function, which, when combined with these medications, could lead to gastrointestinal bleeds or other hemorrhagic events.

2. Antihypertensive Medications

Naproxen may reduce the efficacy of antihypertensive drugs, including beta-blockers, ACE inhibitors, and diuretics. Its mechanism involves the inhibition of prostaglandin synthesis, which plays a crucial role in kidney function and blood pressure regulation. Thus, combining naproxen with these medications may necessitate adjustments in dosing or closer monitoring of blood pressure.

3. Selective Serotonin Reuptake Inhibitors (SSRIs)

Individuals taking SSRIs for depression or anxiety might face an elevated risk of gastrointestinal bleeding when also using naproxen. The synergistic effect of SSRIs on platelet aggregation, along with the gastrointestinal lining irritation caused by naproxen, heightens the risk. Clinical awareness and preventive measures, like using protective agents (e.g., proton pump inhibitors), are recommended for those needing both medications.

4. Other NSAIDs

Combining naproxen with other NSAIDs, including over-the-counter options like ibuprofen, increases the likelihood of adverse effects such as gastrointestinal ulcers and kidney problems. This combination is generally advised against, especially in individuals at high risk for these conditions.

5. Lithium

Naproxen can increase lithium levels in the blood, potentially leading to lithium toxicity. Symptoms might include nausea, tremors, and confusion. Those prescribed lithium should have their levels closely monitored when starting or adjusting naproxen therapy.

Given these significant interactions, it's essential for individuals on naproxen or those considering its use to consult healthcare professionals. This discussion should include a review of all current medications—prescription, over-the-counter, and supplements—to ensure safe and effective use.

Liver and Kidney Health: The Impact of Naproxen

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that's widely used to relieve pain, reduce inflammation, and lower fever. While it's effective for these purposes, its impact on liver and kidney health is a significant concern that users should be aware of. Understanding the relationship between naproxen and these vital organs can help individuals make informed decisions about its use.

Liver Health:

Generally, naproxen is processed by the liver. For most individuals, short-term use does not result in noticeable liver damage. However, long-term use or high doses can increase the risk of liver toxicity. Symptoms of liver damage may include nausea, fatigue, lethargy, itching, yellowing of the skin or eyes (jaundice), and flu-like symptoms.

Studies highlight the rare, but potential risk of liver injury from naproxen use. One such study, published in the Journal of the American Medical Association, notes that NSAIDs like naproxen can cause elevated liver enzymes, an indicator of liver stress or damage, in some patients.

Kidney Health:

The impact of naproxen on kidney health is a matter of concern, especially for individuals with pre-existing kidney conditions or those who are at risk of kidney disease. Naproxen can reduce kidney function by altering the blood flow within the kidneys, which can lead to kidney damage over time. Potential kidney-related side effects include fluid retention, elevated blood pressure, and in severe cases, acute kidney injury or chronic kidney disease.

Research underscores the importance of monitoring kidney function in patients using naproxen, especially those with risk factors for kidney disease. A systematic review in the Nephrology Dialysis Transplantation journal points out that NSAID use, including naproxen, is associated with an increased risk of acute kidney injury, particularly in older adults and those with existing kidney or cardiovascular conditions.

Risk Factors and Recommendations:

  • Individuals with a history of liver or kidney disease should use naproxen with caution and under medical supervision.
  • Monitoring liver and kidney function tests can help detect any adverse effects early on during long-term naproxen therapy.
  • Avoiding alcohol and other medications that can stress the liver or kidneys while using naproxen is advisable to minimize potential risks.
  • Staying hydrated and maintaining a healthy diet can support liver and kidney health during naproxen use.

In summary, while naproxen is an effective pain reliever and anti-inflammatory medication, its impacts on liver and kidney health cannot be overlooked. Potential users should weigh the benefits against the risks and consult healthcare professionals for personalized advice, especially if they have existing health conditions that could be exacerbated by naproxen use.

Frequently asked questions

Naproxen should be used with caution during pregnancy, especially in the third trimester, as it may cause complications for both the mother and the fetus. During breastfeeding, it is generally advised to avoid naproxen as it can pass into breast milk and may affect the nursing infant. Always consult with a healthcare provider before taking naproxen if you are pregnant or breastfeeding.

Yes, naproxen can be effective in treating headaches, including migraines, due to its anti-inflammatory properties. It may help alleviate the pain and inflammation associated with headaches. However, it should be used as directed by a healthcare provider, as overuse of any NSAID for headaches can lead to medication-overuse headaches.

Naproxen is often considered to have a lower risk of cardiovascular events compared to other NSAIDs, such as ibuprofen and diclofenac. However, the risk cannot be entirely dismissed, especially in individuals with existing cardiovascular conditions or high cardiovascular risk factors. It is important to discuss your individual risks and treatment options with your healthcare provider.

Consuming alcohol while taking naproxen can increase the risk of gastrointestinal issues, such as ulcers and bleeding. Alcohol can irritate the stomach lining, and when combined with naproxen, this risk is heightened. It is generally advised to limit or avoid alcohol consumption while taking naproxen.

Ask a question about Naproxen and our team will publish the answer as soon as possible.

Possible short-term side effects

  • nausea
  • vomiting
  • indigestion
  • stomach pain
  • constipation
  • diarrhea
  • headaches
  • dizziness
  • drowsiness
  • fatigue
  • skin rashes
  • itching
  • shortness of breath
  • fluid retention
  • swelling (edema)
  • decreased urine output
  • blood in urine

Possible long-term side effects

  • gastrointestinal ulcers and bleeding
  • increased risk of heart attack or stroke
  • kidney damage
  • liver toxicity
  • elevated blood pressure
  • acute kidney injury
  • chronic kidney disease
  • anemia
  • cognitive disturbances


  • reduces inflammation
  • alleviates pain
  • lowers fever
  • effective for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, tendinitis, bursitis, menstrual cramps, acute gout, musculoskeletal disorders

Healthier alternatives

  • use of lowest effective dose
  • use for shortest duration necessary
  • consider alternative pain management strategies
  • maintain healthy lifestyle
  • stay hydrated
  • limit alcohol consumption
  • quit smoking
  • regular health monitoring

Thank you for your feedback!

Written by Dr. Becky Maes
Published on: 05-02-2024

Thank you for your feedback!

Written by Dr. Becky Maes
Published on: 05-02-2024

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