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naproxen
generic
Black Box Warnings .
Cardiovascular Thrombotic Event
NSAIDs incr. risk of serious and potentially fatal cardiovascular thrombotic events, incl. MI and stroke; risk may occur early in tx and may incr. w/ duration of use; contraindicated for CABG periop pain
GI Bleeding, Ulceration, and Perforation
NSAIDs incr. risk of serious and potentially fatal GI adverse events incl. bleeding, ulcer, and stomach or intestine perforation; GI events may occur at any time during use and w/o warning sx; elderly pts and pts w/ hx of PUD or GI bleeding at greater risk for serious GI events
Adult Dosing .
Dosage forms: TAB: 250 mg, 375 mg, 500 mg; DR TAB: 375 mg, 500 mg; SUSP: 125 mg per 5 mL
Special Note
- [strength clarification]
- Info: 250, 500 mg naproxen = 275, 550 mg naproxen sodium
osteoarthritis
- [250-500 mg PO q12h]
- Max: 1500 mg/day x6mo; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
rheumatoid arthritis
- [250-500 mg PO q12h]
- Max: 1500 mg/day x6mo; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
ankylosing spondylitis
- [250-500 mg PO q12h]
- Max: 1500 mg/day x6mo; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
gout, acute
- [250 mg PO q8h]
- Start: 750 mg x1; Alt: 500 mg PO bid; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
pain, mild-moderate
- [250-500 mg PO q12h]
- Max: 1250 mg/day acute; 1000 mg/day maint.; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
dysmenorrhea
- [250-500 mg PO q12h]
- Max: 1250 mg/day; Alt: 500 mg PO x1, then 250 mg PO q6-8h; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
for anti-inflammatory uses
- [250-500 mg PO q12h]
- Max: 1250 mg/day acute; 1000 mg/day maint.; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
renal dosing
- [see below]
- CrCl >60: no adjustment; CrCl 30-60: not defined, caution advised; CrCl <30: avoid use
- HD/PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: TAB: 250 mg, 375 mg, 500 mg; DR TAB: 375 mg, 500 mg; SUSP: 125 mg per 5 mL
Special Note
- [strength clarification]
- Info: 250, 500 mg naproxen = 275, 550 mg naproxen sodium
juvenile idiopathic arthritis
- [2 yo and older]
- Dose: 10 mg/kg/day PO divided q12h; Max: 1000 mg/day; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
pain, mild-moderate
- [2 yo and older]
- Dose: 10-20 mg/kg/day PO divided q8-12h; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
fever (off-label)
- [2 yo and older]
- Dose: 10-20 mg/kg/day PO divided q8-12h; Max: 1000 mg/day; Info: use lowest effective dose, shortest effective tx duration; give w/ food if GI upset occurs
renal dosing
- [see below]
- CrCl >60: no adjustment; CrCl 30-60: not defined, caution advised; CrCl <30: avoid use
- HD/PD: avoid use
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised