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Brand Name

Apo-Napro-Na

Common Name

naproxen sodium

How does this medication work? What will it do for me?

Naproxen sodium belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It reduces swelling, inflammation and pain, and is used for the relief of mild to moderately severe pain accompanied by inflammation. Naproxen sodium is used to help relieve pain due to muscle injury, dental extraction, menstrual cramps, and cramping after childbirth. It is believed to work by stopping the production of prostaglandins, which cause inflammation.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The recommended adult starting dose of naproxen sodium is 550 mg (two 275 mg tablets) followed by one 275 mg tablet every 6 to 8 hours as needed.

Alternatively, one of the 550 mg tablets may be taken twice daily. Do not take more than 1,375 mg per day. The lowest dose for the shortest period of time should be used to reduce the risk of side effects.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light, and keep it out of the reach of children.

This medication is available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under "What form(s) does this medication come in?"

What form(s) does this medication come in?

Apo-Napro-Na
Each blue, oval, biconvex, film-coated tablet, identified "APO-275" on one side, contains naproxen sodium 275 mg. Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, dextrates, hydroxypropyl cellulose, hydroxypropyl methylcellulose, indigotine aluminum lake (FD&C Blue No. 2), magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), stearic acid, and titanium dioxide.

Apo-Napro-Na DS
Each blue, oval, biconvex, film-coated tablet, identified "APO-550" on one side, contains naproxen sodium 550 mg. Nonmedicinal ingredients: carnauba wax, colloidal silicon dioxide, dextrates, hydroxypropyl cellulose, hydroxypropyl methylcellulose, indigotine aluminum lake (FD&C Blue No. 2), magnesium stearate, microcrystalline cellulose, polyethylene glycol 3350 (carbowax), stearic acid, and titanium dioxide.

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Who should NOT take this medication?

Naproxen sodium should not be taken by anyone who:

• is allergic to naproxen sodium or to any of the ingredients of the medication
• is 18 years of age or younger
• is breast-feeding or planning to breast-feed
• is currently taking other NSAIDs (e.g., ibuprofen, ketorolac, naproxen, indomethacin)
• is going to have or has just had heart bypass surgery
• is in the third trimester (last 3 months) of pregnancy
• has a bleeding disorder
• has a bleeding ulcer in the stomach or intestines
• has bleeding in the brain
• has had an allergic reaction (e.g., difficulty breathing; wheezing; itchy skin rash; swelling of the face, throat, or tongue) to ASA or any other anti-inflammatory medication (e.g., ibuprofen, ketorolac, indomethacin)
• has high levels of blood potassium (hyperkalemia)
• has inflammatory bowel disease (e.g, ulcerative colitis, Crohn's disease)
• has severe liver disease
• has severely reduced kidney function
• has severe, uncontrolled heart failure

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• constipation
• diarrhea
• dizziness, drowsiness, or lightheadedness
• heartburn, indigestion
• increased sweating
• irritation, dryness, or soreness of mouth
• nausea
• unusual tiredness or weakness without any other symptoms

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

bladder pain confusion decreased hearing, any other change in hearing, or ringing or buzzing in ears difficult or painful urination dizziness or lightheadedness feeling of being unwell feeling thirsty feeling unusually tired headache increased sensitivity of the skin to sunlight (sunburn, skin blisters, skin rash, redness, itching, discoloration) loss of appetite persistent heartburn, stomach pain, diarrhea, or nausea

pounding heartbeat rapid weight gain stiff neck swelling of the feet or ankles symptoms of depression (difficulty concentrating, trouble sleeping or sleeping too much, increased or decrease appetite, loss of energy, feeling of guilt or hopelessness, loss of interest in activities) symptoms of liver problems (e.g., yellowing of the skin or eyes with or without itchy skin) tiny pinpoint red spots on the skin unusual bleeding or bruising vomiting

Stop taking the medication and seek immediate medical attention if any of the following occur:

• bloody or black, tarry stools
• blurred vision or any visual disturbance
• change in the amount or colour of urine
• chills, fever, muscle aches or pains along with a skin rash
• symptoms of a severe allergic reaction (e.g., hives; shortness of breath, wheezing, trouble breathing or chest tightness; swelling of the face, mouth, throat ,or tongue)
• vomiting of blood or material that looks like coffee grounds

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Blood clotting: This medication may reduce the ability of the blood to clot for some people. Those who may be adversely affected by such an action should use caution when taking naproxen sodium.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: This medication should not be given to people who have had a reaction to acetylsalicylic acid (ASA) that included a runny nose, itchy skin rash, nasal polyps, or shortness of breath and wheezing. If you experience symptoms of a severe allergic reaction (e.g., hives; difficulty breathing, wheezing; swelling of the face, tongue, or throat), get immediate medical attention.

Aseptic meningitis: This medication can rarely cause symptoms of aseptic meningitis (inflammation or swelling of the membranes around the brain and spinal cord that is not caused by bacteria). People who have autoimmune conditions (e.g., systemic lupus erythematosus, mixed connective tissue disease) are more at risk for developing this. If you experience symptoms such as stiff neck, severe headache, nausea, vomiting, fever, or changes in consciousness, stop taking this medication can get immediate medical attention.

Bladder problems: Some people taking this medication experience bladder pain, painful or difficult urination, or increased frequency of urination. If these symptoms occur without an explanation (e.g., infection), stop taking this medication and contact your doctor.

Blood clotting: This medication may reduce the ability of the blood to clot for some people. People who are taking anticoagulants and people with hemophilia or other blood disorders (e.g., low white blood cells, low platelets) should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with bleeding disorders should not take this medication.

Drowsiness/reduced alertness: As with other NSAIDs, naproxen sodium can cause drowsiness, dizziness, and blurred vision. Avoid driving and other activities that require alertness and concentration until you determine the effect this medication has on you.

Fluid and electrolyte balance: NSAIDs such as naproxen sodium can cause fluid retention and edema (swelling). This can lead to high blood pressure or worsening of heart failure. People with heart failure or high blood pressure should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severe, uncontrolled heart failure should not take this medication.

There is a risk of high blood potassium when treating with naproxen sodium. People most at risk are seniors; people who have diabetes or kidney failure; and people taking beta-adrenergic blockers (e.g., metoprolol, atenolol), angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril, enalapril), or some diuretics (e.g., triamterene, amiloride). People with high blood potassium levels should not take this medication.

Heart attack and stroke: This medication is associated with an increased risk of heart attack and stroke. The risk is increased with higher total daily doses and taking the medication over long periods of time. People with a history of heart disease (e.g., heart attack, stroke, heart failure) or who have risk factors for heart disease (e.g., high blood pressure, high cholesterol, diabetes, smoking, kidney disease) should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Ask your doctor about all available treatment options that may be right for you.

Kidney function: Long-term use of naproxen sodium may lead to kidney problems. People who already have kidney problems, liver disease, or heart failure and people who are dehydrated, on salt restricted diets, or are seniors have an increased risk for kidney problems while taking this medication. People who are taking medications such as diuretics (e.g., hydrochlorothiazide, triamterene, indapamide), ACE inhibitors (e.g., enalapril, ramipril), angiotensin receptor blockers (e.g., valsarten, candesarten), or cyclosporine are also at an increased risk. People with these conditions or taking these medications should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severe kidney problems should not take this medication.

Liver problems: Rarely, this medication causes liver problems. People with reduced liver function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you develop yellowing of the skin or eyes while taking this medication, contact your doctor immediately.

Skin reactions: This medication can cause skin reactions, some of which may be severe. If you experience a skin rash, especially where the skin is blistering or peeling, stop taking this medication and contact your doctor.

Ulcers or bleeding in the stomach or intestines: Naproxen sodium can cause stomach ulcers, perforation, and bleeding from the stomach. These complications can occur at any time and are sometimes severe enough to require immediate medical attention. The risk of ulcers and bleeding are increased in people taking higher doses of this medication for longer periods of time. Other factors that increase the risk of these complications include drinking excessive amounts of alcohol, smoking, poor health, and taking certain medications (e.g., warfarin, ASA, clopidogrel, prednisone, citalopram, fluoxetine, paroxetine, sertraline).

People who have ulcers in the stomach or intestines that are bleeding, or thos who have an inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis) should not take this medication. People with a history of these conditions should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Ask your doctor about all available treatment options that may be right for you.

Stop taking the medication and get immediate medical attention if you experience symptoms or signs of stomach ulcers or bleeding in the stomach (black and tarry stools, vomit that looks like coffee grounds, stomach pain). These reactions can occur at any time during treatment without warning.

Pregnancy: This medication should not be used during the third trimester (last 3 months) of pregnancy. This medication should not be used during the first and second trimester (first 6 months) of pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

This medication may reduce your ability to become pregnant. Taking this medication while trying to become pregnant is not recommended.

Breast-feeding: This medication should not be used by breast-feeding mothers.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors appear to have a higher risk of side effects. They should use the lowest effective dose under close medical supervision. Ask your doctor about all available treatment options that may be right for you.

What other drugs could interact with this medication?

There may be an interaction between naproxen sodium and any of the following:

acetylsalicylic acid (ASA) alcohol angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril, enalapril) antacids beta blockers (e.g., metoprolol, atenolol) cholestyramine clopidogrel colestipol corticosteroids (e.g., prednisone) cyclosporine digoxin diuretics (e.g., spironolactone, triamterene, furosemide, hydrochlorothiazide) heparin herbal products that affect blood clotting (e.g., cat's claw, chamomile, fenugreek, evening primrose, feverfew, garlic, ginger, ginseng, turmeric)

lithium methotrexate oral contraceptives oral hypoglycemics (e.g., glyburide, glicazide) other NSAIDs (e.g., naproxen, ketorolac, ibuprofen, diclofenac) pemetrexed phenytoin potassium supplements probenecid SSRIs (e.g. citalopram, fluoxetine, paroxetine, sertraline) suflonamides (e.g., sulfamethoxazole) tacrolimus warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Disclaimer

The information within this website is for Canadian audiences only. This content is for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. It should not be construed to indicate that the use of a particular drug is safe, appropriate or effective for you. It should not be relied upon or interpreted as a recommendation for any specific treatment plan, product or course of action. The information on the site is not intended as a substitute of any kind for professional medical advice, diagnosis or treatment. Speak to your healthcare professional before taking any product, changing your lifestyle, or beginning or discontinuing any course of treatment. If you suspect that you are ill or may have a medical emergency, contact a physician, a health professional or call 911 immediately.