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Naproxen Sodium

Common brand names: Aleve, Anaprox

Description: Naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID). It relieves pain, reduces fever and reduces swelling.

Dental uses: In dentistry, naproxen sodium is prescribed to treat mild to moderate pain. The pain can be from dental surgery, toothache or the temporomandibular joint. For minor pain, take a 220-milligram dose (that is, 1 Aleve) every 8 to 12 hours. This is roughly equal to the pain-relieving effects of 200 milligrams of ibuprofen (1 Advil) every 4 to 6 hours. For more severe dental pain, such as that after oral surgery, 440 milligrams of naproxen sodium (2 Aleve) has been shown to work better than 1,000 milligrams of acetaminophen. This dose also is at least equivalent to 400 milligrams of ibuprofen (2 Advil). Naproxen sodium (440 to 550 milligrams) is noted for having a relatively long-lasting effect (8 to 12 hours). Naproxen sodium may also be used for the treatment of fever.

Dosages for dental purposes: The prescription for naproxen sodium after dental surgery is usually 440 to 550 milligrams every 8 to 12 hours, as needed. The maximum daily dose should not exceed 1,350 milligrams on the first day of treatment. It should not exceed 1,100 milligrams on the other days. The maximum dose depends on several factors. These include the person's age and whether or not the tablet is an extended-release formula. Treatment for pain after dental surgery is usually less than 5 days.

Do not give naproxen sodium to a child under age 12 unless directed to do so by a physician or dentist. Adults over age 65 should receive lower doses. Consult your physician or dentist. Prescription doses are different than over-the-counter doses.

Your dentist may prescribe naproxen sodium on a scheduled dosing for 2 to 3 days after surgery. This means you would take it by the clock and not just "as needed." As with all medicines, take it as prescribed for maximum benefit.

Concerns and possible side effects: Tell your dentist and physician about all the medicines you take. This should include over-the-counter vitamins and herbal supplements. Also, let your dentist know if you have had a sensitive or allergic reaction to any medicine. If you are pregnant or nursing, or might be pregnant, talk to your primary care doctor before starting any new medicine. This also includes vitamins and supplements.

For dental uses of a week or less, naproxen sodium is a very safe, well-tolerated and effective pain reliever. Side effects can include abdominal pain, nausea and increased bleeding time.

NSAIDs have some black-box warnings. These are warnings on the package insert about possible serious side effects. For naproxen sodium, these include:

  • "NSAIDs are associated with an increased risk of adverse cardiovascular events, including MI [heart attack], stroke, and new onset or worsening of pre-existing hypertension [high blood pressure]."
  • "NSAIDs may increase risk of gastrointestinal irritation, ulceration, bleeding and perforation."

Some people may take naproxen sodium for many weeks or months. For example, people with TMJ pain may need to take this drug for a long time. With long-term use, more serious side effects can occur. They include:

  • Bleeding ulcers
  • Perforations of the stomach and small intestines (occurring in 1% to 4% of patients)
  • Reduced kidney function

Naproxen sodium should not be given to:

  • People who are allergic to aspirin or other NSAIDs
  • Certain people with asthma who are sensitive to NSAIDs — In these people, these drugs can bring on an asthma attack.
  • Pregnant women, especially during the last three months of pregnancy
  • People with kidney disease
  • People with ulcers of the stomach or the small intestine

If you take this medicine and begin to have difficulty breathing or swelling of your face, lips, tongue or throat, get medical help right away.

Avoid drinking alcohol if you are taking naproxen sodium. Alcohol increases the risk of stomach ulcers and bleeding. Naproxen sodium also may interact with other drugs, including:

  • Aspirin — People taking both aspirin and naproxen sodium may lose the heart-protective effects of aspirin and increase the risk for bleeding.
  • Lithium (Eskalith) — If this drug is combined with naproxen sodium, it can lead to lithium toxicity.
  • Warfarin (Coumadin) and other anticoagulants — Taking these with naproxen sodium can lead to increased bleeding.
  • Some high blood pressure medicines, including beta blockers, ACE inhibitors and diuretics — Combining any of these with naproxen sodium may increase blood pressure.
  • Other NSAID medicines, such as ibuprofen (Advil, Motrin and others), diclofenac (Voltaren and others), piroxicam (Feldene), etodolac (Lodine), meloxicam (Mobic) and nabumetone (Relafen).
  • NSAID combination medicines, such as Midol Extended Relief, Combunox and Treximet.

These interactions can be serious. Tell your doctor about any reaction to a prescribed medicine, no matter how minor it might be.

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