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Naproxen (Aleve): Uses, Dosage, and Safety Information

Last reviewed: December 2025

Overview

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that provides longer-lasting pain relief than ibuprofen. Available over-the-counter as Aleve and by prescription in higher doses, naproxen is commonly used for arthritis, menstrual cramps, and various types of pain requiring sustained relief.

What Is Naproxen?

Naproxen belongs to the NSAID class of medications. It works by blocking cyclooxygenase (COX) enzymes, which reduces the production of prostaglandins—chemicals that cause pain, inflammation, and fever.

Key characteristics:

  • Longer duration of action (8-12 hours vs 4-6 hours for ibuprofen)
  • Available OTC (220 mg) and prescription (250-500 mg)
  • Effective for chronic conditions requiring sustained relief
  • Takes slightly longer to start working than ibuprofen

Common Uses

Pain relief:

  • Arthritis (osteoarthritis and rheumatoid arthritis)
  • Menstrual cramps
  • Headaches and migraines
  • Back pain
  • Muscle aches
  • Dental pain
  • Minor injuries

Inflammation:

  • Tendinitis and bursitis
  • Gout attacks
  • Joint inflammation

Fever reduction:

  • General fever (less common use than ibuprofen)

How It Works

Naproxen inhibits both COX-1 and COX-2 enzymes:

  • COX-2 inhibition: Reduces pain and inflammation
  • COX-1 inhibition: Causes side effects (stomach irritation, bleeding risk)

The longer half-life means naproxen stays in your system longer, providing extended relief but also prolonged exposure to side effects.

Dosing Basics

Over-the-counter (Aleve):

  • 220 mg every 8-12 hours
  • Maximum: 660 mg per day (3 tablets)

Prescription:

  • 250-500 mg twice daily
  • Higher doses available under medical supervision

Important: Take with food or milk to reduce stomach upset.

Who Should Avoid Naproxen

Do not use if you have:

  • Allergy to NSAIDs or aspirin
  • History of stomach ulcers or GI bleeding
  • Severe kidney or liver disease
  • Heart failure
  • Recent or planned heart surgery (CABG)

Use with caution if you have:

  • Heart disease or high blood pressure
  • Kidney problems
  • Asthma (especially aspirin-sensitive)
  • History of stomach problems
  • Age over 65

Key Warnings

Cardiovascular risk:

  • NSAIDs may increase risk of heart attack and stroke
  • Risk increases with longer use and higher doses
  • People with heart disease are at greater risk

GI bleeding:

  • Can cause stomach ulcers and bleeding
  • Risk increases with age, alcohol use, and corticosteroid use
  • May occur without warning symptoms

Kidney effects:

  • Can reduce kidney function
  • Stay well hydrated
  • Avoid if you have kidney disease

Drug Interactions

Major interactions:

  • Blood thinners (warfarin, aspirin)
  • Other NSAIDs
  • Lithium
  • Methotrexate
  • ACE inhibitors and ARBs
  • Diuretics
  • SSRIs

Avoid combining with other NSAIDs (including ibuprofen and aspirin).

Naproxen vs Ibuprofen

Naproxen advantages:

  • Longer-lasting (twice daily vs 3-4 times daily)
  • Better for chronic conditions
  • May be slightly easier on the stomach per dose

Ibuprofen advantages:

  • Faster onset of action
  • Lower doses available
  • Better studied in children

Storage

  • Store at room temperature
  • Keep away from moisture and heat
  • Keep out of reach of children

Sources

  • FDA — Naproxen Drug Information
  • American College of Rheumatology — NSAID Guidelines
  • UpToDate — Naproxen: Drug Information
  • Prescribing information for Aleve and Naprosyn
Last reviewed: December 2025