Skip to main content

Naproxen Dosage: Guidelines and Recommendations

Last reviewed: December 2025

Overview

Naproxen dosing depends on the condition being treated and whether you’re using OTC or prescription strength. Its longer duration of action allows for less frequent dosing than ibuprofen—typically twice daily rather than every 4-6 hours.

OTC Dosage (Aleve)

Standard adult dose:

  • 220 mg (one tablet) every 8-12 hours
  • May take 440 mg (two tablets) as first dose
  • Maximum: 660 mg (3 tablets) in 24 hours

Duration limits:

  • Pain: Maximum 10 days without medical advice
  • Fever: Maximum 3 days without medical advice

Prescription Dosage

Naproxen sodium (Anaprox):

  • 275-550 mg twice daily
  • Maximum: 1,375 mg per day (1,100 mg after first day)

Naproxen (Naprosyn):

  • 250-500 mg twice daily
  • Maximum: 1,500 mg per day initially, then 1,000 mg daily

Extended-release (Naprelan):

  • 750-1,000 mg once daily
  • Do not crush or chew

Dosing by Condition

Arthritis (Osteoarthritis/Rheumatoid)

  • Prescription: 250-500 mg twice daily
  • OTC: 220 mg every 8-12 hours
  • May take weeks to see full anti-inflammatory benefit

Menstrual Cramps

  • Prescription: 500 mg initially, then 250 mg every 6-8 hours
  • OTC: 440 mg initially, then 220 mg every 8-12 hours
  • Start at first sign of symptoms

Acute Gout

  • Prescription: 750 mg initially, then 250 mg every 8 hours
  • Treatment typically continues until attack resolves

Mild to Moderate Pain

  • OTC: 220 mg every 8-12 hours
  • Prescription: 250-500 mg twice daily
  • Use lowest effective dose

Migraine

  • OTC: 220-440 mg at onset
  • Best results when taken early

Important Dosing Guidelines

Take with food or milk:

  • Reduces stomach irritation
  • Does not significantly affect absorption

Stay hydrated:

  • Drink adequate fluids
  • Important for kidney protection

Timing consistency:

  • Take at same times each day for chronic use
  • Maintains steady blood levels

Dosage Conversions

Naproxen sodium vs naproxen base:

  • 220 mg naproxen sodium = 200 mg naproxen
  • 550 mg naproxen sodium = 500 mg naproxen
  • Sodium salt is absorbed slightly faster

Special Populations

Elderly (65+)

  • Start with lowest effective dose
  • Higher risk of GI bleeding and kidney effects
  • Maximum 220 mg every 12 hours for OTC

Kidney Impairment

  • Reduce dose or avoid
  • Mild impairment: Use lower doses with monitoring
  • Severe impairment: Not recommended

Liver Impairment

  • Use lower doses
  • Monitor for increased side effects

What If You Miss a Dose?

For regular scheduled doses:

  • Take as soon as remembered
  • If close to next dose, skip the missed dose
  • Never double up doses

For as-needed use:

  • Take when you need pain relief
  • Maintain minimum 8-12 hours between doses

Overdose Warning

Signs of overdose:

  • Nausea and vomiting
  • Stomach pain
  • Drowsiness
  • Dizziness
  • Black or bloody stools

If overdose suspected:

  • Call Poison Control: 1-800-222-1222
  • Seek emergency care for severe symptoms

Common Mistakes to Avoid

  1. Exceeding maximum daily dose — Stay within limits
  2. Combining with other NSAIDs — Don’t take with ibuprofen or aspirin
  3. Taking on empty stomach — Always take with food
  4. Long-term OTC use — See a doctor if needed beyond 10 days
  5. Ignoring warning symptoms — Stop if you have stomach pain or black stools

Sources

  • FDA — Naproxen Prescribing Information
  • Aleve (naproxen sodium) Package Insert
  • American College of Rheumatology — NSAID Dosing Guidelines
  • UpToDate — Naproxen: Drug Information
Last reviewed: December 2025