Naproxen Side Effects: What to Know
Overview
Naproxen shares side effects common to all NSAIDs, including stomach problems, cardiovascular risks, and kidney effects. While generally well-tolerated for short-term use, the longer half-life of naproxen means side effects may persist longer once they occur.
Common Side Effects
Gastrointestinal (most common):
- Stomach upset or pain
- Heartburn
- Nausea
- Constipation or diarrhea
- Gas and bloating
Nervous system:
- Headache
- Dizziness
- Drowsiness
Other common effects:
- Fluid retention (mild swelling)
- Ringing in ears (tinnitus)
Most common side effects improve as your body adjusts or resolve when you stop taking naproxen.
Serious Side Effects
Gastrointestinal Bleeding
Warning signs:
- Black, tarry stools
- Blood in vomit (may look like coffee grounds)
- Severe stomach pain
- Unexplained fatigue or weakness
Risk factors:
- Age over 65
- History of ulcers or GI bleeding
- Concurrent use of blood thinners
- Alcohol use
- High doses or long-term use
- Corticosteroid use
Important: GI bleeding can occur without warning symptoms.
Cardiovascular Events
Risks:
- Heart attack
- Stroke
- High blood pressure
- Heart failure worsening
Risk factors:
- Existing heart disease
- High blood pressure
- Diabetes
- High cholesterol
- Smoking
- Longer duration of use
- Higher doses
Kidney Problems
Warning signs:
- Decreased urination
- Swelling in ankles or feet
- Unusual fatigue
- Unexplained weight gain
Risk factors:
- Existing kidney disease
- Dehydration
- Older age
- Use with ACE inhibitors or diuretics
Liver Problems
Warning signs:
- Yellowing of skin or eyes (jaundice)
- Dark urine
- Severe fatigue
- Upper right abdominal pain
- Nausea
Severe Allergic Reactions
Symptoms:
- Difficulty breathing
- Swelling of face, lips, tongue, throat
- Hives or severe rash
- Chest tightness
Seek emergency care immediately if these occur.
Skin Reactions
Rare but serious:
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Blistering or peeling skin
- Widespread rash with fever
Stop naproxen immediately and seek medical care if severe skin reactions occur.
Side Effects by Body System
Digestive System
- Stomach pain (3-9%)
- Heartburn (3-9%)
- Nausea (3-9%)
- Constipation (3-9%)
- Diarrhea (1-3%)
- Ulcers and bleeding (rare but serious)
Cardiovascular System
- Elevated blood pressure
- Edema (fluid retention)
- Palpitations
- Heart attack, stroke (rare but serious)
Nervous System
- Headache (3-9%)
- Dizziness (3-9%)
- Drowsiness (3-9%)
- Difficulty concentrating
Skin
- Itching
- Rash
- Bruising
- Sweating
Ears
- Tinnitus (ringing in ears)
- Hearing changes
Managing Side Effects
Stomach Problems
- Always take with food or milk
- Avoid alcohol
- Consider taking at bedtime with a snack
- Ask doctor about stomach-protecting medications
Fluid Retention
- Limit salt intake
- Elevate legs when sitting
- Report significant swelling to doctor
Drowsiness/Dizziness
- Avoid driving until you know how naproxen affects you
- Rise slowly from sitting or lying positions
- Avoid alcohol
When to Stop and Seek Help
Stop naproxen and call your doctor if you experience:
- Black or bloody stools
- Vomiting blood
- Severe stomach pain
- Chest pain or shortness of breath
- Weakness on one side of body
- Slurred speech
- Significant swelling
- Signs of allergic reaction
- Unexplained weight gain
Long-Term Use Considerations
With chronic use:
- Regular monitoring of kidney function may be needed
- Blood pressure checks important
- Watch for signs of GI bleeding
- Use lowest effective dose
Periodic reassessment:
- Discuss ongoing need with healthcare provider
- Consider drug holidays if appropriate
- Monitor for cumulative effects
Drug-Related Risk Factors
Increased risk with:
- Other NSAIDs (don’t combine)
- Aspirin or blood thinners
- Corticosteroids
- SSRIs
- Alcohol
Related Pages
Sources
- FDA — Naproxen Safety Information
- FDA — NSAID Cardiovascular and GI Risk Warnings
- UpToDate — Naproxen: Drug Information
- American College of Gastroenterology — NSAID GI Risk Guidelines