Naproxen Accord (Naproxen)

Naproxen works by inhibiting cyclooxygenase enzymes that drive inflammatory pathways, making it useful for several painful and inflammatory conditions.

• Osteoarthritis: reduces joint pain and swelling, improving mobility.
• Rheumatoid arthritis: lessens systemic inflammation and joint damage.
• Dysmenorrhea: eases menstrual cramps and associated discomfort.
• Acute pain: provides rapid relief for injuries, dental procedures, or postoperative discomfort.
• Fever: lowers elevated body temperature in infectious or inflammatory states.

• Naproxen is a non‑selective cyclooxygenase (COX‑1 and COX‑2) inhibitor. By blocking COX enzymes, it decreases the synthesis of prostaglandins, which are mediators of inflammation, pain, and fever. The reduction in prostaglandin levels leads to diminished inflammatory responses and analgesic effects throughout the body.

Naproxen may cause a range of adverse reactions, from mild to severe, depending on individual susceptibility and duration of therapy.

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia, or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Mild skin rash or pruritus.
• Elevated blood pressure.
• Fluid retention or peripheral edema.

Serious or Rare Side Effects

• Gastrointestinal bleeding or ulcer perforation.
• Cardiovascular events such as myocardial infarction or stroke.
• Acute renal failure or worsening of chronic kidney disease.
• Severe skin reactions (e.g., Stevens‑Johnson syndrome, toxic epidermal necrolysis).
• Hepatotoxicity with marked liver enzyme elevation.
• Anaphylaxis or severe hypersensitivity reactions.

Before initiating naproxen therapy, consider the following safety measures.

• Assess gastrointestinal risk: avoid in patients with active ulcers or a history of GI bleeding.
• Evaluate cardiovascular risk: use cautiously in those with coronary artery disease or hypertension.
• Monitor renal function: adjust or discontinue if renal impairment develops.
• Check for hypersensitivity: discontinue if rash, swelling, or breathing difficulties occur.
• Use the lowest effective dose for the shortest duration needed.
• Store at ambient temperature: keep in the original packaging, protect from moisture and direct sunlight.

Naproxen can interact with several drug classes, influencing efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Selective serotonin reuptake inhibitors (SSRIs): heightened gastrointestinal bleeding risk.
• Lithium: naproxen may raise lithium serum concentrations.
• Methotrexate: reduced clearance leading to toxicity.
• High‑dose aspirin: additive gastrointestinal toxicity.

Moderate Interactions (Monitor Closely)

• Diuretics: possible reduction in renal perfusion.
• ACE inhibitors or ARBs: may impair renal function when combined.
• Corticosteroids: synergistic increase in ulcer risk.
• Beta‑blockers: potential attenuation of antihypertensive effect.
• Alcohol: enhances gastric irritation and bleeding risk.