Naproxen Accord (Naproxen)

Naproxen is indicated for musculoskeletal and inflammatory conditions where prostaglandin‑mediated pain and swelling are present.

• Osteoarthritis: alleviates joint pain and improves mobility.
• Rheumatoid arthritis: reduces joint inflammation and stiffness.
• Acute pain: provides rapid relief of moderate to severe pain.
• Fever: lowers elevated body temperature.
• Inflammatory disorders: diminishes swelling and redness associated with inflammation.

• Naproxen exerts its effect by non‑selectively inhibiting cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes, which blocks the conversion of arachidonic acid to prostaglandins. The reduced prostaglandin synthesis leads to decreased inflammation, pain perception, and fever generation at the site of tissue injury.

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: dyspepsia, abdominal pain, nausea.
• Headache: mild to moderate intensity.
• Dizziness: transient episodes of light‑headedness.
• Diarrhea: loose stools without blood.
• Skin rash: mild erythema or itching.

Serious or Rare Side Effects

• Gastrointestinal bleeding or ulceration.
• Renal impairment or acute kidney injury.
• Cardiovascular events such as myocardial infarction or stroke.
• Severe skin reactions (e.g., Stevens‑Johnson syndrome).
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Anaphylaxis: rare but potentially life‑threatening allergic reaction.

Before initiating naproxen therapy, clinicians should evaluate patient‑specific risk factors and monitor relevant clinical parameters.

• Assess gastrointestinal risk: consider ulcer history or concurrent NSAID use.
• Monitor renal function: especially in patients with dehydration or pre‑existing kidney disease.
• Evaluate cardiovascular risk: use lowest effective dose in patients with heart disease.
• Use lowest effective dose: limit duration to the shortest period necessary.
• Avoid in known hypersensitivity: discontinue if allergic reactions occur.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Naproxen can alter the pharmacodynamics or pharmacokinetics of several co‑administered medicines, requiring careful management.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Other NSAIDs or aspirin: additive gastrointestinal toxicity.
• Lithium: naproxen may raise serum lithium levels.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: potential reduction in antihypertensive effect and renal function.
• Selective serotonin reuptake inhibitors (SSRIs): heightened bleeding tendency.
• Diuretics: possible decrease in renal clearance of naproxen.