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Drug

Naproxen

Pronounced

"nah-PROX-en"

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug are: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), cidofovir, corticosteroids (such as prednisone), lithium, "water pills" (diuretics such as furosemide).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to naproxen and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Daily use of naproxen may decrease aspirin's ability to prevent heart attack/stroke. Talk with your doctor about the risks and benefits. Ask about other medications that can be used to treat pain/fever.

This medication may interfere with certain lab tests, possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

  • Negative Interactions

    2
    • Naproxen

      Sodium

      Potential Negative Interaction

      Naproxen may cause sodium and water retention. It is healthful to reduce dietary salt intake by decreasing the use of table salt and avoiding heavily salted foods.

      Sodium
      Naproxen
      ×
      1. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 251n-1o.
    • Naproxen

      White Willow

      Potential Negative Interaction

      White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs. Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.

      White Willow
      Naproxen
      ×
      1. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172-90.
  • Supportive Interactions

    3
    • Naproxen

      Iron

      Replenish Depleted Nutrients

      NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and naproxen are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.

      Iron
      Naproxen
      ×
      1. Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
      2. Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.
    • Naproxen

      Stinging Nettle

      Support Medicine

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.

      Stinging Nettle
      Naproxen
      ×
      1. Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.
    • Naproxen

      Licorice

      Reduce Side Effects

      The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.

      Licorice
      Naproxen
      ×
      1. Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
      2. Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.
  • Explanation Required

    2
    • Naproxen

      Copper

      Needs Explanation

      Supplementation with copper may enhance the anti-inflammatory effects of NSAIDs while reducing their ulcerogenic effects. One study found that when various anti-inflammatory drugs were chelated with copper, the anti-inflammatory activity was increased. Animal models of inflammation have found that the copper chelate of aspirin was active at one-eighth the effective dose of aspirin. These copper complexes are less toxic than the parent compounds, as well.

      Copper
      Naproxen
      ×
      1. Sorenson JRJ. Copper chelates as possible active forms of the antiarthritic agents. J Medicinal Chem 1976;19:135-48.
    • Naproxen

      Potassium

      Needs Explanation

      Naproxen has caused kidney problems and increased blood potassium levels, especially in older people. People taking naproxen should not supplement potassium without consulting with their doctor.

      Potassium
      Naproxen
      ×
      1. Bailie GR. Acute renal failure. In Applied Therapeutics: The Clinical Use of Drugs, 6th ed. Vancouver, WA: Applied Therapeutics, 1995, 29-33.
      2. Perazella MA. Drug-induced hyperkalemia: Old culprits and new offenders. Am J Med 2000;109:307-14 [review].

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