Naproxen (Anaprox®, Naprelan®, Naprosyn®)

Section 1.1

Midwives may independently prescribe, order and administer this drug.

(Anaprox®, Naprelan®, Naprosyn®) is an (NSAID) with analgesic and antipyretic properties. It works by blocking the enzyme that makes prostaglandins, thereby reducing levels of prostaglandins.

Indications and Clinical Use:

Commonly used post-surgically for pain relief and inflammation.

Contraindications:

Naproxen should not be given during pregnancy. Naproxen should not be given with a known sensitivity to NSAIDs, has heart, GI or kidney disease or any bleeding disorders. Avoid the concurrent use of Naproxen with other NSAIDs.

Warnings and Precautions:

All NSAIDs cross the human placenta in pregnancy and distribute to the fetus NSAIDs increase the risk of premature closure or constriction of the ductus arteriosus. Their use is not recommended in pregnancy, especially during the last three months. Naproxen should be used with caution if under the age of 16. Suppositories should not be given if there is a recent history of rectal or anal bleeding or inflammatory lesions. Naproxen when taken with some SSRIs may cause increased bruising or bleeding.

Pregnancy:

Human Data Suggest Risk in the 1st and 3rd Trimesters

Lactation:

Category L3 – Limited Human Data – Probably Compatible

Adverse Reactions:

Abdominal pain or cramping, rash, ringing in the ears, headaches, dizziness, diarrhea or constipation, and/or headaches, bleeding, hemorrhoid exacerbation, irritation and anal inflammation especially with suppository administration.

Dosage and Administration:

Suppository: 500 mg every 12 hours (bid)
Oral tablet: 250 mg, 375 mg, or 500 mg every 12 hours (bid)

Maximum daily dose of 1500 mg for three days post-surgery. The suppository form of naproxen is usually used initially, followed by oral administration.

Onset of Action:

Onset of action: Analgesic: 1 hour; Anti-inflammatory: ~2 weeks
Peak effect: Anti-inflammatory: 2-4 weeks
Time to peak, serum: 1-4 hours

Half-life:

Normal renal function: 12-17 hours; End-stage renal disease: No change

Elimination:

Urine (95%; primarily as metabolites); feces (≤3%)