Med of the Month: Naproxen

July is UV Safety Awareness Month, making it the perfect time to spotlight a medication with an often-overlooked side effect: photosensitivity. While most patients know naproxen as a go-to pain reliever, fewer realize it can make the skin more sensitive to sunlight, increasing the risk of sunburn in susceptible individuals. As one of the most commonly used NSAIDs, naproxen is frequently encountered in dental practice, making it important to understand both its benefits and its clinical considerations.

Generic Name: Naproxen / Naproxen Sodium

Brand Name(s) - Naproxen: EC-Naprosyn, Naprosyn, Flanax

Brand Name(s) - Naproxen Sodium: Aleve, Anaprox, Anaprox DS, Naprelan

Pronunciation: na PROX en

About Naproxen:

• Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve mild to moderate pain and inflammation associated with conditions such as arthritis, ankylosing spondylitis, tendinitis, bursitis, gout, and menstrual cramps.

• The extended-release formulation is intended for chronic conditions requiring long-term therapy and is not appropriate for the rapid relief of acute pain.

• The primary difference between naproxen and naproxen sodium is the rate of absorption. Naproxen sodium is absorbed more rapidly, resulting in a faster onset of pain relief (e.g 275 mg naproxen sodium is equivalent to 250 mg naproxen base).

Dentistry-related tidbits:

If you're treating a patient taking naproxen, a few considerations are worth keeping in mind:

Local Anesthetic Warnings: Common local anesthetics are generally safe to use with naproxen. However, be mindful that epinephrine can increase the patient’s blood pressure if they’re also taking naproxen. Always monitor blood pressure, especially if the patient has hypertension.

Oral Manifestations: Naproxen has been associated with thrombocytopenia, which may increase the risk of bleeding during or after dental procedures.

Staying Safe: important interactions to be aware of

Using a tool like MedAssent DDS Rx Check can help support safe prescribing and identify clinically relevant interactions.

Important interactions include:

• Steroids, other NSAIDs, and penicillin G (not penicillin VK) may increase the risk of gastrointestinal ulceration, perforation, and bleeding.

• Itraconazole may increase the risk of auditory and vestibular adverse effects when used with naproxen.

• Quinolone antibiotics (such as ciprofloxacin) may increase the risk of CNS stimulation and seizures when combined with naproxen.

Prescribing precautions:

• Before prescribing naproxen, confirm that the patient is not already taking another NSAID, aspirin, aspirin-containing products, or anticoagulant therapy, as combination use increases the risk of bleeding and gastrointestinal complications.

• If additional pain control is needed, consider an acetaminophen-containing alternative rather than combining NSAIDs. (Avoid prolonged acetaminophen use because of potential liver and kidney toxicity.)

• Advise patients to carefully check over-the-counter medications, as many cold, flu, and pain relief products also contain NSAIDs or aspirin.

• Naproxen should not be prescribed for patients who are pregnant, planning to become pregnant, or breastfeeding.

• Patients taking naproxen have an increased risk of serious cardiovascular events, including heart attack and stroke, particularly with prolonged use. It should also be avoided immediately before or after coronary artery bypass graft (CABG) surgery.

• Like other NSAIDs, naproxen may increase the risk of serious gastrointestinal adverse events, including bleeding, ulceration, and perforation of the stomach or intestines.

• A lower dose is recommended in patients with renal or hepatic impairment or in elderly patients.

• See MedAssent DDS Rx Check for dental dosing information and recommendations.

Fun facts:

• Naproxen is one of the few common medications that can increase sun sensitivity. Although uncommon, naproxen has been associated with photosensitivity reactions, making UV protection especially important during the summer months.

• One dose lasts longer than many other OTC pain relievers. Naproxen typically provides pain relief for 8-12 hours, allowing many patients to dose only twice daily.

• It wasn't always available over the counter. Naproxen was originally prescription-only before lower-dose formulations (like Aleve®) became available without a prescription.

Get more dental-specific drug information with the Digital Drug Handbook (web) or BrushUp Rx (mobile app).