Naproxen: Comprehensive NHS-Aligned Information

Naproxen is a non-steroidal anti-inflammatory drug (NSAID). It has been used in medicine since 1976. It blocks COX-1 and COX-2 enzymes. These enzymes produce prostaglandins.

Prostaglandins cause pain, inflammation, and fever. Naproxen reduces prostaglandin production. This helps relieve many conditions.

The NHS lists common uses for naproxen:

• Rheumatoid arthritis and osteoarthritis: It eases joint pain, swelling, and morning stiffness.
• Ankylosing spondylitis: It helps manage inflammatory back pain.
• Acute gout: NICE recommends naproxen as a first-line treatment for gout attacks.
• Period pain (dysmenorrhoea): It is very effective as prostaglandins cause uterine cramping.
• Musculoskeletal injuries: Short courses help sprains, strains, and soft-tissue injuries.
• Post-surgical and dental pain: It is often part of a pain relief plan.
• Migraine: Naproxen 500 mg can treat acute migraines. Sometimes it is combined with a triptan.

Naproxen comes as standard tablets (250 mg and 500 mg). It is also available as gastro-resistant tablets and a liquid. Most forms need a prescription in the UK.

However, naproxen 250 mg is sold over the counter for period pain. Its brand name is Feminax Ultra. It is a common NHS NSAID. Over 12 million prescriptions are given out yearly in England.

In the UK, naproxen 500 mg tablets are prescription-only (POM). You need a prescription from a qualified prescriber. This includes GPs, nurse prescribers, and pharmacist independent prescribers.

GP appointment

Seeing your GP is the most common way. Your doctor will check your symptoms. They will also look for reasons not to give you naproxen. If prescribed, it will be on your NHS prescription.

You can then get it from any community pharmacy.

NHS prescription charges

In England, there is a set charge per item. This applies regardless of the amount. Prescriptions are free in Scotland, Wales, and Northern Ireland.

A prepayment certificate can save you money if you need naproxen often.

Pharmacy consultation

Naproxen 250 mg is available without a prescription for period pain. A pharmacist can sell it after a short check. This is only for women aged 15 to 50. It treats primary dysmenorrhoea.

Online prescribing services

NHS-linked and private online services can issue naproxen prescriptions. You complete a medical questionnaire. A prescriber then reviews it. These services are regulated by the CQC.

They must follow the same prescribing rules as face-to-face visits.

Emergency supply

If you have had naproxen before and run out, a pharmacist may give an emergency supply. This can be for up to 30 days. It is under specific legal rules. The pharmacist decides this.

It is not available for controlled drugs.

Naproxen is not safe for everyone. The BNF lists conditions where it must not be used. It also lists important warnings. Your prescriber will check these before giving you a prescription.

Absolute contraindications

• Active stomach ulcer or bleeding in the gut.
• Two or more past episodes of stomach ulcers or gut bleeding.
• Severe heart failure (NYHA class III-IV).
• Severe liver problems.
• Severe kidney problems (eGFR below 15 mL/min).
• Third trimester of pregnancy (from 30 weeks).
• Allergy to naproxen or any other NSAID. This includes aspirin-sensitive asthma.

Use with caution

• Patients over 65: They have a higher risk of gut and heart problems. Use the lowest dose with stomach protection.
• History of a single gut bleed or ulcer: Prescribe a PPI and monitor closely.
• Cardiovascular disease: Naproxen has the best heart safety profile among NSAIDs. Still, use it carefully.
• Mild to moderate kidney problems: Monitor eGFR and avoid dehydration.
• Asthma: NSAIDs can trigger breathing problems in some people. This affects about 10 to 20% of asthma patients.
• Inflammatory bowel disease: NSAIDs might worsen Crohn's disease or ulcerative colitis.
• Taking anticoagulants or antiplatelets: This increases the risk of bleeding.

Always tell your prescriber your full medical history. List all your medical conditions. This ensures naproxen is safe for you. Or, they can choose a suitable alternative.

Naproxen's safety during pregnancy depends on the stage. It also needs careful thought during breastfeeding.

First trimester (weeks 1 to 12)

Avoid NSAIDs unless benefits clearly outweigh risks. Some studies suggest a small rise in miscarriage risk. They also suggest a small rise in birth defects with early pregnancy NSAID use.

However, the overall risk is low.

Second trimester (weeks 13 to 29)

Naproxen may be used for the shortest time and lowest dose. This is if other pain relief, like paracetamol, does not work. Your obstetrician or midwife should be part of this decision.

Third trimester (from week 30)

Do not use naproxen. All NSAIDs at this stage can cause problems for the baby. These include early closure of the ductus arteriosus. They can also cause low amniotic fluid (oligohydramnios).

Labour might also be delayed. These effects can seriously harm the baby.

Breastfeeding

Small amounts of naproxen pass into breast milk. The BNF says it can be used with caution while breastfeeding. Use the lowest dose for the shortest time.

Ibuprofen is generally preferred for breastfeeding mothers. It has a shorter half-life. This means less exposure for the baby.

Talk to your doctor or health visitor if you need anti-inflammatory pain relief while nursing.

Paracetamol is the safest painkiller. Use it at standard doses throughout pregnancy and breastfeeding.

Correct storage keeps naproxen effective. Safe disposal protects people and the environment.

Storage

Keep naproxen tablets in their original packaging. Store them at room temperature. Keep them away from direct heat, sunlight, and moisture. A bathroom cabinet is often too humid.

A bedroom drawer or kitchen cupboard (away from the cooker) is better.

Do not use naproxen after its expiry date. This date is on the packaging. Expired NSAIDs may not work as well. Rarely, degraded forms can cause unexpected side effects.

Keep all medicines out of children's sight and reach. If you have young children, consider a locked medicine cabinet.

Disposal

Do not flush unused naproxen down the toilet. Do not put it in household rubbish. NSAIDs can pollute water supplies. They can also harm aquatic life.

Return unused or expired naproxen to any community pharmacy. UK pharmacies accept medicines for safe disposal. This is free as part of their NHS contract. Just hand the packets over at the counter.

If you are unsure about your naproxen, ask your pharmacist. They can check if it is still in date or stored correctly. They can advise if it is safe to use or needs replacing.

This check is quick and needs no appointment.