Naproxen Dosage

Usual Adult Dose for Ankylosing Spondylitis

Initial: 250 mg to 500 mg (naproxen) or 275 mg to 550 mg (naproxen sodium) orally twice a day. The initial dose for naproxen sodium controlled-release is two 375 mg tablets (750 mg) orally once a day, one 750 mg tablet orally once a day, or two 500 mg tablets (1000 mg) orally once a day.

Maintenance: May be increased to a daily maximum of 1500 mg (naproxen) or 1650 mg (naproxen sodium) in 2 divided doses, for limited periods up to 6 months. In patients who tolerate lower doses well, the dose of naproxen sodium controlled-release may be increased to two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) orally once a day for limited periods.

Usual Adult Dose for Osteoarthritis

Initial: 250 mg to 500 mg (naproxen) or 275 mg to 550 mg (naproxen sodium) orally twice a day. The initial dose for naproxen sodium controlled-release is two 375 mg tablets (750 mg) orally once a day, one 750 mg tablet orally once a day, or two 500 mg tablets (1000 mg) orally once a day.

Maintenance: May be increased to a daily maximum of 1500 mg (naproxen) or 1650 mg (naproxen sodium) in 2 divided doses, for limited periods up to 6 months. In patients who tolerate lower doses well, the dose of naproxen sodium controlled-release may be increased to two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) orally once a day for limited periods.

Usual Adult Dose for Rheumatoid Arthritis

Initial: 250 mg to 500 mg (naproxen) or 275 mg to 550 mg (naproxen sodium) orally twice a day. The initial dose for naproxen sodium controlled-release is two 375 mg tablets (750 mg) orally once a day, one 750 mg tablet orally once a day, or two 500 mg tablets (1000 mg) orally once a day.

Maintenance: May be increased to a daily maximum of 1500 mg (naproxen) or 1650 mg (naproxen sodium) in 2 divided doses, for limited periods up to 6 months. In patients who tolerate lower doses well, the dose of naproxen sodium controlled-release may be increased to two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) orally once a day for limited periods.

Usual Adult Dose for Acute Gout

750 mg (naproxen) or 825 mg (naproxen sodium) orally one time, followed by 250 mg (naproxen) or 275 mg (naproxen sodium) every 8 hours until the gouty attack has resolved, usually 2 to 3 days. The recommended dose of naproxen sodium controlled-release is two to three 500 mg tablets (1000 to 1500 mg) orally on the first day, followed by two 500 mg tablets (1000 mg) orally daily until the attack has subsided.

Usual Adult Dose for Bursitis

550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen. The recommended initial dose of naproxen sodium controlled-release is two 500 mg tablets (1000 mg) orally once a day. For patients requiring greater analgesic benefit, two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) may be used for a limited period. Thereafter, the total daily dose should not exceed two 500 mg tablets (1000 mg).

Usual Adult Dose for Tendonitis

550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen. The recommended initial dose of naproxen sodium controlled-release is two 500 mg tablets (1000 mg) orally once a day. For patients requiring greater analgesic benefit, two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) may be used for a limited period. Thereafter, the total daily dose should not exceed two 500 mg tablets (1000 mg).

Usual Adult Dose for Dysmenorrhea

550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen.

Over-the-counter preparation: naproxen sodium 220 mg orally every 8 hours as needed. Do not exceed 2 caplets in any 8- to 12-hour period.

The recommended initial dose of naproxen sodium controlled-release is two 500 mg tablets (1000 mg) orally once a day. For patients requiring greater analgesic benefit, two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) may be used for a limited period. Thereafter, the total daily dose should not exceed two 500 mg tablets (1000 mg).

Usual Adult Dose for Pain

550 mg naproxen sodium orally once, followed by 550 mg naproxen sodium every 12 hours, or 275 mg (naproxen sodium)/250 mg (naproxen) every 6 to 8 hours as needed. Titrate to a maximum daily dose of 1100 mg naproxen sodium or 1000 mg naproxen.

Over-the-counter preparation: naproxen sodium 220 mg orally every 8 hours as needed. Do not exceed 2 caplets in any 8- to 12-hour period.

The recommended initial dose of naproxen sodium controlled-release is two 500 mg tablets (1000 mg) orally once a day. For patients requiring greater analgesic benefit, two 750 mg tablets (1500 mg) or three 500 mg tablets (1500 mg) may be used for a limited period. Thereafter, the total daily dose should not exceed two 500 mg tablets (1000 mg).

Usual Geriatric Dose for Pain

Over-the-counter preparation - 220 mg (naproxen sodium) orally every 12 hours or 250 mg (naproxen) orally every 8 hours as needed.

Usual Pediatric Dose for Fever

Dosage guidelines are based on naproxen:
Greater than 2 years: 2.5 to 10 mg/kg/dose. Maximum daily dose is 10 mg/kg, given every 8 to 12 hours.

Usual Pediatric Dose for Pain

Dosage guidelines are based on naproxen:
Greater than 2 years: 2.5 to 10 mg/kg/dose. Maximum daily dose is 10 mg/kg, given every 8 to 12 hours.

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

Dosage guidelines are based on naproxen:
Greater than or equal to 2 years: 5 mg/kg orally twice a day. Maximum dose: 1000 mg/day.

Renal Dose Adjustments

A lower dose should be considered in patients with renal impairment or in elderly patients.

CrCl less than 30 mL/min: not recommended

Liver Dose Adjustments

A lower dose should be considered in patients with hepatic impairment.

Dose Adjustments

The dose should be titrated based on patient response and tolerance. Patients taking naproxen 250 mg, 375 mg, or 500 mg twice daily may have their total daily dose replaced with the controlled release formulation as a single daily dose.

A lower dose should be considered in elderly patients.

Precautions

Patients should be advised to avoid concomitant use of naproxen-containing products since they all circulate in the plasma as naproxen anion.

Safety and effectiveness of naproxen have not been established in pediatric patients under the age of 2 years. Safety and effectiveness of naproxen sodium controlled-release have not been established in pediatric patients under the age of 18 years.

Dialysis

Naproxen is not dialyzable.

Other Comments

If no improvement is seen within 4 weeks of therapy, an alternative NSAID should be considered.

The delayed-release formulation of naproxen should not be broken, crushed or chewed.

Naproxen EC is not recommended for initial treatment of acute pain because absorption of naproxen is delayed compared to other naproxen-containing products.

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