naproxen
Apo-Naproxen (CAN), EC-Naprosyn,
Naprosyn, Naprosyn-E (CAN), Naxen
(CAN), Novo-Naprox (CAN), Nu-Naprox
(CAN)
naproxen sodium
Aleve, Anaprox, Anaprox DS, Apo-
Napro-Na (CAN), Naprelan, Naprosyn-
SR (CAN), Novo-Naprox Sodium (CAN)
Nursing Considerations
• Use naproxen with extreme caution in
patients with a history of ulcer disease or
GI bleeding because NSAIDs such as
naproxen increase risk of GI bleeding and
ulceration. Expect to use naproxen for the
shortest time possible in these patients.
• Serious GI tract ulceration, bleeding, and
perforation may occur without warning
symptoms. Elderly patients are at greater
risk. To minimize risk, give drug with
food. If GI distress occurs, withhold drug
and notify prescriber immediately.
• Use naproxen cautiously in patients with
hypertension, and monitor blood pressure
closely. Drug may cause hypertension or
worsen it. Because of naproxen’s sodium
content, watch for fluid retention.
• Rehydrate a dehydrated patient before giving
drug. If patient has renal disease, monitor
renal function closely during therapy.
• Naproxen isn’t recommended for patients
with advanced renal disease.
WARNING Monitor patient closely for
thrombotic events, including MI and
stroke, because NSAIDs increase the risk,
especially if used in higher doses than recommended
or for extended periods of
time.
•Monitor patient—especially if elderly or
receiving long-term naproxen therapy—
for less common but serious adverse GI
reactions, including anorexia, constipation,
diverticulitis, dysphagia, esophagitis,
gastritis, gastroenteritis, gastroesophageal
reflux disease, hemorrhoids, hiatal hernia,
melena, stomatitis, and vomiting.
•Monitor liver function test results because,
in rare cases, elevations may progress to
severe hepatic reactions, including fatal
hepatitis, liver necrosis, and hepatic failure.
•Monitor BUN and serum creatinine levels
in elderly patients, patients taking diuretics
or ACE inhibitors, and patients with
heart failure, impaired renal function, or
hepatic dysfunction; naproxen may cause
renal failure.
•Monitor CBC for decreased hemoglobin
and hematocrit because drug may worsen
anemia.
WARNING If patient has bone marrow suppression
or is receiving treatment with an
antineoplastic drug, monitor laboratory
results (including WBC count), and watch
for evidence of infection because antiinflammatory
and antipyretic actions of
naproxen may mask signs and symptoms,
such as fever and pain.
• Assess patient’s skin regularly for signs of
rash or other hypersensitivity reaction
because naproxen is an NSAID and may
cause serious skin reactions without warning,
even in patients with no history of
NSAID sensivitity. At first sign of reaction,
stop drug and notify prescriber.
• Assess drug effectiveness in ankylosing
spondylitis, as evidenced by decreased
night pain, morning stiffness, and pain at
rest; in osteoarthritis: decreased joint pain
or tenderness and increased mobility,
range of motion, and ability to perform
daily activities; in rheumatoid arthritis:
increased mobility and decreased joint
swelling and morning stiffness; in acute
gouty arthritis: decreased heat, pain,
swelling, and tenderness in affected joints.
• Tell prescriber if patient complains of
vision changes; patient may need ophthalmic
exam.
PATIENT TEACHING
• Caution patient not to exceed recommended
dosage, take for longer than
directed, or take for more than 10 days
without consulting prescriber because
serious adverse reactions may occur.
• Tell patient to swallow delayed-release tab-
lets whole and not to break, crush, or
chew them.
• Advise patient to take drug with food to
reduce GI distress.
• Tell patient to take drug with a full glass of
water and to remain upright for 15 to
30 minutes after taking it to prevent drug
from lodging in esophagus and causing
irritation.
• Caution patient to avoid hazardous activities
until drug’s CNS effects are known.
• Urge patient to keep scheduled appointments
with prescriber to monitor progress.
• Tell pregnant patient to avoid taking
naproxen-containing products late in
pregnancy.
• Explain that naproxen may increase risk of
serious adverse cardiovascular reactions;
urge patient to seek immediate medical
attention if signs or symptoms arise, such
as chest pain, shortness of breath, weakness,
and slurring of speech.
• Inform patient that naproxen may increase
risk of serious adverse GI reactions; stress
the importance of seeking immediate
medical attention for such signs and
symptoms as epigastric or abdominal
pain, indigestion, black or tarry stools, or
vomiting blood or material that looks like
coffee grounds.
• Alert patient to rare but serious skin reactions.
Urge her to seek immediate medical
attention for rash, blisters, itching, fever,
or other indications of hypersensitivity.
• Advise patient to consult prescriber before
taking naproxen-containing OTC products
if he has asthma, ulcers, bleeding problems,
high blood pressure, heart or kidney
disease, a need for diuretic therapy, serious
adverse effects from previous use of fever
reducers or pain relievers, or persistent
stomach problems, such as heartburn,
upset stomach, or stomach pain.
