How do I take Naproxen?

Hi All, just reading the earlier post on Naproxen and I think I might have been taking it wrong! My GP prescribed it to me a couple of years ago, at the start of the diagnostic process when I was having a lot of random flares. I was diagnosed with seropositive RA a few months later and put on Hydrox. I have since been put on Sulfasalazine as well (although my consultant is constantly trying to get me to take Mtx which I am resisting.) However, I never took Naproxen regularly, only when I was in a lot of pain. Have I been taking it wrong all these years? Should I be taking it daily? And is it safe to take with Hydroxy and Sulfasalazine?

I'm really confused now!

Any advice welcome.

Thanks.

12 Replies

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  • Have you checked the directions label, the one your Pharmacist sticks on the box? It should have your name, the medication name, the dose, how to take it & how often. I take etoricoxib (a different type of NSAID) nightly though at one time my Rheumy had me change it to alternate days.... so both times on a continual basis.

  • Hi nomoreheels,

    Yes I think the directions label said one to be taken twice a day - but I just assumed that was until the flare subsided. Since then I have only taken Naproxen when I have a particularly bad flare. But now I'm wondering if I should be taking it twice a day, every day? But as I mentioned, I'm on Hydroxy and Sulfasalazine daily - so this would bring me up to 3 medicines a day. My Consultant has never mentioned Naproxen at all. I'm very confused!!!

  • I take my Naproxen twice a day and have been alon g side Hydroxy, MTX, Sulfasalazaline for nearly 4 years now. I have no problems with it. I also take paracetomol daily. folic acid 4 days a week, Omeprazole daily ( a stomach protector which is important if you take naproxen). and since april inject Humira fortnightly.

    If you are in doubt about any of your meds please consult ypur Rheumy team or your Gp.

  • I suppose really it depends on if you need it on a regular basis. It's always preferable to not take NSAIDs long term, that is unless they're necessary. If you find you're well enough controlled taking it as you are now then I would mention that to your Rheumy. Unfortunately I'm not, realised when an SpR told me to take them only when absolutely necessary (& also asked me to taper my steroids) & I flared. My GP reinstated my steroids & at my next appointment my Rheumy ok'd that & also asked me to take the etoricoxib alternate days until I had a full cardiovascular check (in my case necessary annually as they're a COX-2), if all was ok I could return to taking them nightly. I'm on MTX & SSZ. Apols for long-winded reply!

  • Hi Tracylux, Not to tell you how to take your meds, but just a reminder about pain. One thing we have learned over the years is that pain is a hard beast to control, especially once it gets the upper hand. If you wait to take a pain medication until you are non-functional, you will find that it takes longer to control and more of the medication. I get mine down to the minimum level to control it and think I have less flares. Like I said, not to tell you what to do, just a thought...

  • Yes do discuss with your rheumy team or GP. For some people there is no alternative but to take them every day as they need the extra oomph that NSAIDs bring to keep inflammation under control. However, if you don't absolutely need to take it then best to adopt a different strategy as long term use of NSAIDs is to be avoided if you can as they do increase other risks.

    I use a different NSAID, etoricoxib like NMH, but the plan I have with my rheumy is that I only take it when I really need to. And then I take it for 5 days (which usually calms things down) and stop. And because my disease is well controlled this usually mean I only have to take it every 4 weeks or so. What she advised me not to do was just take it for one day and then stop for a few days and then take it one more day and so on. But we are all have different and have different medical histories so always best to discuss with your own doctors.

  • NSAIDs are usually taken regularly, and at full prescription doses, for spondyloarthritis, as they are probably the most effective treatment (other than biologics) for spondy inflammation. I always understood that they were more of a top-up antiinflammatory for RA, as DMARDs are the primary treatment for that. Always best to check with your doctor what they specifically wanted you to do though.

  • Bottom line I'd bite the bullet & take the Methotrexate!

    Like a lot of people. I held off for a long while with pie in the sky ideas that my RA would "just go away"! It also meant admitting I really did have it!

    I don't think Naproxen helps with joint damage & that really matters.

    I did have to stop Mtx after 7 years, but my scans show very little joint damage & I had seven virtually pain free years!

    I sounds scary, but your Rheumy will keep a good eye on you...do hope you are successful on it & can get on with your life without Naproxen!

  • I find with all painkillers that if you take them constantly, the body gets used to them and they do not work very well or at all. The standard dose of Naproxen is one tablet taken twice per day, spaced out. It reduced pain and stiffness/disability slightly in my shoulder, which enabled me to go to the gym/swimming, but it was the exercise that had the greater effect at pain reduction. It did nothing to relieve pain in my hands. After taking it for about three weeks, it gave me diarrhea and bleeding so I had to stop it and I also found that it was not effective after a while.

    Having just looked Naproxen up, I see it is an anti-prostaglandin. I used to take an anti-prostaglandin decades ago for endometriosis. This was called Fenopron and it was very effective, taken by many women, and there were no side effects albeit all women with that are young. However, you can reduce the level of anti-prostaglandins in the body by around 50% simply by not eating red meat as it contain anti-prostaglandins. Another painkiller which I and many other women used to take was phenylanaline, which is naturally produced in the body. I used to get it through the Endometriosis Society. It is also a natural anti-depressant. None of the women belonging to that used to take painkillers every day and the general consensus of opinion was that they do not work if you use them all the time.

    I notice that HelixHelix uses etoricoxib, which I am going to raise with my GP, who told me that if I could not get on with Naproxen then there was nothing else available and it was my problem. I am also going to raise the proton pump inhibitor because the GP did not offer that either to counteract the Naproxen side effects - yet a number of posters on here have mentioned it as a necessity to counteract stomach problems arising with Naproxen. Needless to say, the GP also said Fenopron was no longer available - and I don't really believe that either.

    I take chinese herbal tablets, in a particular blend, which I find wonderful for relieving pain, stiffness/disability and inflammation in my hands and wrists but they are quite expensive and I cannot currently get further supplies.

  • If you need it every day, take it every day. Clearly you didn't need it every day, so your use is appropriate. It's better not to take it every day if you don't have to, so that's great. But many of us need an NSAID every day for symptom control. And yes, its safe to take with sufla and plaquenil. commonly co-prescribed.

  • Fenopron seems to be still available. However, for each area the local committee for drugs usually draws up a list of "preferred drugs". These are usually those for which their is the most evidence and thought to be most cost effective. In order to prescribe something not on the list, the GP would then have to be able to justify why he/she prescribed that rather than one of the other NSAIs on the list.

    Also, rheumatologists tend to prescribe NSAIs more than GPs do. GPs are more wary because of the side effects. It is all a matter of pros and cons. If you are in a lot of pain and have raised inflammatory markers. reduction of this will be rated higher as an advantage, than if you have pain without raised inflammatory markers, when the adverse effects are likely to weigh more heavily in the equation.

  • Despite being on Enbrel and Hydroxychloroquine ( can't tolerate any other traditional DMARDS)

    They weren't having any effect on the residual swelling and inflammation left behind after my explosive onset, it took me taking my Naproxen regularly 500mg morning and 500mg evening with 40mg Omaprezole with the morning dose to protect my stomach. To feel as good as I do now.

    Naproxen added to my other cocktail of drugs has finally helped beyond belief. All my mini flare ups stopped.

    Still stiff in the mornings in my fingers and feet but I'm back at work after 11 months off sick after onset and my job is an extremely demanding one.

    I would echo everyone above and ask your GP, Rheumy and Rheumy nurse for advice.

    All the best

    Mx

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