Naproxen: what it treats, how to take it, side effects
Last updated September 3, 2026.
Naproxen is an NSAID that relieves pain, fever, and inflammation. It is sold over the counter as Aleve and generics, and by prescription in higher strengths and long-acting forms. Like every drug in its class, it carries boxed warnings about heart attack, stroke, and stomach bleeding.
What does it treat?
Prescription naproxen treats the pain, tenderness, swelling, and stiffness of osteoarthritis, rheumatoid arthritis, juvenile arthritis, and ankylosing spondylitis, plus bursitis, tendinitis, gout attacks, and menstrual pain. Over-the-counter naproxen reduces fever and relieves mild pain from headaches, muscle aches, arthritis, menstrual periods, colds, toothaches, and backaches.
How do you take it?
Over the counter: one dose every 8 to 12 hours as needed, with a full glass of water, and food or milk if your stomach complains. Prescription schedules run twice a day for arthritis, every 8 hours for gout, every 6 to 8 hours as needed for pain, and once a day for the extended-release tablet. Swallow delayed-release and extended-release tablets whole. If you take it for arthritis, expect improvement within a week but give it 2 weeks or more for full benefit. Two hard stops from MedlinePlus: call your doctor if OTC pain lasts more than 10 days or fever more than 3 days. If you miss a scheduled dose, take it when you remember unless the next one is close; never double up.
Side effects to know
- Common: constipation, gas, excessive thirst, headache, dizziness, drowsiness, trouble sleeping, burning or tingling in the arms or legs, cold symptoms, and ringing in the ears.
- Serious: the boxed warning risks - heart attack and stroke (chest pain, shortness of breath, weakness on one side, slurred speech) and ulcers or bleeding in the stomach or intestine (stomach pain, vomit that is bloody or looks like coffee grounds, black or tarry stools). Also serious: liver problems (upper right stomach pain, yellowing skin or eyes, dark urine), kidney problems (cloudy or bloody urine, difficult or painful urination, decreased urination), unexplained weight gain or swelling, vision changes, blisters or rash, and allergic reactions with facial swelling or trouble breathing.
Who should not take it?
Do not take naproxen right before or after coronary artery bypass graft (CABG) surgery, and not after a recent heart attack unless your doctor directs it. Skip it if you have had an allergic reaction to naproxen, aspirin, or another NSAID. MedlinePlus says not to take it around or after 20 weeks of pregnancy unless your doctor tells you to, and notes it can temporarily decrease fertility in women. Adults 65 and older should usually take lower doses for short periods. The bleeding risk climbs if you also take blood thinners, aspirin, other NSAIDs, oral steroids, or SSRI/SNRI antidepressants, or if you drink large amounts of alcohol. Flag asthma (especially with nasal polyps), heart failure, anemia, kidney or liver disease, and any past ulcers or stomach bleeding.
When is it an emergency?
Call 911 for chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech. Bloody or coffee-ground vomit and black, tarry stools mean internal bleeding - get immediate care. Call 911 for an allergic reaction with swelling of the face or throat or trouble breathing. For an overdose, call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
How is naproxen different from ibuprofen?
Both are NSAIDs, and the practical difference is schedule: over-the-counter naproxen is taken every 8 to 12 hours, while OTC ibuprofen runs every 4 to 6 hours. What matters for safety is never combining them - MedlinePlus says not to take nonprescription naproxen with any other pain medication unless your doctor tells you to.
Can I drink alcohol while taking naproxen?
Heavy drinking is a named risk. MedlinePlus lists drinking large amounts of alcohol while taking naproxen among the factors that raise the risk of ulcers and stomach or intestinal bleeding. Ask your doctor what, if anything, is safe for you.
Should I take naproxen with food?
It helps. MedlinePlus says nonprescription naproxen may be taken with food or milk to prevent nausea, and to take each dose with a full glass of water. The stomach is where this drug does its collateral damage, so the habit is worth keeping.
How long does naproxen take to work for arthritis?
Longer than for a headache. MedlinePlus says arthritis symptoms may begin improving within 1 week, but the full benefit can take 2 weeks or longer. Single doses for pain or fever work much faster - the slow timeline applies to the anti-inflammatory effect on joints.
Is naproxen safe during pregnancy?
Not in the second half. MedlinePlus warns it may harm the fetus and cause problems with delivery if taken around 20 weeks of pregnancy or later, and says not to take it then unless your doctor directs it. It also notes naproxen can temporarily decrease fertility in women - worth raising with your doctor if you are trying to conceive.
I am over 65 - should I take naproxen differently?
Yes. MedlinePlus advises that older adults should usually take lower doses of naproxen for short periods, because higher regular doses may not work better and are more likely to cause serious side effects. Talk to your doctor about the risks and benefits for you specifically.