Naproxen/naproxen sodium are members of the non-steroidal anti-inflammatory drug (NSAIDs) family. NSAIDs reduce inflammation (swelling),
pain, and temperature. Naproxen is used to
treat mild to moderate pain, osteoarthritis,
rheumatoid arthritis, ankylosing spondylitis,
primary dysmenorrhea, tendinitis, bursitis, and other conditions. Naproxen and naproxen
sodium are available in prescription strength; naproxen sodium is also available in
nonprescription strength.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
May Be Beneficial:Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them.
Iron
May Be Beneficial:Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication.
Copper*
Licorice
May Be Beneficial:Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better.
Copper*
Avoid:Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results.
Lithium*
Sodium*
White willow*
Check:Other—Before taking any of these supplements or eating any of
these foods with your medication, read this article in full for details.
Potassium
Reduced drug
absorption/bioavailability
None known
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Copper
Supplementation with copper may enhance the anti-inflammatory effects of NSAIDs while reducing
their ulcerogenic effects. One study found
that when various anti-inflammatory drugs were chelated with copper, the anti-inflammatory
activity was increased.1 Animal models of inflammation have found that the copper
chelate of aspirin was active at one-eighth
the effective dose of aspirin. These copper complexes are less toxic than the parent
compounds, as well.
Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts
to treat mood disorders such as manic-depression (bipolar disorder). Most NSAIDs inhibit the excretion
of lithium from the body, resulting in higher blood levels of the mineral, though sulindac may have an opposite effect.2
Since major changes in lithium blood levels can produce unwanted side effects or interfere
with its efficacy, NSAIDs should be used with caution, and only under medical supervision, in
people taking lithium supplements.
Iron
NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss.3 Iron
supplements can cause GI irritation.4 However, iron supplementation is sometimes
needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and naproxen are
prescribed, they should be taken with food to reduce GI irritation and bleeding risk.
Potassium
Naproxen has caused kidney problems and increased blood potassium levels, especially in older
people.56 People taking naproxen should not supplement potassium
without consulting with their doctor.
Sodium
Naproxen may cause sodium and water
retention.7 It is healthful to reduce dietary salt intake by decreasing the use of table
salt and avoiding heavily salted foods.
Interactions with Herbs
Licorice(Glycyrrhiza glabra)
The flavonoids found in the extract of licorice known as DGL (deglycyrrhizinated licorice) are
helpful for avoiding the irritating actions
NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL
taken together with each dose of aspirin
reduced gastrointestinal bleeding caused by the aspirin.8 DGL has been shown in
controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.9
White willow bark
(Salix alba)
White willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce
anti-inflammatory effects after they have been converted to salicylic acid in the body. The
administration of salicylates like aspirin to individuals taking oral NSAIDs may result in
reduced blood levels of NSAIDs.10 Though no studies have investigated interactions
between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more
information is available.
Interactions with Foods and Other Compounds
Food
Naproxen should be taken with food to prevent gastrointestinal upset.11
Alcohol
Naproxen may cause drowsiness, dizziness, or blurred vision.12 Alcohol may
intensify these effects and increase the risk of accidental injury. Use of alcohol during
naproxen therapy increases the risk of stomach irritation and bleeding. People taking naproxen
should avoid alcohol.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. Sorenson JRJ. Copper chelates as possible active forms of the
antiarthritic agents. J Medicinal Chem 1976;19:135–48.
2. Olin BR, ed. Central Nervous System Drugs, Analgesics and
Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and
Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
3. Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal
anti-inflammatory drugs. Pharmacol Ther 1994;62:145–57.
4. Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In
Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998,
62–9a.
5. Bailie GR. Acute renal failure. In Applied Therapeutics: The
Clinical Use of Drugs, 6th ed. Vancouver, WA: Applied Therapeutics, 1995,
29–33.
6. Perazella MA. Drug-induced hyperkalemia: Old culprits and new
offenders. Am J Med 2000;109:307–14 [review].
7. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal
Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO:
Facts and Comparisons, Mar 1993, 251n–1o.
8. Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated
liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol
1979;14:605–7.
9. Morgan AG, McAdam WAF, Pascoo C, Darnborough A. Comparison between
cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance
therapy. Gut 1982;23:545–51.
10. Olin BR, ed. Central Nervous System Drugs, Analgesics and
Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and
Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172–90.
11. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal
Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO:
Facts and Comparisons, Feb 1992, 251n–1o.
12. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal
Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO:
Facts and Comparisons, Feb 1992, 251n–1o.
The information presented in Aisle7 is for informational purposes only.
It is based on scientific studies (human, animal, or in vitro), clinical experience,
or traditional usage as cited in each article. The results reported may not necessarily occur
in all individuals. For many of the conditions discussed, treatment with prescription or over
the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist
for any health problem and before using any supplements or before making any changes in
prescribed medications. Information expires February 2010.
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