Non-Opioid Pain Medicines
Naproxen
(generic; Aleve®; Naprosyn®) tablets or capsules
Naproxen (generic; Aleve®; Naprosyn®) is a common over-the-counter pain medicine that comes in tablets or capsules.
Which one should I buy?
At the drug store, naproxen is sold over-the-counter (without a prescription). It is fine to buy generic (not brand name) naproxen, or you can buy one of the common brand-name versions like Aleve®. Over-the-counter naproxen usually comes in 220mg tablets, although you can also find different doses.
How do I take this medicine?
Make sure you ask your care team before taking this medicine, because it can sometimes cause serious side effects.
Take with a glass of water or other liquid. Some people to find it helpful to take with food, milk, or an acid reducer to prevent stomach upset.
Naproxen can help pain in addition to opioids. Here are some ways you might try to use it. Remember, never take a higher dose or take it more often than what is described on the medication bottle
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If your doctor tells you to, take naproxen on a regular schedule for several days. This can reduce inflammation, which can help pain.
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If your pain is mild, try taking naproxen before taking your short-acting (breakthrough) opioid. If your pain doesn’t improve, then try the opioid.
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If you don’t get enough relief from your short-acting (breakthrough) opioid, try taking naproxen.
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If you find that naproxen is not helpful, stop taking it. It’s better to focus on things that work for your pain.
How much can I take?
Always follow your doctor’s instructions for taking naproxen. If you have bought naproxen over-the-counter, the usual dose recommended on the package is:
Take 1 tablet/capsule (220 mg) every 8-12 hours as needed for pain.
Do not take more than 2 tablets/capsules (440 mg total) in a 12-hour period.
Do not take more than 3 tablets (660 mg total) in 24 hours.
How does it work?
Naproxen helps with pain by reducing inflammation.
What are the side effects?
Naproxen commonly causes an upset stomach, stomach pains, or heart burn. To prevent this, it is helpful to take it with food or to take an acid blocking medicine like omeprazole (Prilosec) or famotidine (Pepcid).
Rarely, this medicine can severe inflammation of the stomach or gut that causes bleeding. Call your care team right away if you have any signs of bleeding from your stomach and gut:
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if you vomit and see red or black material
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If you see red colored stools
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If your stools are black and sticky
If you have kidney problems, Naproxen may not be safe for you. Even with healthy kidneys, naproxen can rarely cause kidney problems – especially if you get dehydrated. Make sure you drink plenty of fluids (at least 2 liters per day) while taking naproxen. If you have severe vomiting, diarrhea, or difficulty keeping down fluids – call your care team and stop taking naproxen.
Naproxen can cause a few other side effects that are more rare, like swelling, allergic reaction (swelling in the lips, tongue, or difficulty breathing), dizziness, drowsiness, or headache.
How can I be safe when taking this medicine?
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Always follow the instructions on your prescription bottle.Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take. For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.
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Take them when you have pain and need quick relief.These take about 30 minutes to start working and 1 ½ hour to get the most relief, so take them early on when you feel your pain creeping up.
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If you don’t have pain, don’t take them.If your pain is manageable and you don’t expect it to get worse, you shouldn’t take this medicine. It should be used “as needed” when you have pain.
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Take them before your pain gets severe.Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.
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Choose the dose that matches your pain level.Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed. If your pain is severe, start with the higher dose (for example: 2 tablets). If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.
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Take them about 30 minutes before painful activities.Some people know they will have pain with certain activities, like walking or taking a long car ride. Think of activities that usually worsen your pain. To help you be more active, you may want to take your short-acting opioid 30 minutes beforehand.
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If your short-acting opioid is not working well, talk to your care team.Every person is different and it can take some time to find the right medicines and right doses for you. Your care team might decide to increase the dose of your opioid or change to a different medication. The important thing is to let them know how you are doing.
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