From the Guidelines
Naproxen is a viable treatment option for acute gout arthritis, as high-quality evidence shows that NSAIDs, including naproxen, are effective in reducing pain in patients with acute gout 1. The management of acute gout involves reducing inflammation and pain, and naproxen, as an NSAID, works by inhibiting prostaglandin synthesis through blocking cyclooxygenase enzymes. When considering naproxen for gout arthritis, the following key points should be taken into account:
- The recommended dosage is typically 500 mg initially, followed by 250 mg every 8 hours until the gout attack resolves, which usually takes 5-7 days 1.
- For severe gout pain, some patients may require 500 mg twice daily.
- Naproxen should be taken with food to minimize gastrointestinal side effects, such as stomach upset and heartburn.
- Patients should be aware of the potential increased risk of cardiovascular events with prolonged use.
- Naproxen should be avoided in patients with kidney disease, heart failure, or a history of gastrointestinal bleeding, as these conditions may be contraindications or increase the risk of adverse effects 1.
- For optimal gout management, combining naproxen with rest, ice application to affected joints, elevation of the limb, and increased water intake can help flush uric acid and reduce symptoms.
- If symptoms do not improve within 48 hours or worsen, medical attention should be sought, as alternative treatments like colchicine or corticosteroids may be needed 1.
From the FDA Drug Label
Naproxen tablets are also indicated: For relief of the signs and symptoms of acute gout Naproxen is indicated for the relief of the signs and symptoms of acute gout.
- The FDA drug label directly supports the use of naproxen for acute gout 2, 2.
- A favorable response to naproxen was shown by significant clearing of inflammatory changes (e.g., decrease in swelling, heat) within 24 to 48 hours, as well as by relief of pain and tenderness in patients with acute gout 2.
From the Research
Naproxen for Gout Arthritis
- Naproxen is a non-steroidal anti-inflammatory drug (NSAID) that has been studied as a treatment option for gout arthritis 3, 4.
- A double-blind, randomized equivalence trial compared the effectiveness of naproxen and prednisolone in treating monoarticular gout, and found that they were equally effective in reducing pain over 4 days 3.
- Another study found that naproxen was effective in alleviating the inflammation of acute gout, with 15 out of 20 patients experiencing an excellent or good response to treatment 4.
- The use of naproxen for gout arthritis is also supported by its inclusion as a first-line agent for treating gout flares, along with other NSAIDs, colchicine, and glucocorticoids 5.
- However, it is worth noting that the management of gout arthritis often involves a combination of medications, including urate-lowering therapies such as allopurinol and febuxostat, and that naproxen may be used in conjunction with these medications to manage acute flares 6, 7.