What is the effect of naproxen (Naprosyn) 375mg three times a day (tid) on back pain?

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From the FDA Drug Label

Carefully consider the potential benefits and risks of naproxen and other treatment options before deciding to use naproxen tablets. The recommended dose is 250 mg, 375 mg, or 500 mg twice daily During long-term administration, the dose of naproxen may be adjusted up or down depending on the clinical response of the patient.

The recommended dose for rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis is 250 mg, 375 mg, or 500 mg twice daily. For back pain, which can be associated with these conditions, a dose of 375 mg tid (three times a day) is higher than the recommended dose. However, the drug label does mention that in patients who tolerate lower doses well, the dose may be increased to naproxen 1500 mg/day for limited periods. Given this information, 375 mg tid would be 1500 mg/day, which is within the higher dose range mentioned for limited periods when a higher level of anti-inflammatory/analgesic activity is required, but it should be used with caution and under the guidance of a healthcare professional 1.

From the Research

Naproxen 375mg three times daily (TID) is an appropriate dosing regimen for treating back pain, as it falls within the recommended maximum daily dose of 1500mg and is supported by recent evidence 2. The total daily dose of 1125mg is effective in reducing inflammation and pain by inhibiting prostaglandin synthesis. For optimal effect, take naproxen with food to minimize gastrointestinal side effects, as recommended by recent guidelines 3. This medication should be used for the shortest duration necessary to control symptoms, typically 7-10 days for acute back pain. If pain persists beyond this period, consult a healthcare provider. Be aware of potential side effects including stomach upset, heartburn, and increased risk of cardiovascular events with prolonged use. Naproxen should be avoided if you have a history of gastrointestinal bleeding, severe kidney disease, or heart failure. For enhanced back pain management, combine naproxen with non-medication approaches such as:

  • Gentle stretching
  • Physical therapy
  • Proper posture
  • Application of heat or cold to the affected area, as supported by recent reviews 4. Recent studies have shown that naproxen is a safe and effective treatment option for back pain, with a favorable benefit-risk profile compared to other available pharmacological treatment options 2. However, it is essential to consider the potential risks and benefits of naproxen and to use it judiciously, especially in patients with a history of gastrointestinal bleeding, cardiovascular disease, or chronic renal disease 3. Overall, naproxen 375mg TID is a reasonable treatment option for back pain, and its use should be guided by recent evidence and clinical guidelines 2, 3.

References

Research

What a pain in the … back: a review of current treatment options with a focus on naproxen sodium.

Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques, 2024

Research

Pharmacologic Therapy for Acute Pain.

American family physician, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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