Recommended Dosage and Treatment Duration for Naproxen (Nafrin)
The standard recommended dosage of naproxen (Nafrin) is 275-550 mg every 2-6 hours, with a maximum initial dose of 825 mg and a maximum daily dose of 1500 mg. 1
Dosing Guidelines by Formulation
Prescription Naproxen:
- Standard dosage: 250 mg three times daily or 500 mg twice daily 1
- Higher dosage (if needed): 500 mg three times daily
- Maximum daily dose: 1500 mg
Naproxen Sodium (Over-the-counter):
Treatment Duration
Treatment duration depends on the condition being treated:
- Acute pain (postoperative, injury): 3-5 days
- Acute gout: 3-5 days 1
- Migraine: Short-term use during attacks 1
- Chronic conditions (arthritis): Ongoing treatment with regular monitoring
For chronic conditions, the shortest effective duration should be used to minimize adverse effects.
Special Populations
Elderly:
- Start at lower dosages and titrate upward 2
- Consider increased risk of adverse effects
Renal/Hepatic Impairment:
- Dosage adjustments generally not required for mild impairment
- Start at lower dosages and titrate upward 2
- Avoid in severe impairment
Safety Considerations
Gastrointestinal Protection:
- When used over prolonged periods, gastric protection with a proton pump inhibitor is recommended 1, 3
- A study showed omeprazole 20 mg daily significantly reduced gastroduodenal ulcers in patients taking naproxen 500 mg twice daily (11.8% vs 46.9% without protection) 3
Cardiovascular Risk:
- Use lowest effective dose for shortest duration in patients with cardiovascular risk factors
Common Side Effects:
- Gastrointestinal: Upset, nausea, dyspepsia
- Central nervous system: Dizziness, headache
- Skin: Rash, pruritus
Clinical Pearls
- Naproxen has a relatively long half-life, allowing for convenient twice-daily dosing in most cases 4
- For acute pain, naproxen sodium 550 mg provides approximately 7.6 hours of pain relief compared to 2.6 hours with placebo 5
- Taking with food can help reduce gastrointestinal side effects
- Avoid concurrent use with other NSAIDs or high-dose aspirin
- Monitor for signs of GI bleeding, especially in high-risk patients (elderly, history of ulcers, concurrent corticosteroids)
Common Pitfalls to Avoid
- Exceeding the maximum daily dose of 1500 mg
- Failing to provide gastric protection during prolonged use
- Using in patients with severe renal impairment or heart failure
- Not considering drug interactions (particularly with anticoagulants, antihypertensives, and lithium)
- Using in late pregnancy (beyond 30 weeks gestation)
Naproxen's efficacy and tolerability have been well established over many years of clinical use, making it a reliable first-line treatment for various rheumatic diseases and pain states 2.