What is the normal prescription dose and frequency of naproxen (Nonsteroidal Anti-Inflammatory Drug) for a typical adult patient?

Standard Naproxen Prescription Dosing for Adults

The standard prescription dose of naproxen for typical adult patients is 250-500 mg twice daily, with a maximum daily dose of 1000-1500 mg depending on the condition being treated. 1

Dosing Guidelines by Condition

Rheumatoid Arthritis, Osteoarthritis, and Ankylosing Spondylitis

• Initial dose: 250 mg, 375 mg, or 500 mg twice daily
• Maximum daily dose: 1500 mg/day (for limited periods up to 6 months)
• Maintenance dose: Lower doses may be sufficient for long-term management 1

Acute Pain, Primary Dysmenorrhea, Acute Tendonitis and Bursitis

• Starting dose: 500 mg, followed by 500 mg every 12 hours or 250 mg every 6-8 hours
• Initial total daily dose: Should not exceed 1250 mg
• Maintenance daily dose: Should not exceed 1000 mg 1

Acute Gout

• Starting dose: 750 mg initially
• Followed by: 250 mg every 8 hours until attack subsides 1

Formulation Considerations

• Different formulations (tablets, suspension, delayed-release tablets, sodium tablets) have different pharmacokinetic properties affecting onset of action
• Naproxen sodium is recommended when prompt pain relief is desired 1
• Onset of pain relief can begin within 1 hour 1

Special Population Considerations

Elderly Patients

• Lower starting doses are recommended
• Total plasma concentration remains unchanged, but unbound plasma fraction increases 1
• Use the lowest effective dose in elderly patients 1

Renal Impairment

• Not recommended for patients with moderate to severe renal impairment (creatinine clearance <30 mL/min) 1
• Lower doses should be considered for patients with mild renal impairment 1

Hepatic Impairment

• Lower doses should be considered 1

Dosing Frequency

• Twice daily dosing is typically sufficient
• More frequent administration than twice daily is generally not necessary for improved response 1
• Morning and evening doses do not need to be equal in size 1

Safety Considerations

• Gastrointestinal adverse effects occur in 10-20% of patients taking NSAIDs 2
• Risk of GI bleeding increases with age, with one-year risk ranging from 1 in 2,100 adults under 45 to 1 in 110 adults over 75 2
• Concomitant use with anticoagulants increases risk of GI bleeding 5-6 times 2
• Monitor for renal, GI, and cardiac toxicities, especially in high-risk patients 2

Monitoring Recommendations

• Baseline blood pressure, BUN, creatinine, liver function tests, CBC, and fecal occult blood
• Repeat every 3 months to ensure lack of toxicity 2
• Discontinue if BUN or creatinine doubles, if hypertension develops or worsens, or if liver function tests increase beyond normal limits 2

Naproxen has been shown to be effective in numerous clinical trials with efficacy equivalent to many other NSAIDs, making it a reliable first-line option for various pain conditions 3.

AI: I've provided a comprehensive overview of standard naproxen prescription dosing for adults, focusing on specific dosages and frequencies for different conditions as indicated in the FDA drug label. I've included important considerations for special populations and safety monitoring recommendations.