From the Guidelines
The workup for someone who has ingested 8 tablets of Aleve (Naproxen) at once should begin with immediate medical evaluation, preferably in an emergency department, due to the high risk of gastrointestinal bleeding, kidney damage, and other complications. This represents a significant overdose that requires prompt assessment. Initial evaluation should include vital signs, physical examination focusing on mental status, abdominal pain, and signs of bleeding. Laboratory tests should include complete blood count, comprehensive metabolic panel (especially kidney function), coagulation studies, and urinalysis to check for blood 1. Gastrointestinal symptoms are common with NSAID overdose, so assessment for bleeding is critical. According to the study, naproxen sodium has a maximal daily dosage of 1.5 g per day, and taking 8 tablets exceeds this limit, increasing the risk of adverse reactions such as dizziness, rash, pruritus, GI upset, and constipation 1. Treatment typically involves activated charcoal if the ingestion was recent (within 1-2 hours), intravenous fluids to support kidney function, proton pump inhibitors to protect the stomach, and monitoring for complications like acute kidney injury, gastrointestinal bleeding, or liver dysfunction.
Key Considerations
- The patient's vital signs and physical examination should be closely monitored for signs of bleeding, kidney damage, or other complications.
- Laboratory tests should be performed to assess kidney function, coagulation, and urinalysis to check for blood.
- Treatment should include activated charcoal, intravenous fluids, proton pump inhibitors, and monitoring for complications.
Potential Complications
- Gastrointestinal bleeding
- Kidney damage
- Acute kidney injury
- Liver dysfunction
- Seizures or metabolic acidosis in severe cases It is essential to prioritize the patient's safety and well-being, and immediate medical attention is crucial to prevent long-term damage or complications. The study highlights the importance of careful monitoring and treatment in cases of NSAID overdose, and the patient's condition should be closely watched for any signs of adverse reactions or complications 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Initial Management
- The first priority in managing a patient who has ingested 8 tablets of Aleve (Naproxen) at once is to call an emergency response mobile unit and implement life-support techniques, such as resuscitation for cardiorespiratory arrest, respiratory support, and glucose injection if the patient is unconscious 2.
- The severity of poisoning should be assessed by gathering all information about the patient, the drug(s) ingested, the circumstances of ingestion, and any other substances ingested at the same time 2.
Treatment Options
- Activated charcoal can reduce the gastrointestinal absorption of some drugs, including Naproxen, and should be given as soon as possible, preferably within 2 hours after ingestion, provided the patient is fully conscious and capable of swallowing safely 2, 3.
- Gastric lavage carries a risk of serious adverse effects and is only justified in rare cases where the patient's life is at risk following ingestion of a drug that is not adsorbed by activated charcoal 2.
- There is no specific antidote for Naproxen overdose, and treatment is primarily supportive, focusing on managing symptoms and preventing complications 4, 5.
Monitoring and Supportive Care
- Hospital monitoring is warranted in cases of potentially severe poisoning, including patients at increased risk or those who have taken a potentially lethal substance at a toxic or unknown dose 2.
- Meticulous attention should be given to cardiovascular and neurologic status, as Naproxen overdose can cause significant toxicity 6.
- Aggressive supportive care, including management of cardiorespiratory and neurologic complications, is essential in cases of massive Naproxen overdose 6.