Is naproxen (nonsteroidal anti-inflammatory drug, NSAID) safe for pain management in an otherwise healthy 16-year-old?

Safety of Naproxen for Pain Management in a Healthy 16-Year-Old

Naproxen is safe and effective for short-term pain management in an otherwise healthy 16-year-old, with a well-established safety profile that makes it a preferred NSAID option for adolescents. 1

Evidence Supporting Naproxen Use in Adolescents

The Pan-American League of Associations for Rheumatology (PANLAR) specifically recommends naproxen as the preferred NSAID for children and young people due to its established efficacy and safety profile. According to their 2025 guidelines, naproxen is recommended over other selective COX-1 or COX-2 inhibitors for pain and inflammation in the pediatric population 1.

The FDA-approved labeling for naproxen confirms its safety and efficacy in juvenile arthritis patients aged 5-16 years, with pharmacokinetic studies showing that plasma naproxen levels in pediatric patients following appropriate dosing are similar to those found in adults 2.

Dosing Considerations

For an otherwise healthy 16-year-old:

• Standard dosing: 500 mg twice daily (or naproxen sodium 550 mg twice daily)
• Maximum daily dose should not exceed 1000 mg of naproxen
• Treatment should be limited to the shortest duration necessary to control symptoms

Advantages of Naproxen

1. Convenient dosing: Due to its relatively long half-life (12-17 hours), naproxen can be administered on a convenient twice-daily schedule 2, 3
2. Established efficacy: Naproxen has demonstrated effectiveness for various types of pain including acute pain, postoperative pain, and inflammatory conditions 4, 5
3. Duration of action: The weighted mean time to remedication for naproxen sodium 550 mg is 7.6 hours compared with 2.6 hours for placebo 4

Safety Considerations and Monitoring

While naproxen is generally safe for adolescents, certain precautions should be observed:

1. Gastrointestinal effects: Monitor for signs of GI distress, though these are less common in adolescents than adults 2
2. Duration of use: Limit to short-term use when possible; prolonged use increases risk of adverse effects
3. Hydration: Ensure adequate hydration during treatment
4. Concomitant medications: Avoid combining with other NSAIDs or medications that may interact with naproxen

Multimodal Approach to Pain Management

For optimal results, naproxen should be part of a multimodal approach:

• Start with naproxen as first-line pharmacological therapy
• Incorporate non-pharmacological approaches (physical therapy, activity modification, etc.)
• Consider acetaminophen as an alternative or adjunct if naproxen is not tolerated 1

Important Contraindications

Naproxen should be avoided in adolescents with:

• History of hypersensitivity to NSAIDs
• Active peptic ulcer disease
• Significant renal impairment
• Severe hepatic dysfunction
• Concomitant use of other NSAIDs 1, 2

Follow-up and Monitoring

• Assess response to therapy within 1-2 weeks
• Monitor for adverse effects, particularly with extended use
• If pain persists beyond expected duration, reevaluate for underlying conditions

In conclusion, naproxen represents a safe and effective option for pain management in an otherwise healthy 16-year-old, with a well-established safety profile that has been confirmed through extensive clinical use in pediatric populations.