Can naproxen (nonsteroidal anti-inflammatory drug (NSAID)) be given to a child?

Naproxen Use in Children: Safety and Efficacy Considerations

Naproxen can be safely given to children over 2 years of age, with appropriate dosing and monitoring for specific conditions like juvenile idiopathic arthritis, but it is not approved for children under 2 years of age. 1

Safety Profile and Age Considerations

• Naproxen is FDA-approved for pediatric use in children 2 years and older, with established safety and effectiveness data for juvenile arthritis 1
• Safety and effectiveness in pediatric patients below the age of 2 years have not been established, making naproxen contraindicated in this age group 1
• Naproxen is the preferred NSAID for children with conditions like juvenile idiopathic arthritis due to its established efficacy and safety profile 2, 3

Appropriate Dosing

• For children over 2 years of age, single doses of 2.5 to 5 mg/kg (as naproxen suspension) with total daily dose not exceeding 15 mg/kg/day are well tolerated 1
• An adequate trial period of at least 8 weeks is recommended for chronic conditions like juvenile idiopathic arthritis 2, 3
• Twice-daily dosing regimen is suitable for therapeutic use in children, similar to adults, based on pharmacokinetic studies showing comparable peak blood levels and half-life 4

Clinical Indications

• Naproxen is recommended for:
  • Juvenile idiopathic arthritis 2, 3
  • Postoperative pain management 2
  • Inflammatory conditions 5
  • Management of fever in specific circumstances (though not as first-line antipyretic) 6

Precautions and Contraindications

• Naproxen should be avoided in:
  • Children under 2 years of age 1
  • Dehydrated patients (especially with diarrhea and vomiting) 7
  • Children with wheezing and persistent asthma 7
  • Patients with varicella (chickenpox) 7
  • Children sensitive to NSAIDs 7

Risk Management

• Treatment should be initiated with the lowest age-appropriate or weight-based dose 8
• Duration of treatment should be regularly evaluated and kept as short as possible for non-chronic conditions 8
• Maximum dose limits and manufacturer recommendations should be strictly followed 8
• Parents should be educated about correct dosing and storage in childproof containers to prevent accidental overdose 9

Comparison with Other Antipyretics

• For fever reduction, acetaminophen (paracetamol) should remain the first-line therapy due to its comparable efficacy but superior tolerability profile 5
• Acetylsalicylic acid (aspirin) is not recommended for children due to safety concerns and risk of Reye's syndrome 3, 5

Monitoring Recommendations

• Patients with chronic conditions should be regularly monitored for possible adverse effects 8
• Special attention should be paid to gastrointestinal and renal function in children on long-term naproxen therapy 8, 5

By following these guidelines and precautions, naproxen can be safely and effectively used in children over 2 years of age for appropriate clinical indications.