Can a 12-year-old use naproxen (nonsteroidal anti-inflammatory drug)?

Can a 12-Year-Old Use Naproxen?

Yes, a 12-year-old can safely use naproxen—it is recommended as the preferred NSAID for children and adolescents due to its established efficacy and safety profile. 1, 2

Evidence Supporting Use in This Age Group

The most recent 2025 guidelines from the Pan-American League of Associations for Rheumatology explicitly recommend naproxen as the preferred NSAID for children and young people, including 12-year-olds. 1 This recommendation is based on:

• Evidence-supported efficacy and safety profile specifically in pediatric populations 1
• FDA and European Medicines Agency approval for pediatric use 1
• Clinical expertise consensus from rheumatology panels 1

A 2018 multicenter study demonstrated that naproxen was well-tolerated in adolescents aged 12-16 years with juvenile idiopathic arthritis, with 80.4% experiencing only mild to moderate adverse events and good therapeutic response. 3

Clinical Indications at Age 12

Naproxen is appropriate for:

• Pain and inflammation management as adjuvant therapy 1, 2
• Postoperative pain (oral, rectal, or intravenous formulations) 2
• Juvenile idiopathic arthritis and other inflammatory conditions 1, 3
• Acute pain conditions including traumatic injury 4

Dosing Considerations

• Twice-daily dosing regimen is suitable for children, similar to adults 5
• Weight-based dosing should be used, with formulations adjusted for age 3, 6
• Trial period of at least 8 weeks may be needed for chronic inflammatory conditions to assess full therapeutic response 1
• Start with the lowest effective dose and titrate as needed 6

Safety Profile

Naproxen has a well-established safety profile in children:

• No significant difference in peak blood levels and half-life between children and adults 5
• Comparable or superior tolerability to other NSAIDs in pediatric populations 7
• Most adverse effects are mild to moderate and gastrointestinal or upper respiratory in nature 3

Important Caveats

• Monitor for gastrointestinal effects: Consider co-administration with proton pump inhibitors (like esomeprazole) for prolonged use to reduce gastric ulcer risk 3
• Avoid in specific contraindications: Do not use in children with aspirin-sensitive asthma, active GI bleeding, severe renal or hepatic impairment 8
• Monitor hemoglobin periodically if long-term therapy is planned 8
• Check liver function if symptoms of hepatic dysfunction develop, as rare cases of severe hepatic reactions have been reported 8
• Assess platelet function in patients with coagulation disorders or those on anticoagulants 8

Advantages Over Alternatives

Naproxen is preferred over:

• Acetylsalicylic acid (aspirin): Not recommended in children due to controversial efficacy, safety concerns, and Reye's syndrome risk 1, 7
• Other NSAIDs: While ibuprofen, indomethacin, and meloxicam are acceptable alternatives, naproxen is specifically recommended as first-choice based on its established pediatric safety data 1, 2

Practical Approach

For a 12-year-old requiring NSAID therapy:

1. Initiate naproxen at appropriate weight-based dose using twice-daily regimen 5, 6
2. Use shortest duration necessary for acute conditions like fever or postoperative pain 6
3. Monitor for adverse effects including GI symptoms, changes in renal function, and signs of hepatotoxicity 8, 6
4. Consider gastroprotection with proton pump inhibitor if prolonged use is anticipated 3
5. Reassess regularly and discontinue if adverse effects develop 8, 6