Aleve (Naproxen Sodium) 3-Day Prescription Script
For a 3-day course of over-the-counter Aleve (naproxen sodium), prescribe 440 mg (two 220 mg tablets) taken orally twice daily (every 12 hours) with food, for a total daily dose of 880 mg. 1, 2
Specific Prescription Details
Medication: Naproxen sodium (Aleve) 220 mg tablets
Dosing Instructions:
- Take 2 tablets (440 mg) by mouth twice daily
- Space doses 12 hours apart (e.g., 8 AM and 8 PM)
- Take with food or milk to minimize gastrointestinal discomfort
- Duration: 3 days only
- Total quantity: 12 tablets 1, 2
Clinical Rationale
The American College of Rheumatology recommends 440 mg twice daily as the equivalent over-the-counter dose when converting from prescription naproxen 375-500 mg twice daily. 1 The FDA labeling confirms that naproxen can be safely administered twice daily with onset of pain relief beginning within 1 hour. 2
For acute pain management, the initial dose should not exceed 1250 mg on day 1, with subsequent days not exceeding 1000 mg daily—the 880 mg daily regimen falls well within these safety parameters. 2
Critical Safety Considerations for 3-Day Use
Contraindications to verify before prescribing:
- Active peptic ulcer disease or history of NSAID-associated GI bleeding 3
- Moderate to severe renal impairment (creatinine clearance <30 mL/min) 3, 2
- Congestive heart failure 3
- Current anticoagulant therapy (increases GI bleeding risk 3-6 fold) 3
Patient counseling points:
- Take with food to reduce GI upset (10-20% experience dyspepsia) 3
- Stop immediately and seek care if black/tarry stools, severe abdominal pain, or signs of bleeding occur 3
- Avoid alcohol during treatment period 3
- May cause mean blood pressure increase of 5 mmHg in hypertensive patients 3
When to Avoid This Regimen
Use lower starting dose (220 mg twice daily) in:
- Elderly patients (>65 years)—unbound plasma fraction increases with age 2
- Patients taking ACE inhibitors or beta blockers (additive renal effects) 3
- Mild renal or hepatic impairment 2
Common pitfall: The 3-day duration is appropriate for acute pain, but if symptoms persist beyond this period, reassessment is needed rather than automatic continuation, as prolonged NSAID use requires monitoring for cardiovascular and GI complications. 3