Maximum Single Dose of Naproxen
The maximum single dose of naproxen for acute pain is 825 mg of naproxen sodium (equivalent to 750 mg naproxen base), as recommended for the initial dose in acute gout. 1, 2
Standard Single Dose Recommendations by Indication
Acute Pain Conditions (Migraine, Postoperative Pain, Dysmenorrhea)
- Initial dose: 550 mg naproxen sodium (500 mg naproxen base) 1
- Maximum initial dose: 825 mg naproxen sodium 1
- This can be followed by 275-550 mg every 2-6 hours as needed 1
Acute Gout
- Starting dose: 750 mg naproxen base 2
- This represents the highest FDA-approved single dose
- Followed by 250 mg every 8 hours until attack subsides 2
General Pain Management
- Starting dose: 500 mg naproxen base 2
- Can be followed by 500 mg every 12 hours or 250 mg every 6-8 hours 2
- The initial total daily dose should not exceed 1250 mg 2
Important Dosing Context
The distinction between naproxen base and naproxen sodium matters for calculating actual drug content:
- 550 mg naproxen sodium = approximately 500 mg naproxen base 1, 3
- 275 mg naproxen sodium = approximately 250 mg naproxen base 1
Naproxen sodium is preferred for acute pain conditions because it is more rapidly absorbed and provides quicker onset of pain relief (within 1 hour), making it the better choice when prompt analgesia is needed 2, 3
Critical Safety Considerations
Gastrointestinal Risks
- Patients over 60 years, those with history of peptic ulcer, or significant alcohol use require careful monitoring 4
- Consider gastroprotection in high-risk patients 5
Renal Precautions
- Use caution in patients over 60 years or with compromised hydration 4
- Not recommended for patients with creatinine clearance <30 mL/min 2
- Discontinue if BUN or creatinine doubles 4
Cardiovascular Concerns
- Treat patients with cardiovascular disease history cautiously 4
- Monitor for development or worsening of hypertension 4
Common Pitfall to Avoid
Do not confuse formulations: The 825 mg maximum initial dose applies specifically to naproxen sodium for acute conditions like migraine or gout 1, 2. For chronic conditions like rheumatoid arthritis, standard dosing is 250-500 mg twice daily 2. The higher single doses (750-825 mg) are reserved for acute flares and should not be used routinely for chronic pain management.