Naproxen Dosing for Mild Headache
For mild headache, use naproxen 500 mg as a single dose, which can be repeated every 12 hours if needed, not exceeding 1000 mg per day after the initial dose. 1
Dosing Strategy
- Initial dose: 500 mg of naproxen at headache onset, followed by 500 mg every 12 hours or 250 mg every 6-8 hours as required 1
- The first day maximum is 1250 mg total; thereafter, do not exceed 1000 mg daily 1
- Pain relief typically begins within 1 hour of administration 1
Clinical Context and Evidence Quality
While the question asks about mild headache, the available evidence primarily addresses moderate to severe migraine. However, the dosing principles remain consistent:
- NSAIDs like naproxen (550-825 mg) are more effective than aspirin or acetaminophen for tension-type headaches 2
- For mild episodic migraine, the American College of Physicians recommends considering NSAIDs as first-line treatment 3
- Naproxen 275-550 mg has demonstrated efficacy for tension headaches 4
Important Caveats
Medication overuse headache risk:
- Limit naproxen use to fewer than 15 days per month to prevent medication overuse headache 3
- This threshold is higher than for triptans (≥10 days/month), but still requires monitoring 3
Formulation considerations:
- Different naproxen formulations (tablets, suspension, delayed-release, naproxen sodium) have different pharmacokinetic profiles affecting onset of action 1
- For acute pain requiring rapid onset, naproxen sodium is preferred over standard naproxen 1
Dose adjustments:
- Use lower doses in elderly patients, as the unbound plasma fraction increases with age 1
- Avoid in patients with creatinine clearance <30 mL/min 1
When to Escalate Treatment
If naproxen at adequate doses (500 mg) fails to provide sufficient relief for what progresses beyond mild headache, consider adding a triptan to the NSAID for combination therapy 3. This approach is superior to either medication alone for moderate to severe headaches 5.