What is the dosing for Naproxen (Aleve)?

From the Guidelines

Aleve (naproxen sodium) should be dosed at 220 mg (one tablet) every 8-12 hours for adults, with a maximum of 660 mg (three tablets) in 24 hours, as recommended by recent guidelines 1. When considering the management of acute pain, it is essential to weigh the benefits and risks of nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen sodium.

• The dosage of Aleve is crucial in minimizing adverse effects while maximizing its therapeutic benefits.
• For the first dose, taking 440 mg (two tablets) can achieve faster pain relief, but it is essential to follow the recommended dosage to avoid potential side effects.
• Aleve should be taken with food or milk to reduce stomach irritation, which is a common side effect of NSAIDs.
• The recommended duration for over-the-counter use is no more than 10 days for pain or 3 days for fever unless directed by a healthcare provider, as prolonged use can increase the risk of adverse effects.
• Naproxen works by blocking enzymes that produce prostaglandins, chemicals that cause pain and inflammation, making it an effective treatment for various types of pain.
• However, people with heart conditions, kidney problems, stomach ulcers, or those taking blood thinners should consult a doctor before using Aleve, as they may be at increased risk of adverse effects.
• Side effects may include stomach pain, heartburn, nausea, or dizziness, and patients should be monitored closely for these adverse reactions.
• For children under 12, elderly patients, or those with chronic conditions, dosing should be determined by a healthcare provider, as they may require special consideration and monitoring.
• According to the American Family Physician guidelines 1, NSAIDs like naproxen sodium are effective for mild to moderate migraine attacks, but their use should be limited and carefully monitored to minimize adverse effects.

From the FDA Drug Label

The recommended dose is 250 mg, 375 mg, or 500 mg twice daily The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. A lower daily dose may suffice for long-term administration. In patients who tolerate lower doses well, the dose may be increased to naproxen 1500 mg/day for limited periods of up to 6 months when a higher level of anti-inflammatory/analgesic activity is required.

The dosing for Aleve (naproxen) varies by condition:

• Rheumatoid Arthritis, Osteoarthritis and Ankylosing Spondylitis: 250 mg, 375 mg, or 500 mg twice daily
• Management of Pain, Primary Dysmenorrhea, and Acute Tendonitis and Bursitis: 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required
• Acute Gout: 750 mg of naproxen followed by 250 mg every 8 hours until the attack has subsided
• Juvenile Arthritis: approximately 10 mg/kg given in 2 divided doses (i.e., 5 mg/kg given twice a day) 2

From the Research

Aleve Dosing Information

There is no direct information available on Aleve dosing in the provided studies. However, we can look at the information available on NSAIDs, which Aleve (naproxen) is a part of.

NSAID Dosing and Safety

• The studies suggest that NSAIDs, including naproxen, should be used with caution due to their potential gastrointestinal and cardiovascular adverse events 3, 4, 5.
• The dosing of NSAIDs should be individualized based on the patient's risk factors, such as gastrointestinal and cardiovascular risk 5.
• Short-term use of NSAIDs appears to be safe, but long-term use or high doses should be avoided, especially in patients with active inflammation 4.
• COX-2 selective agents, such as celecoxib, may be safer for the gastrointestinal tract, but have a worse cardiovascular profile 3, 5.
• Naproxen, on the other hand, seems safer for the cardiovascular system, but has higher gastrointestinal toxicity 3, 5.

Considerations for Specific Patient Groups

• Patients with liver, kidney, or cardiovascular disease, gastrointestinal disorders, asthma, or who are older, should use NSAIDs with caution and under the guidance of a physician 6.
• No evidence supports routine dose reduction for older people, but dosing should be individualized in consultation with their physician 6.