From the Guidelines
Naproxen is a viable treatment option for acute gout arthritis, as high-quality evidence shows that NSAIDs, including naproxen, are effective in reducing pain in patients with acute gout. According to the American College of Physicians guideline 1, NSAIDs, such as naproxen, can be used to manage acute gout, although corticosteroids are recommended as first-line therapy due to their safety and low cost. The guideline notes that there is no difference between different types of NSAIDs, including indomethacin, naproxen, and ibuprofen, in terms of efficacy for treating acute gout 1.
When using naproxen for acute gout, it is essential to consider the potential adverse effects, such as dyspepsia, gastrointestinal perforations, ulcers, and bleeding 1. Patients with renal disease, heart failure, or cirrhosis may need to avoid NSAIDs or use them with caution. The recommended dosage of naproxen for acute gout is typically 500 mg initially, followed by 250 mg every 8 hours until the gout attack subsides.
Key considerations for using naproxen in acute gout include:
- Starting treatment at the first sign of an attack
- Combining naproxen with rest, ice application, and elevation of the affected joint
- Taking naproxen with food or milk to reduce stomach irritation
- Staying well-hydrated
- Monitoring for potential adverse effects, especially in patients with pre-existing medical conditions.
It is crucial to note that while naproxen can effectively manage acute gout symptoms, it does not address the underlying high uric acid levels causing gout, and long-term preventive medications like allopurinol may be necessary for recurrent attacks.
From the FDA Drug Label
Naproxen tablets are also indicated: For relief of the signs and symptoms of acute gout Naproxen is indicated for the relief of the signs and symptoms of acute gout.
- The FDA drug label directly supports the use of naproxen for acute gout 2, 2.
- A favorable response to naproxen was shown by significant clearing of inflammatory changes (e.g., decrease in swelling, heat) within 24 to 48 hours, as well as by relief of pain and tenderness in patients with acute gout 2.
From the Research
Naproxen for Gout Arthritis
- Naproxen is a non-steroidal anti-inflammatory drug (NSAID) that has been studied as a treatment option for gout arthritis 3, 4.
- A double-blind, randomized equivalence trial compared the effectiveness of naproxen and prednisolone in treating monoarticular gout, and found that they were equally effective in reducing pain over 4 days 3.
- Another study found that naproxen was effective in alleviating the inflammation of acute gout, with 15 out of 20 patients experiencing an excellent or good response to treatment 4.
- The use of naproxen for gout arthritis is also supported by its inclusion as a first-line agent for treating gout flares, along with other NSAIDs, colchicine, and glucocorticoids 5.
- However, it is worth noting that the management of gout arthritis often involves a combination of medications, including urate-lowering therapies such as allopurinol and febuxostat, and that naproxen may be used in conjunction with these medications to manage acute flares 6, 7.