does naproxen thin blood?
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does naproxen thin blood?
What is naproxen?
Naproxen is a pain medication that relieves inflammation and joint stiffness. Other NSAIDs in the same medication class include acetylsalicylic acid, diclofenac, ibuprofen, and meloxicam.
Naproxen works by blocking the enzyme that produces prostaglandins. Prostaglandins play an essential role in inflammation. The body produces them at the site of injured tissue, and they cause redness, heat, swelling, and pain.
Naproxen is available as naproxen or naproxen sodium. The major difference between naproxen and naproxen sodium is that naproxen sodium is more rapidly absorbed.
The body reaches peak levels of naproxen in 2–4 hours and naproxen sodium in 1–2 hours, meaning that it absorbs naproxen sodium faster than regular naproxen.
How should this medicine be used?
Prescription naproxen comes as a regular tablet, a delayed-release (a tablet that releases the medication in the intestine to prevent damage to the stomach) tablet, an extended-release (long-acting) tablet, and a suspension (liquid) to take by mouth. The extended-release tablets are usually taken once a day. The tablets, delayed-release tablets, and suspension are usually taken twice a day for arthritis. The tablets and suspension are usually taken every 8 hours for gout, and every 6 to 8 hours as needed for pain. If you are taking naproxen on a regular basis, you should take it at the same time(s) every day.
Nonprescription naproxen comes as tablet and a gelatin coated tablet to take by mouth. It is usually taken with a full glass of water every 8 to 12 hours as needed. Nonprescription naproxen may be taken with food or milk to prevent nausea.
How should this medicine be used?
Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take naproxen exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor or written on the package.
Shake the liquid well before each use to mix the medication evenly. Use the measuring cup provided to measure each dose of the liquid.
Swallow the delayed-release tablets and extended release tablets whole; do not split, chew, or crush them.
If you are taking naproxen to relieve the symptoms of arthritis, your symptoms may begin to improve within 1 week. It may take 2 weeks or longer for you to feel the full benefit of the medication.
Stop taking nonprescription naproxen and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, the part of your body that was painful becomes red or swollen, your pain lasts for more than 10 days, or your fever lasts for more than 3 days.
About blood thinners
Blood thinners come in two classes: Antiplatelet drugs such as aspirin stop platelets from forming clots. Anticoagulants such as warfarin (Coumadin) and the newer direct acting oral anticoagulants (DOACs) lengthen the time it takes to form a blood clot. NSAIDs affect the way platelets work and could interfere with normal blood clotting. “That could raise the risk of bleeding, especially in the digestive tract. Taking them together with blood thinners raises the bleeding risk even more,” says Dr. Bhatt.
What are the risks of taking NSAIDs while on blood thinners?
Just because some NSAIDs are available without a prescription doesn’t mean that they are without risks. While possible side effects of NSAIDs include stomach upset, high blood pressure, and kidney problems, a big concern for people taking blood thinners is that NSAIDs raise your risk of bleeding. Even common medications like ibuprofen and naproxen pose a danger if you take anticoagulants or antiplatelets.
In 2009, the FDA required that a warning about bleeding risks be added to the labels of all OTC products containing NSAIDs. This change helped communicate this information to the public since these medications can be purchased without a prescription, meaning your provider may not know you’re taking them. However, bleeding isn’t the only NSAID risk for people taking blood thinners.
In addition to the higher risk of bleeding, you also have a higher risk of heart attacks if you take both blood thinners and NSAIDs. This risk is still there even when NSAIDs are used for a short time — as short as one week.
This combination of possible problems makes using NSAIDs riskier for people who take blood thinners than for those who don’t.
How do NSAIDs work?
NSAIDs block the production of certain body chemicals that cause inflammation. they are good at treating pain caused by slow tissue damage, such as arthritis pain. NSAIDs also work well fighting back pain, menstrual cramps and headaches.
they work like corticosteroids (also called steroids), without many of the side effects of steroids. Steroids are man-made drugs that are similar to cortisone, a naturally-occurring hormone. Like cortisone, NSAIDs reduce pain and inflammation that often come with joint and muscle diseases and injuries.
How long do NSAIDs take to work?
That depends on the NSAID and the condition being treated. Some NSAIDs may work within a few hours, while others may take a week or two.
Generally, for acute (sharp sudden pain) muscle injuries, we recommend NSAIDs that work quickly. However, these may need to be taken as often as every four to six hours because of their short action time.
For osteoarthritis and rheumatoid arthritis that need long-term treatment, doctors usually recommend NSAIDs that are taken only once or twice a day. However, it generally takes longer for these drugs to have a therapeutic (healing) effect.
side effects from short-term use
Prostaglandins naturally help protect your stomach from damage. When Aleve reduces your prostaglandin production, it can cause:
- stomach pain
- constipation
- diarrhea
- gas
- heartburn
- nausea or vomiting
These effects are more likely the older you are or the longer you use Aleve.
More serious side effects include:
- swelling
- bleeding
- ulcers
- tears in your stomach, small intestine, or large intestine
These effects can be fatal and can happen without warning. If you notice severe stomach pain or bloody or black, tarry stools while you take Aleve, stop taking the drug and call your doctor right away. To lower your risk of digestive system side effects, use the lowest effective dosage for the shortest time.
Aleve can also increase your blood pressure. You might not notice any signs that your blood pressure is increased. And if you already have high blood pressure, taking Aleve might make it worse. You should talk to your doctor before using Aleve if you have high blood pressure.
Aleve can also reduce your blood’s ability to clot. This can lead to bleeding. Talk to your doctor before using Aleve if you plan on having surgery soon.
Side effects from long-term use
Long-term use of Aleve can make your heart work harder. Aleve makes you retain water, which increases the load on your heart. This extra work can cause pressure on your cardiovascular system and can sometimes lead to a heart attack or stroke. These risks are even greater at higher dosages, even if you don’t have any heart conditions or risk of heart disease. Call 911 or local emergency services if you have:
- chest pain
- shortness of breath
- slurred speech
- weakness in your arms or legs
These are signs of a stroke or heart attack. If you take Aleve and have unexplained weight gain or swelling, especially in your legs and feet, talk to your doctor right away. These may be signs of heart failure. To lower your risk of heart problems, use the lowest dosage for the shortest amount of time.
Prostaglandins maintain the pressure in your kidneys so that these organs can filter the fluids in your body. A decrease in your level of prostaglandins from taking Aleve can cause problems with your kidney function. You may notice fluid retention or changes in how much you urinate. If you notice these changes while taking Aleve, stop taking it and contact your doctor.
Aleve Dosages and Forms
Aleve over-the-counter comes in 220 mg. But other naproxen brands are available by prescription and dosages can go as high as 750 mg.
Aleve OTC is available in tablet, gelcap, caplet or liquid gel. But other formulas are available in delayed release tablets, extended release tablets, capsules and oral suspension.
For Aleve OTC, take one 220 mg pill every 8 to 12 hours. For the first dose, patients can take 2 pills within the first hour. Don’t take more than 2 pills in 12 hours, and do not take more than 3 pills in 24 hours.
Don’t take Aleve for more than 10 consecutive days unless your doctor tells you to. The maximum daily dose for naproxen is 660 mg.
What drugs interact with Aleve?
Naproxen is associated with several suspected or probable interactions that affect the action of other drugs. The following examples are the most common suspected interactions.
- Naproxen may increase the blood levels of lithium (Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.
- Naproxen may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins play a role in the regulation of blood pressure.
- When naproxen is used in combination with methotrexate (Rheumatrex, Trexall) or aminoglycosides (for example, gentamicin) the blood levels of the methotrexate or aminoglycoside may increase, presumably because the elimination from the body of these drugs is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.
- Individuals taking anticoagulants, for example, warfarin, (Coumadin), should avoid naproxen because naproxen also thins the blood, and excessive blood thinning may lead to bleeding.
- Naproxen increases the negative effect of cyclosporine on kidney function and reduces the effect of furosemide (Lasix) and thiazide diuretics because of prostaglandin inhibition.
- Naproxen should be avoided by patients with a history of asthma attacks, hives or other allergic reactions to aspirin or other NSAIDs. If aspirin is taken with naproxen there may be an increased risk for developing an ulcer.
- Persons who have more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking naproxen or other NSAIDs.
How long does naproxen stay in your system?
After taking your last dose of naproxen it should be out of your system within 93.5 hours. Naproxen has an elimination half life of 12 to 17 hours. This is the time it takes for your body to reduce plasma drug levels by half. It takes approximately 5.5 x elimination half-life for a drug to be eliminated from your system.
Therefore naproxen will be in your system for about 93.5 hours (5.5 x 17 hours).
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