Naproxen Precautions and Warnings (Cont.)

• There are certain other medications that naproxen can interact with (see Naproxen Drug Interactions).
   
• All NSAIDs, including naproxen, have been reported to cause cardiovascular events such as a heart attack or stroke, which can result in loss of life. People who have cardiovascular disease or cardiovascular risk factors appear to be at greater risk.

To decrease the chances of these problems occurring, it is recommended that people take the smallest effective dose for the shortest period of time. Also, call 911 or an ambulance if you notice things such as chest pain, shortness of breath, weakness, or slurring of speech.

• All NSAIDs, including naproxen, may worsen high blood pressure or cause high blood pressure. Naproxen should be used with caution in people with known high blood pressure.
   
• All NSAIDs, including naproxen, may cause congestive heart failure or swelling. Make sure to contact your healthcare provider if you notice unexplained weight gain or swelling. Also, naproxen should be used with caution in people with heart failure.
   
• All NSAIDs, including naproxen, have been reported to cause problems in the stomach and intestines, including bleeding (known as gastrointestinal bleeding), stomach ulcers, or holes in the stomach or intestines. These problems can lead to serious complications or even loss of life. Extreme caution should be used if naproxen is prescribed for people with a history of ulcers or gastrointestinal bleeding.

To decrease the chances of these problems occurring, it is recommended that people take the smallest effective dose for the shortest period of time. Make sure to contact your healthcare provider immediately if you experience any signs or symptoms of stomach ulcers or bleeding, including:

o Stomach pain

o Indigestion

o Black, tarry stools

o Vomiting blood.

• Kidney damage can happen in people taking NSAIDs, including naproxen. It is more common in people with kidney disease, heart failure, liver problems, those taking diuretics or ACE inhibitor medication, and the elderly.
   
• Liver damage can happen with people taking naproxen. Contact your healthcare provider immediately if you notice things such as nausea, tiredness, lethargy, itchy or yellowing skin, abdominal pain, or flu-like symptoms.
   
• NSAIDs, including naproxen, have been reported to cause allergic reactions. Seek emergency medical attention immediately if you notice things such as difficulty breathing and swelling of the face and throat.
   
• In rare cases, people taking naproxen can develop a very serious rash. If you notice an unexplained rash or blisters, fever, or itchy skin, stop taking the naproxen and call your healthcare provider.
   
• If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting naproxen. Alcohol can affect the way the liver works, indirectly affecting the naproxen.
   
• NSAIDS have been known to cause an increase in liver enzymes. Therefore, it is recommended that you have a blood test that looks at your liver function before starting naproxen and 12 weeks after treatment has started.
   
• Naproxen had been known to cause anemia. If you are taking naproxen for an extended amount of time and show signs of anemia, talk to your healthcare provider.
   
• You should not take naproxen with any other NSAIDs, as this may increase your risk for any of the problems discussed above. There are many NSAIDs available with or without a prescription; make sure to read labels carefully. Some examples of NSAIDs are ibuprofen (Advil^®, Motrin^®), diclofenac (Cataflam^®, Voltaren^®), indomethacin (Indocin^®), nabumetone (Relafen^®), oxaprozin (Daypro^®), celecoxib (Celebrex^®), meloxicam (Mobic^®), etodolac (Lodine^®), ketoprofen, ketorolac (Toradol^®), and others. You can ask your doctor or pharmacist for a complete list of these medications.
   
• Naproxen is a pregnancy Category C medicine, meaning that it could potentially cause harm to your unborn child. If you are pregnant, you should take naproxen only if the benefit outweighs the possible risk to your unborn child. Naproxen is not recommended for women in the third trimester of pregnancy because it can cause injury (and even death) to the developing fetus. If you become pregnant while taking naproxen, contact your healthcare provider immediately (see Naproxen and Pregnancy).
   
• If you are nursing, it is recommended that you do not take naproxen. Therefore, if you are taking naproxen, discuss with your healthcare provider whether to stop nursing or discontinue the medicine.