Naproxen Sodium
Common brand names: Aleve, Anaprox.
Description: Naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID) that relieves pain, reduces fever and lessens swelling and other symptoms of arthritis.
Dental Uses: In dentistry, naproxen sodium is employed to treat pain from dental surgery, toothache, and the temporomandibular joint. A 220-milligram dose (that is, one Aleve) is roughly equal to the pain-relieving effects of the maximum prescribed doses of aspirin or acetaminophen (1,000 milligrams). For more severe dental pain, such as that following oral surgery, the analgesic effects of 440 to 550 milligrams of naproxen sodium (that is, two Aleve or one Anaprox) is superior to 1,000 milligrams of aspirin or acetaminophen and is at least equivalent to 600 milligrams of acetaminophen plus 60 milligrams of codeine (that is, two Tylenol #3s). Naproxen sodium is noted for its relatively long duration of action (eight to 12 hours).
Dosages for dental purposes: The generally effective prescription for naproxen sodium following dental surgery is 440 to 550 milligrams every eight to 12 hours as needed for pain. The maximum daily dose should not exceed 1,350 milligrams on the first day of therapy and 1,100 milligrams on subsequent days. The duration of therapy for post-surgical pain varies, but is usually less than five days. Naproxen sodium is not recommended for children under the age of 14.
Concerns and possible side effects: With short-term use (less than one week), common side effects include abdominal pain, nausea and increased bleeding time, with an incidence about equal to that of aspirin. Naproxen sodium also occasionally causes a dry mouth (xerostomia).
With chronic dosing (many weeks or months), as employed in the treatment of arthritis, more serious side effects can occur, often requiring hospitalization. These may include bleeding ulcers and perforations of the stomach and small intestines (occurring in 1 percent to 4 percent of patients) and impairment of kidney function. Still, under the typical dental usage scenario of a few days at most, naproxen sodium is generally a safe, well-tolerated and effective analgesic.
Patients allergic to aspirin or other NSAIDs (ibuprofen, diflunisal and many others) should avoid naproxen sodium. Allergic reactions can range from a mild rash to life-threatening closure of the airway and a fall in blood pressure. In addition, about 5 percent to 10 percent of patients with asthma — called aspirin- or NSAID-sensitive asthmatics — cannot tolerate aspirin, naproxen sodium, related NSAIDs, or COX-2 inhibitors because they will precipitate life-threatening asthmatic attacks.
Patients with ulcers of the stomach or the small intestine should avoid naproxen sodium. Patients should avoid alcohol consumption during naproxen sodium therapy for dental pain because alcohol increases the risk of stomach ulcers and bleeding.
Other drugs with which naproxen sodium may adversely interact include:
The manic-depression drug lithium (Eskalith), which when combined can lead to lithium toxicity
Warfarin (Coumadin) and other anticoagulants, which can lead to bleeding
Oral drugs for diabetes (ie, Diabinase and Orinase), which can lead to low blood sugar
Some high blood pressure medications, including beta blockers (propranolol, brand name Inderal), ACE inhibitors (enalapril, brand name Vasotec), and diuretics (hydrochlorothiazide, brand name Hydrodiuril). Combining any of these with naproxen may cause elevations in blood pressure.
These interactions can be serious, so it is imperative to inform your dentist of all medications you are taking.
