Naproxen – known and unknown faces of a non-steroidal anti-inflammatory drug in clinical practice. Part II Review article
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Published:
Nov 30, 2025
Keywords:
naproxen, nonsteroidal anti-inflammatory drugs, pain, headache, fever
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Abstract
Naproxen is a well-known, prescription and over-the-counter nonsteroidal anti-inflammatory drug (NSAID), whose analgesic, anti-inflammatory, and antipyretic properties are used in the treatment of numerous pain syndromes, both acute and chronic. Its pharmacological activity includes, in addition to inhibiting cyclooxygenases, other multifaceted mechanisms of action, including blocking purine receptors and antiviral effects confirmed in in vitro and human studies. Numerous clinical studies have confirmed its effectiveness in the treatment of conditions such as rheumatoid arthritis, osteoarthritis, gout, nonspecific low back pain, primary menstrual pain, headaches, and fever. Its relatively rapid analgesic effect, long half-life, and well-established safety profile among NSAIDs make it an effective drug used in everyday medical practice. This paper presents key aspects of naproxen, including its mechanisms of action, possible side effects, efficacy and safety in pain relief in many conditions, as well as in the treatment of fever and colds.
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Bitner-Bieleszuk, M., Bryła, A., & Kocot-Kępska, M. (2025). Naproxen – known and unknown faces of a non-steroidal anti-inflammatory drug in clinical practice. Part II. Medycyna Faktow (J EBM), 18(3(68), 378-384. https://doi.org/10.24292/01.MF.0325.07
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References
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9. Marjoribanks J, Ayeleke RO, Farquhar C et al. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015; 2015(7): CD001751.
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12. Coskun O, Karakas A, Savasci M et al. The Value of Naproxen Test as a Diagnostic Method to Differentiate Cause of Fever. TAF Prev Med Bull. 2012; 11(6): 779.
13. Zhang H, Wu Y, Lin Z et al. Naproxen for the treatment of neoplastic fever: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2019; 98(22): e15840.
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17. Terrier O, Dilly S, Pizzorno A, Chalupska D et al. Antiviral Properties of the NSAID Drug Naproxen Targeting the Nucleoprotein of SARS-CoV-2 Coronavirus. Molecules. 2021; 26(9): 2593.
18. Hung IFN, To KKW, Chan JFW et al. Efficacy of Clarithromycin-Naproxen-Oseltamivir Combination in the Treatment of Patients Hospitalized for Influenza A(H3N2) Infection. Chest. 2017; 151(5): 1069-80.
19. Azh N, Barzkar F, Motamed-Gorji N et al. Nonsteroidal anti-inflammatory drugs in acute viral respiratory tract infections: An updated systematic review. Pharmacol Res Perspect. 2022; 10(2): e00925.
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24. Castellsague J, Riera-Guardia N, Calingaert B et al. Safety of Non-Steroidal Anti-Inflammatory Drugs (SOS) Project. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012; 35(12): 1127-46.
25. Fan M, Liu J, Zhao B et al. Indirect comparison of NSAIDs for ankylosing spondylitis: Network meta-analysis of randomized, double-blinded, controlled trials. Exp Ther Med. 2020; 19(4): 3031-41.
26. Hinz B, Cheremina O, Besz D, Zlotnick S, Brune K. Impact of naproxen sodium at over-the-counter doses on cyclooxygenase isoforms in human volunteers. Int J Clin Pharmacol Ther. 2008; 46(04):180-6.
27. Woroń J. The use of non-steroidal anti-inflammatory drugs in patients with osteoarthritis and the risk of gastrointestinal side effects. Lek POZ. 2019; 5(5): 395-401.
28. Meek IL, Vonkeman HE, Kasemier J et al. Interference of NSAIDs with the thrombocyte inhibitory effect of aspirin: A placebo-controlled, ex vivo, serial placebo-controlled serial crossover study. Eur J Clin Pharmacol. 2013; 69(3): 365-71.
29. Woroń J. Miejsce naproksenu w farmakoterapii bólu i gorączki. Co wiemy w 2022 roku? Med Faktów. 2022; 4(57): 401-3.
30. Brune, Patrignani P. New insights into the use of currently available non-steroidal anti-inflammatory drugs. J Pain Res. 2015; 8: 105-18.
31. Capone ML, Sciulli MG, Tacconelli S et al. Pharmacodynamic interaction of naproxen with low-dose aspirin in healthy subjects. J Am Coll Cardiol. 2005; 45(8): 1295-301.
32. Scarpignato C, Hunt RH. Nonsteroidal Antiinflammatory Drug-Related Injury to the Gastrointestinal Tract: Clinical Picture, Pathogenesis, and Prevention. Gastroenterol Clin N Am. 2010; 39: 433-64.
33. Rainsford KD, Bjarnason I. NSAIDs: take with food or after fasting? J Pharm Pharmacol. 2012; 64(4): 465-9.
2. Charakterystyka Produktu Leczniczego – Naproksen.
3. Charakterystyka Produktu Leczniczego – Naproksen sodowy.
4. Law S, Derry S, Moore RA. Naproxen with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev. 2013; 2013(10): CD009455.
5. Wilcha R, Afridi SK, Barbanti P et al. Sumatriptan-naproxen sodium in migraine: A review. Eur J Neurol. 2024; 31 Suppl 2(Suppl 2): e16434.
6. Martin VT, Ballard J, Diamond MP et al. Relief of Menstrual Symptoms and Migraine with a Single-Tablet Formulation of Sumatriptan and Naproxen Sodium. J Womens Health. 2014; 23(5): 389-96.
7. Bendtsen L, Evers S, Linde M et al. EFNS guideline on the treatment of tension-type headache – Report of an EFNS task force. Eur J Neurol. 2010; 17(11): 1318-25.
8. Xie R, Li J, Jing Y et al. Efficacy and safety of simple analgesics for acute treatment of episodic tension-type headache in adults: a network met-analysis. Ann Med. 2024; 56(1): 2357235.
9. Marjoribanks J, Ayeleke RO, Farquhar C et al. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2015; 2015(7): CD001751.
10. Chang JC, Gross HM. Utility of naproxen in the differential diagnosis of fever of undetermined origin in patients with cancer. Am J Med. 1984; 76(4): 597-603.
11. Sperber SJ, Hendley JO, Hayden FG et al. Effects of Naproxen on Experimental Rhinovirus Colds: A Randomized, Double-Blind, Controlled Trial. Ann Intern Med. 1992; 117(1): 37-41.
12. Coskun O, Karakas A, Savasci M et al. The Value of Naproxen Test as a Diagnostic Method to Differentiate Cause of Fever. TAF Prev Med Bull. 2012; 11(6): 779.
13. Zhang H, Wu Y, Lin Z et al. Naproxen for the treatment of neoplastic fever: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2019; 98(22): e15840.
14. Kim SY, Chang YJ, Cho HM et al. Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database Syst Rev. 2015; 2015(9): CD006362.
15. Krüger K, Töpfner N, Berner R et al. Clinical Practice Guideline: Sore Throat. Dtsch Ärztebl Int. 2021.
16. Brutzkus JC, Shahrokhi M, Varacallo MA. Naproxen. In: StatPearls. Treasure Island (FL). StatPearls Publishing; 2020.
17. Terrier O, Dilly S, Pizzorno A, Chalupska D et al. Antiviral Properties of the NSAID Drug Naproxen Targeting the Nucleoprotein of SARS-CoV-2 Coronavirus. Molecules. 2021; 26(9): 2593.
18. Hung IFN, To KKW, Chan JFW et al. Efficacy of Clarithromycin-Naproxen-Oseltamivir Combination in the Treatment of Patients Hospitalized for Influenza A(H3N2) Infection. Chest. 2017; 151(5): 1069-80.
19. Azh N, Barzkar F, Motamed-Gorji N et al. Nonsteroidal anti-inflammatory drugs in acute viral respiratory tract infections: An updated systematic review. Pharmacol Res Perspect. 2022; 10(2): e00925.
20. Coxib and traditional NSAID Trialists’ (CNT) Collaboration; Bhala N, Emberson J, Merhi A et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013; 382(9894): 769-79.
21. Kocot-Kępska M. Naproksen – multifunkcjonalny niesteroidowy lek przeciwzapalny. Lek POZ. 2020; 6(3): 215-20.
22. Lewek P. Bezpieczeństwo stosowania naproksenu u pacjentów z nadciśnieniem tętniczym. Lek w Polsce. 2015; 9: 27-8.
23. Ikdahl E, Kerola A, Sollerud E et al. Cardiovascular Implications of Non-steroidal Anti-inflammatory Drugs: A Comprehensive Review, with Emphasis on Patients with Rheumatoid Arthritis. Eur Cardiol. 2024; 19: e27.
24. Castellsague J, Riera-Guardia N, Calingaert B et al. Safety of Non-Steroidal Anti-Inflammatory Drugs (SOS) Project. Individual NSAIDs and upper gastrointestinal complications: a systematic review and meta-analysis of observational studies (the SOS project). Drug Saf. 2012; 35(12): 1127-46.
25. Fan M, Liu J, Zhao B et al. Indirect comparison of NSAIDs for ankylosing spondylitis: Network meta-analysis of randomized, double-blinded, controlled trials. Exp Ther Med. 2020; 19(4): 3031-41.
26. Hinz B, Cheremina O, Besz D, Zlotnick S, Brune K. Impact of naproxen sodium at over-the-counter doses on cyclooxygenase isoforms in human volunteers. Int J Clin Pharmacol Ther. 2008; 46(04):180-6.
27. Woroń J. The use of non-steroidal anti-inflammatory drugs in patients with osteoarthritis and the risk of gastrointestinal side effects. Lek POZ. 2019; 5(5): 395-401.
28. Meek IL, Vonkeman HE, Kasemier J et al. Interference of NSAIDs with the thrombocyte inhibitory effect of aspirin: A placebo-controlled, ex vivo, serial placebo-controlled serial crossover study. Eur J Clin Pharmacol. 2013; 69(3): 365-71.
29. Woroń J. Miejsce naproksenu w farmakoterapii bólu i gorączki. Co wiemy w 2022 roku? Med Faktów. 2022; 4(57): 401-3.
30. Brune, Patrignani P. New insights into the use of currently available non-steroidal anti-inflammatory drugs. J Pain Res. 2015; 8: 105-18.
31. Capone ML, Sciulli MG, Tacconelli S et al. Pharmacodynamic interaction of naproxen with low-dose aspirin in healthy subjects. J Am Coll Cardiol. 2005; 45(8): 1295-301.
32. Scarpignato C, Hunt RH. Nonsteroidal Antiinflammatory Drug-Related Injury to the Gastrointestinal Tract: Clinical Picture, Pathogenesis, and Prevention. Gastroenterol Clin N Am. 2010; 39: 433-64.
33. Rainsford KD, Bjarnason I. NSAIDs: take with food or after fasting? J Pharm Pharmacol. 2012; 64(4): 465-9.