How Many Aleve Can I Take and How Often?

Aleve
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Aleve, aka Naproxen

Aleve (naproxen) is a non-steroidal anti-inflammatory (NSAID) medication used for pain relief and fever reduction. It can be purchased over the counter. Naproxen, its active ingredient, can also be obtained via prescription. It's common knowledge that naproxen is effective in reducing the pain, tenderness, swelling and stiffness experienced by people with both inflammatory and non-inflammatory arthritis.

This includes osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. People with back pain can also use Aleve for muscle aches, arthritis and other ails.

NSAIDs, including but not limited to Aleve, work largely by inhibiting the formation of body chemicals known as prostaglandins. In doing so, these medications reduce inflammation and pain.

Over-the-counter Aleve comes as a regular tablet and with gelatin coating. Prescription naproxen comes as a regular tablet, an enteric coated medication, extended release tablet, and a liquid.

When to Take Aleve, and How Much

As with any drug, your doctor is the best person to help you determine how much to take and how often. If she is not available to speak with you, follow the instructions on the package very carefully, and/or ask your pharmacist. Don't take it more or less than the amount recommended, nor more frequently. Because Aleve has known side effects which can be very serious in nature, the rule of thumb is to take as little as you can for only the shortest time period necessary.

If you have stomach, heart or kidney problems, your doctor may suggest you take less than the normal dosage, to protect yourself from problems associated with taking the drug.

Aleve is taken by mouth, with a full glass of water, approximately every 8-12 hours, while symptoms last. Within the first hour you could take 2 tablets, if you need.

Aleve tablets contain 220 mg of naproxen. For pain and fever relief, you should not take more than 440 mg, or 2 tablets, within a 12-hour period. Also, you should not take more than 660 mg, or 3 tablets, within a 24 hour (1 day) period. For arthritis pain, the maximum is one gram diving twice per day, which can be increased to 1.5 grams for limited periods of time. For other uses, discuss dosing with your doctor.

If you take Aleve with food, you may be able to minimize stomach discomfort associated with taking this drug.

In all but the extended release tablets, prescription naproxen is usually taken twice a day in cases of arthritis, and every 6-8 hours as needed for other types of pain. Do not crush or chew enteric-coated naproxen, as that will cancel its stomach protective benefits. If your doctor has prescribed long-term use of naproxen, be sure to take it at the same time each day.

What to do if You Forget to Take Aleve When You Should

If you miss a dose, take one as soon as you remember.

An exception would be when it is almost time for the next dose. In that case, just wait until it is time to take it again. Stay as close to your regular dosing schedule and never double dose this medication.

If you Take Too Much Aleve (Overdoes) and Drug Interactions

Taking other medications, including other pain drugs or cold and allergy drugs, increases your risk of overdosing by accident. This is because many over-the-counter medicines also contain NSAIDs. So read the label on the box. If you take more than one medication, check the box or insert of each one of them to be sure that you are getting naproxen and any other NSAID only once.

If you think you may have overdosed, call 911 or your local poison control center.

When Not to Take Aleve

Having certain health problems means you might not be able to take Aleve, or you may need to consult with your doctor to get the dose adjusted.

If you have a history of heart problems, blood clots, high blood pressure, stroke, kidney problems, blood clots or stomach ulcers, you should know that the class of drugs into which Aleve is categorized, known as NSAIDs, has been found to increase the risk of cardiovascular related incidents. Ask your doctor if Aleve or naproxen is right for you, and at which dosage. If it is not a good choice given your condition, perhaps your doctor can suggest a suitable substitute for pain management. The longer you take Aleve, the greater will be your risk for cardiovascular events. In particular, Aleve may increase the risk of heart attack, stroke and high blood pressure, especially with long-term use.

Taking Aleve or any naproxen product just before or after a heart bypass operation is not recommended.

Aleve and other NSAIDs also increase the risk of ulcers (holes in the stomach), bleeding in the stomach and related GI problems. These known side effects can have very serious consequences, including death. They can occur at any time when taking Aleve, and may show up without previous warning. These and other risks for side effects are amplified in older adults who take Aleve. Again, the wisest thing to do if you already have stomach problems is to speak with your doctor before taking Aleve.

Related: Enteric Coated Medication

Don’t drink and take Aleve. Taking alcohol increases the risk for stomach bleeding.

Aleve and other naproxen medications cause the skin to be more sensitive to sunlight, so if you take it, stay away from the sun, tanning beds or sunlamps. This will help protect you from sunburn.

Other conditions that may increase your risk for the dangerous side effects of Aleve include liver or kidney disease, asthma, polyps in the nose, bleeding and clotting disorders and being a smoker. If you have any of these conditions, you may not be able to use Aleve, or you may need your dose adjusted. Speak with your physician or pharmacist to be sure.

Related: What are NSAIDs?

Aleve - Drug Interactions

When taking Aleve or medication with naproxen in it, it is very important to tell your doctor or pharmacist about any other medication, supplement or drug you take. This includes nutritional supplements, herbs, recreational drugs, coffee and alcohol. Because these substances can interact with the Aleve and alter the way it works, your health care provider may change your dosage or suggest a different drug for you to take.

Also, talk to your doctor if you plan to start or stop taking any of your medications.

The following is an incomplete list of drugs and other substances that may interact with Aleve. Consult with your doctor or pharmacist if your other medication(s) is on this list, or if you take other medication or drugs:

  • alcohol
  • alendronate, taken to prevent bone loss
  • other NSAIDs, including aspirin. If you use aspirin long term, your chances of stomach bleeding are increased.
  • other anti-inflammatory drugs (such as ibuprofen or prednisone)
  • entecavir, for hepitits-B infections
  • cidofovir, taken for eye infections in HIV patients
  • entecavir, for hepitits-B infections
  • cyclosporine, given to transplant patients
  • water pills (diuretics)
  • blood pressure medications, such as ACE inhibitors
  • blood thinners such as Coumadin, or other medications treat or prevent blood clots
  • methotrexate, chemotherapy drug
  • pemetrexed, a chemotherapy drug
  • herbal products that contain feverfew, garlic, ginger, or ginkgo biloba
  • lithium medication such as Eskolith Lithobid

Aleve - Side Effects

There are a number of possible side effects that may occur from taking Aleve. Some require immediate medical attention; others should be mentioned to your doctor if they persist.

Seek immediate medical attention if you have circulation or heart symptoms including chest pain, weakness, shortness of breath, slurred speech or vision or balance problems. If you have heart or other cardiovascular problems, fluid retention is another sign you need immediate medical attention.

The risk of stomach or intestine problems that may be caused by taking Aleve can be serious, and even fatal. Stomach and GI symptoms that require immediate medical attention include: bleeding in stomach or intestines, black, bloody or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

If you experience nausea, vomiting, loss of appetite, itching, yellowing of your skin or eyes, flu-like symptoms and dark urine, you may have liver damage. Stop taking the medicine and call your doctor immediately.

Allergy also may occur in some individuals, which would take the form of a rash, wheezing, and/or problems breathing or swallowing. Other symptoms that require immediate medical attention include changes in your vision, signs of infection, unexplained weight gain, or a feeling that the tablet is stuck in your throat.

If the following symptoms persist, you should talk to your doctor about them:

  • constipation, diarrhea or gas
  • sores in the mouth
  • you are very thirsty
  • headache
  • dizzy or lightheaded
  • drowsy
  • sleeping problems
  • burning or tingling in arms or legs
  • you feel like you have a cold
  • ringing in the ears or other hearing problems.

If you are pregnant or you plan to become pregnant, talk to your doctor before taking Aleve. Taken in the last trimester of pregnancy, it can cause birth defects. Naproxen can pass through breast milk to the nursing child and may do harm. It is not recommended to give Aleve to a child under the age of 2 except as directed by your doctor.

Storing Aleve

Safely store your Aleve by keeping it tightly closed in the container it came in, away from heat and moisture. This means not keeping it in the bathroom. Also, Aleve should be kept at room temperature. Discard it if it is outdated, or you don’t need it anymore. You can ask you pharmacist the best way to do that. Keep Aleve out of the reach of children.

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Wanders, A., Heijde, D., Landewe, R., Behier, JM, Callin, A., Olivieri, I., Zeidler, H., Dougados, M., Nonsteroidal anti-inflammatory drugs reduce radiographic progression in patients with ankylosing spondylitis: a randomized clinical trial. Arthritis Rheum. June 2005
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