My mother-in-law was recently hospitalized because her kidneys were not working. Turns out it was because of long-term use of naproxen. She is going to be fine now, but it made me wonder. I take naproxen every day and have for a long time. Anyone know anymore about this danger?
Renal Effects: Caution should be used when initiating treatment with naproxen in
patients with considerable dehydration. It is advisable to rehydrate patients first and then
start therapy with naproxen. Caution is also recommended in patients with pre-existing
kidney disease (see WARNINGS: Advanced Renal Disease).
As with other nonsteroidal anti-inflammatory drugs, long-term administration of
naproxen to animals has resulted in renal papillary necrosis and other abnormal renal
pathology. In humans, there have been reports of impaired renal function, renal failure,
acute interstitial nephritis, hematuria, proteinuria, renal papillary necrosis, and
occasionally nephrotic syndrome associated with naproxen-containing products and other
NSAIDs since they have been marketed.
A second form of renal toxicity has been seen in patients taking naproxen as well as other
nonsteroidal anti-inflammatory drugs. In patients with prerenal conditions leading to a
EC-NAPROSYN® (naproxen delayed-release tablets), NAPROSYN® (naproxen tablets),
ANAPROX®/ANAPROX® DS (naproxen sodium tablets), NAPROSYN® (naproxen
suspension)
reduction in renal blood flow or blood volume, where the renal 385 prostaglandins have a
supportive role in the maintenance of renal perfusion, caution should be observed since
administration of a nonsteroidal anti-inflammatory drug may cause a dose-dependent
reduction in prostaglandin formation and may precipitate overt renal decompensation or
failure. Patients at greatest risk of this reaction are those with impaired renal function,
hypovolemia, heart failure, liver dysfunction, salt depletion, those taking diuretics and
ACE inhibitors, and the elderly. Discontinuation of nonsteroidal anti-inflammatory
therapy is typically followed by recovery to the pretreatment state.
Naproxen and its metabolites are eliminated primarily by the kidneys; therefore, the drug
should be used with caution in such patients and the monitoring of serum creatinine
and/or creatinine clearance is advised. A reduction in daily dosage should be considered
to avoid the possibility of excessive accumulation of naproxen metabolites in these
patients. Naproxen-containing products are not recommended for use in patients with
moderate to severe and severe renal impairment (creatinine < 30 ml/min).
Chronic alcoholic liver disease and probably other diseases with decreased or abnormal
plasma proteins (albumin) reduce the total plasma concentration of naproxen, but the
plasma concentration of unbound naproxen is increased. Caution is advised when high
doses are required and some adjustment of dosage may be required in these patients. It is
prudent to use the lowest effective dose.
Studies indicate that although total plasma concentration of naproxen is unchanged, the
unbound plasma fraction of naproxen is increased in the elderly. Caution is advised when
high doses are required and some adjustment of dosage may be required in elderly
patients. As with other drugs used in the elderly, it is prudent to use the lowest effective
dose.
My rheumatologist runs hepatic and renal panels every 4 to 6 months even if all I'm taking is naproxen.