Drug interactions
Acetylsalicylic acid + Naproxen
Severity: Major
Acetylsalicylic acid and Naproxen: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Naproxen with aspirin increases the risk of gastrointestinal ulcers and bleeding. Naproxen can also interfere with the irreversible platelet inhibition of low-dose aspirin, reducing cardioprotection.
What this interaction means in plain words
Acetylsalicylic acid and Naproxen can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Acetylsalicylic acid belongs to Musculoskeletal; Naproxen belongs to Musculoskeletal.
Why it happens
Additive COX-1 inhibition impairs mucosal protection and platelet function, and naproxen competitively blocks aspirin's access to platelet COX-1.
What to do
Avoid combination when possible; if unavoidable, add a proton pump inhibitor, monitor for GI bleeding, and consider an alternative analgesic. Take aspirin at least 30 minutes before or 8 hours after naproxen.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Alteplase + Naproxen Major
- Amiloride + Naproxen Major
Frequently asked questions
Can I take Acetylsalicylic acid with Naproxen?
MediHelp rates the interaction as major. Acetylsalicylic acid and Naproxen can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Naproxen with aspirin increases the risk of gastrointestinal ulcers and bleeding. Naproxen can also interfere with the irreversible platelet inhibition of low-dose aspirin, reducing cardioprotection.
How serious is the interaction between Acetylsalicylic acid and Naproxen?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combination when possible; if unavoidable, add a proton pump inhibitor, monitor for GI bleeding, and consider an alternative analgesic. Take aspirin at least 30 minutes before or 8 hours after naproxen.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
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