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Naproxen Withdrawal (Aleve)
Old 12-14-2019, 08:27 AM   #1
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Naproxen Withdrawal (Aleve)

In the spirit of helping others, let me share my recent experience with Aleve. I’m a fit 62YO/M who exercises every day – pickleball, gym, yoga, biking, hiking – something to stay in motion (big believer in the book Younger Next Year). To enable this level of activity I became a habitual user of Aleve (Naproxen), mostly daily (1-2 tablets of 220 mg) for over two years (hey, it’s OTC, what could go wrong? /s).
A recent PB injury to my non-dominant shoulder led me to medical specialists, questions, and a reexamination of my supplements. Based upon this, I decided to stop cold turkey.
I’m glad that I stopped and I’m now more aware of the long term risks of NSAIDs. While I never had significant GI symptoms, the risk of internal bleeding is serious (a side effect that is blamed for more than 200,000 hospital visits every year). Even more worrisome for me is the association with cardiovascular events.
There are studies on both sides of the CV effect (pharma funds lots of studies). A good review of recent guidance: https://www.health.harvard.edu/blog/fda-strengthens-warning-that-nsaids-increase-heart-attack-and-stroke-risk-201507138138 Bottom line is that I should have known better, especially after the Vioxx scandal (great book - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2648690/
What really brought home the power of this drug was my surprise at the withdrawal symptoms. Lightheaded, dizziness, sweating and overall discomfort. I wondered if I was coming down with the flu, but while my blood pressure was lower than normal, my temperature was fine and no other symptoms presented. My PB game went to **** and I stayed very aware of the fact that CV events are much more likely (>50% in the first month from the below study) after stopping long term naproxen use : https://consumer.healthday.com/bone-and-joint-information-4/rheumatoid-arthritis-news-43/heart-risk-spikes-after-stopping-painkillers-522865.html
Fischer's team found that, compared with those who did not take NSAIDs, those who stopped taking the drugs had an almost 50 percent higher risk of having a heart attack in the first month after ending NSAID therapy.
The greatest risk was among patients who had been taking NSAIDs for rheumatoid arthritis or lupus. For these patients, the risk of having a heart attack was about three times higher. For others who used NSAIDs for long-term therapy, the risk was about two times higher.
So, I hope my learning and experience might help others. We are all unique, but we must make good decisions (and be lucky) to maintain our health.
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Old 12-14-2019, 08:43 AM   #2
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I'll take an NSAID when I hurt too much to sleep, but would never take one so I can do more sports or harder workouts.

Well before I became aware of the CV side effects, I was suspicious of long-term NSAID use, because it can disguise pain which your body is serving up as a warning of "Stop wearing out my components, or you'll be really sorry."
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Old 12-14-2019, 08:44 AM   #3
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Wow! Thanks for sharing!

Fortunately I very rarely take an Advil. But this is really important to know, and I may switch to acetaminophen instead.

Relative became severely anemic and it was probably the NSAIDs.
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Old 12-14-2019, 08:51 AM   #4
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Great information. I cannot take NSAID's. They're very bad for the kidneys. I stopped taking them a few years back. Over the counter pain meds have just as many side effects as prescription drugs. So many people think they're safe because they're over the counter available.
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Old 12-14-2019, 08:58 AM   #5
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Because of bad sciatica I have to take Aleve for weeks at a time but I stop as soon as I can. I am surprised though that you had withdraws.

I am curious, How many were you taking?
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Old 12-14-2019, 09:08 AM   #6
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I had 3 surgeries over 14 months and I took NSAIDS every day I wasn't taking an opiod for about 1.5 years straight. I have now cut way back. I didn't have any withdrawal symptoms and my blood work showed no signs of problems. If I had to choose between reducing chronic pain while also slightly increasing the chance of a CV event OR living with worse chronic pain every day I would take the chance and reduce the pain. YMMV
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Old 12-14-2019, 09:08 AM   #7
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Good article, thanks for sharing. Here in England naproxen is not available over the counter but ibuprofen is. The article does not differentiate between the two so I don’t know why naproxen is prescription only and ibuprofen is available OTC.

For occasional back and knee pain I have started using good old aspirin so it was good to read the following in that article:

Quote:
Aspirin is also an NSAID, but it does not pose a risk of heart attack or stroke. In fact, aspirin is commonly used to prevent heart attacks and strokes. So, it is not covered by this warning.
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Old 12-14-2019, 09:11 AM   #8
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Aspirin has some bleeding risk associated with it.
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Old 12-14-2019, 09:33 AM   #9
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Originally Posted by audreyh1 View Post
Aspirin has some bleeding risk associated with it.
So do all NSAIDs, which is why it is important to always take NSAIDs with food and a glass of water.

The bleeding risk is why even baby aspirin taken for long periods is not advised by the physician guidelines here.

https://cks.nice.org.uk/antiplatelet-treatment
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Old 12-14-2019, 09:56 AM   #10
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I think acetaminophen is the only one recommended in the case where someone might be at higher risk for bleeding such as low platelets or whatever.
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Old 12-14-2019, 10:04 AM   #11
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Thank you very much for this timely post. I have been wondering about over-the-counter painkillers lately and I even asked my doctor last week about them as I'm experiencing more exercise-induced pain as I'm getting older. He said as my liver numbers are good, Tylenol is the safest choice for me as long as I don't go over the recommended dosage. (YMMV) I only take one or two tablets when I do take it, and I consider that necessary evil. I wasn't sure about NSAIDs as I bruise easily when I take them and my doc agreed that they are more problematic, but I didn't know how bad until I read the article you posted. I will try to stay away from them even more than before.
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Old 12-14-2019, 10:08 AM   #12
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Most of my friends take Aleve every time they play Pickleball.
I have always hated pills and will not take any pill unless I have a fever, or it is prescribed non OTC.
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Old 12-14-2019, 10:10 AM   #13
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I recently had back surgery (double fusion L4,5 & S1) two months ago and my back Dr. said NO NSAIDs whatsoever, it is thought to be detrimental to bone growth and healing. Tylenol is ok but nothing like Aleve or anything along those lines. Just FWIW.
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Old 12-14-2019, 10:26 AM   #14
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With my low iron episode (see the "Iron is new cholesterol" thread), I am off NSAIDs except for very occasional use, like about one or two pills per month, when I overdo it with exercise.

I try to limit Tylenol (APAP/acetaminophen/paracetamol) too, but take one occasionally in lieu of an NSAID. I don't touch it if I had any alcohol or will have some.

Thanks for sharing, OP. The withdrawal is interesting. I think I had some mild withdrawal from dropping the baby aspirin per day, but nothing like yours. I just seemed to feel achy for a week.
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Old 12-14-2019, 10:56 AM   #15
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I take (1) naproxen/aleve 220mg or acetaminophen/tylenol 500mg almost daily for arthritis, but alternate a few weeks at a time . I try to take a break of a week or two about every few months.
Labs show no problems with liver or kidneys and I have never had any withdrawal symptoms or GI problems.
But I am an aware consumer, and choose pain relief over small risk of daily low dose.
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Old 12-14-2019, 02:19 PM   #16
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I love Advil/Ibuprofen. Gets ride of the pain especially headaches. However, I know that it can have serious side effects if taken continuously so I save it for major pain or a headache that just won't go away.

Tylenol? Why bother. Doesn't do a thing for me and is hard on the liver. Had a small surgery recently and they offered me Tylenol beforehand and I turned it down.
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Old 12-14-2019, 02:41 PM   #17
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Good article, thanks for sharing. Here in England naproxen is not available over the counter but ibuprofen is. The article does not differentiate between the two so I don’t know why naproxen is prescription only and ibuprofen is available OTC.

For occasional back and knee pain I have started using good old aspirin so it was good to read the following in that article:
Here in Ireland Naproxen is not available either OTC. However there's Nurofen Plus, which is ibuprofen+codeine! They work really well together You can get it from the pharmacy and they give you a little lecture about not taking it for more than three days etc.
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Old 12-14-2019, 02:46 PM   #18
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Originally Posted by frayne View Post
I recently had back surgery (double fusion L4,5 & S1) two months ago and my back Dr. said NO NSAIDs whatsoever, it is thought to be detrimental to bone growth and healing. Tylenol is ok but nothing like Aleve or anything along those lines. Just FWIW.

NSAIDs do slow the healing process but I will be honest. For post surgical or sciatica pain I have not choice but to take both. I do not know what I would do if the doctor told me no NSAIDs for my back pain. The only choice is opioids or extreme misery.
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Old 12-14-2019, 02:59 PM   #19
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Know your drugs

1. I take naproxen sporadically. Sometimes after walking a lot on vacation. Sometimes if I have bad leg cramp at night. I also take aspirin sporadically. I always have weird, vivid dreams when I take naproxen.
2. I never take ibuprofen, acetaminophen as alcohol is dangerous with them.

P.S. Aspirin, regular ordinary aspirin, requires a pharmacist to dispense/sell it in España.
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Old 12-14-2019, 03:34 PM   #20
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Originally Posted by bmcgonig View Post
Here in Ireland Naproxen is not available either OTC. However there's Nurofen Plus, which is ibuprofen+codeine! They work really well together You can get it from the pharmacy and they give you a little lecture about not taking it for more than three days etc.
Yes, Nurofen Plus is available OTC here as well, behind the desk at pharmacies.

Even Miralax (Movicol here) is behind the counter so you have to get the little lecture each time you buy it.
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