Can I double up on pain killers?

How Naproxen 500 and Ibuprofen work (mode of action)?

• Naproxen 500 and Ibuprofen both are selective cyclo-oxygenase or COX inhibitors.
• Both the drugs act through inhibition of molecules or hormones involved in pain and inflammation.
• The hormones that are involved in pain and inflammation in the body are known as prostaglandins.
• Prostaglandins are produced rapidly at the site of injury or damage, which results in immediate pain and inflammation.
• Cyclooxygenases are enzymes that are involved in prostaglandin biosynthesis. In mammals, two cyclooxygenases, namely COX1 and COX2 are reported.
• COX-1 is involved in prostaglandin synthesis required for normal gastrointestinal and renal functions.
• Cyclooxygenase COX-2 is involved in the synthesis of prostaglandins involved in pain and inflammation.
• Inhibition of COX-1 and COX-2 by Naproxen 500 and Ibuprofen is supposed to be the main reason of anti-inflammatory activity by these drugs.
• Although, the antipyretic effect of Naproxen 500 and Ibuprofen is not due to inhibition of prostaglandin biosynthesis, it has been suggested that anti pyretic activity of both NSAIDs is possibly due to their direct effect on hypothalamus.

Can both Naproxen 500 and Ibuprofen be taken together in combination?

Before addressing the question regarding combinatorial use, it is necessary to understand some common facts about Naproxen 500 and Ibuprofen.

1. Naproxen 500 and Ibuprofen both belong to the same class NSAIDs and act in a similar manner at the same place (prostaglandin biosynthesis).
2. Taking both these drugs in combination is similar to double up the drug concentration or overdosing of the drug.
3. NSAIDs (Naproxen 500 and Ibuprofen) are well renowned due to their associated side effects. The most notorious side effects of this class of drugs are gastrointestinal upset, stomach pain, intestinal areas or stomach bleeding etc.
4. Overdosing sometimes can also lead to damage of the internal organs and various organ failure.
5. Thus, if you are taking Naproxen 500 in combination with Ibuprofen, the chances of gastrointestinal problems and serious side effects is relatively high.

Based on these observations, it is usually recommended not to take Naproxen 500 in combination with Ibuprofen. However, in case if a benefit justifies the risk, take advice of your healthcare professional before using a combination of Naproxen 500 with Ibuprofen. It is essential to adjust dose and timing to suppress the associated side effects.

Safety and precautions while taking Naproxen 500 and Ibuprofen

Naproxen 500 and Ibuprofen both belong to the class of NSAIDs drugs that are associated with severe side effects. It is therefore advisable to keep the following safety precautions in mind before taking these drugs either alone or in combination.

• It is advisable not to take Naproxen 500 or Ibuprofen alone or in combination if you have any allergy (allergic reaction) to NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs overdose may result in death in case of patients who are allergic to them.
• Naproxen 500 and Ibuprofen both, either alone or in combination can increase the risk of stroke or heart attack when used at higher doses or for long term, particularly if you have any heart disease.
• The use of these medications is strictly prohibited in case of patients who have a heart bypass surgery (coronary artery bypass graft, or CABG).
• Naproxen 500 and Ibuprofen both can cause minor stomach upsetting to fatal stomach or intestinal bleeding. Therefore, caution should be taken in taking these medications in combination or at higher dosage or for longer periods. The chances of severe side effects are more frequent in older adults.
• Stop these medication and find professional help if you have any shortness of breath, chest pain, slurred speech, weakness, or problems with vision or balance while taking these medications either alone or in combination.
• Avoid Naproxen 500 and Ibuprofen use or take the drugs only under professional supervision in the following medical conditions:
  • Heart disease or a history of stroke, heart attack, or blood clot.
  • High cholesterol and diabetes
  • History of stomach ulcers or bleeding;
  • Asthma
  • High blood pressure
  • Liver or kidney disease
• Naproxen 500 and Ibuprofen either alone or in combination can harm the unborn baby during the last 3 months of pregnancy.
• Naproxen 500 and Ibuprofen can also pass through breast milk to developing babies therefore, can harm the baby.
• Naproxen 500 and Ibuprofen both are not approved to child less than 2 year of age. Do not give these medications to your child without professional healthcare
• If you are taking Naproxen 500 and Ibuprofen either alone or combination for longer period (more than two week), it is necessary to be under professional advice.

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