Migraine is a neurovascular condition that affects 29.5 million Americans. Migraine attacks can be severe and debilitating, lasting from 4 to 72 hours. They’re characterized by intense pain, often centered on one side of the head.

Naproxen, also sold under the brand name Aleve, is a nonsteroidal anti-inflammatory drug (NSAID) that’s sometimes used to treat these symptoms. It’s also used to prevent chronic migraine, alongside other medications, such as:

  • Antidepressants
  • Anticonvulsants
  • Beta-blockers

Naproxen has black box warnings, which are serious warnings from the Food and Drug Administration (FDA). They let doctors and patients know about effects that may be dangerous. These include:

  • Serious cardiovascular thrombotic events. Naproxen may increase the risk of heart disease, which can be fatal. Using naproxen in the long term or at high doses increases your risk. People with heart disease or risk factors for heart disease, such as high blood pressure, also have higher risk. Naproxen shouldn’t be used for pain before or after heart bypass surgery. Doing so may increase your risk of a heart attack and stroke.
  • Serious gastrointestinal bleeding, ulceration, and perforation. Naproxen may cause ulcers and bleeding in your stomach and intestines. This can happen at any time during treatment and may occur without symptoms. This effect can result in death. You’re at higher risk if you’re older than 65 years, or if you have a history of ulcers or stomach bleeding.

Side effects of naproxen

While naproxen can help relieve migraine attacks, it can also cause certain side effects. These may include:

  • Confusion
  • Headaches
  • Ringing in the ears
  • Changes in vision
  • Tiredness and feeling sleepy
  • Dizziness

The risk of side effects may increase with use over time. If you do experience side effects, talk with your doctor or pharmacist. They can help determine if naproxen is the right medication for you. They may also be able to help you figure out an alternative medication if needed.

Who shouldn’t take naproxen?

Some people may have a higher risk of developing negative side effects from naproxen. These include people who: 

  • Have high blood pressure
  • Have chronic kidney disease
  • Are pregnant
  • Have a decreased blood volume
  • Have alcohol use disorder
  • Smoke cigarettes
  • Are allergic to NSAIDs and salicylates (chemicals derived from salicylic acids)

Taking naproxen with these medications may increase the risk of complications. It may also alter the effects of the other medications.

Recommended dosage

If your doctor prescribes naproxen, they’ll let you know how much you should take and how often you should take it. 

If you’re taking over-the-counter naproxen sold as Aleve, the manufacturer recommends taking 1 tablet every 8 to 12 hours. You shouldn’t take more than 2 tablets every 12 hours or 3 every 24 hours if you’re over the age of 18. 

Naproxen will come with a medication guide that you should follow carefully. If any instructions are unclear, ask your doctor or pharmacist.

Naproxen and sumatriptan 

To treat acute migraine attacks (with or without aura), your doctor may prescribe Treximet. Treximet contains sumatriptan and naproxen sodium. Refer to the product package insert or your healthcare provider for further information.

Potential side effects of Treximet include:

  • Dizziness
  • Drowsiness
  • Paresthesia (prickling or burning sensation typically felt in the hands, feet, arms, or legs)
  • Irregular heartbeat
  • Pain, discomfort, or stiffness in your neck, jaw, throat, or chest
  • Nausea
  • Muscle tightness

Treximet may also cause more serious side effects, including:

  • Increased blood pressure
  • Fluid retention that could lead to heart failure
  • Kidney problems
  •  Anemia
  • Liver problems
  • Stomach and intestinal problems 

Stop taking Treximet and call your doctor immediately if you experience:

  • Nausea that seems out of proportion to your migraine attack
  • Sudden or severe stomach pain
  • Vomiting blood
  • Blood in your bowel movement
  • Tenderness in your upper right side
  • Yellowing of your eyes or skin
  •  Unusual weight gain

When to talk with your doctor about migraine 

Sometimes, head pain is a warning of a more serious problem. Get medical help if you experience severe head pain combined with any of the following symptoms:

  • Fever, vomiting, or nausea
  • Shortness of breath
  • Stiff neck
  • Pain around the eye or ear
  • Double vision
  • Confusion
  • Convulsions

 

Here are other symptoms that should warrant a call to your doctor:

  • You have a headache following a head injury.
  • You experience a sudden, severe headache.
  • You can describe a headache as “the worst of your life.”
  • You used to be headache-free, but now have headaches a lot.
  • Your headaches disrupt your home, work, or school life.
  • You experience several headaches every month, each lasting for several hours or days.

Takeaway

Naproxen can be used to treat migraine symptoms. It may cause side effects. Talk to your doctor before taking naproxen, or if your migraine attack is paired with other troubling symptoms.