Naproxen Safety: What You Need to Know About Risks, Side Effects, and Alternatives

When you reach for naproxen, a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain, swelling, and fever. Also known as Aleve, it's one of the most widely used over-the-counter pain relievers in the U.S. But just because it’s easy to buy doesn’t mean it’s safe for everyone. Thousands of people end up in the hospital each year from naproxen-related stomach bleeds, high blood pressure spikes, or kidney damage — often because they didn’t know the risks.

NSAIDs like naproxen, a type of nonsteroidal anti-inflammatory drug that reduces inflammation and pain work by blocking enzymes that cause swelling, but they also shut down protective chemicals in your stomach lining. That’s why long-term use raises your risk of ulcers, especially if you’re over 60, take blood thinners, or have a history of stomach problems. And it’s not just your gut. Studies show regular naproxen use can increase your chance of heart attack or stroke, even in people with no prior heart issues. If you’re taking it daily for arthritis or back pain, you’re playing a high-stakes game with your cardiovascular system.

Then there’s the kidney factor. Your kidneys rely on the same enzymes naproxen blocks to regulate blood flow. If you’re dehydrated, have high blood pressure, or already have kidney disease, naproxen can cause sudden kidney failure — sometimes without warning. People on diuretics or ACE inhibitors are especially vulnerable. And here’s the kicker: many don’t realize they’re taking it. Naproxen hides in combo meds for colds, migraines, and menstrual cramps. Check your labels. If you see "naproxen sodium" or "220 mg" on the bottle, you’re getting the same drug.

So what’s the alternative? For mild pain, acetaminophen (Tylenol) is often safer for your stomach and heart — but watch your liver. For chronic inflammation, physical therapy, weight loss, or even topical capsaicin can help without the systemic risks. Some people find relief with meloxicam, a longer-acting NSAID sometimes prescribed for arthritis, but it carries the same dangers. And if you’re on it long-term, your doctor should check your blood pressure, kidney function, and stool for hidden bleeding at least once a year.

There’s no perfect painkiller. But understanding naproxen’s real risks — not the ones on the box, but the ones in the medical literature — lets you make smarter choices. You don’t need to avoid it completely. You just need to know when it’s worth the trade-off, and when it’s not.

Below, you’ll find real-world guides on how naproxen stacks up against other pain meds, what side effects to watch for, how to reduce your risk, and when to switch to something safer — all based on actual patient experiences and clinical data.