Taking Aleve to Manage Pain and Inflammation

Take one Aleve every 8 to 12 hours or two Aleve for your first dose

Aleve (naproxen) is an over-the-counter (OTC) non-steroidal anti-inflammatory drug (NSAID) that comes in tablet, caplet, or gel cap forms. The recommended dose is one pill every eight to 12 hours while symptoms last.

Taking one Aleve every eight to 12 hours should relieve symptoms such as:

  • Headaches
  • Back pain
  • Fever
  • Arthritis pain and stiffness

For your first dose, you can take two pills within the first hour, but never take more than two pills within any 8- to 12-hour period, You should also not take more than three pills within 24 hours.

This article explains how to take Aleve safely for pain and inflammation, including possible side effects, interactions, and contraindications.

aleve serious side effects
Illustration by Emily Roberts, Verywell

What Is Aleve (Naproxen)?

Aleve is the brand name for naproxen. Naproxen is also available as a generic.

Naproxen is an NSAID that blocks two enzymes called COX-1 and COX-2 that the body uses to make prostaglandins. Prostaglandins are compounds that serve many purposes in the human body. including blood clotting and the induction of labor. But they are also responsible for regulating inflammation.

By temporarily blocking the production of prostaglandin, Aleve can reduce inflammation and, with it, symptoms of swelling, redness, pain, and fever.

What Conditions Does Aleve Help With?

Aleve is used to treat a variety of inflammatory conditions, including symptoms of acute (sudden, severe) or chronic (persistent) inflammation.

Among the conditions that Aleve can help treat are:

When taken by mouth, Aleve usually starts to relieve symptoms within an hour and reaches its peak concentration in the bloodstream within one to two hours.

How to Take Aleve

Aleve is intended for the short-term relief of pain and inflammation. Each pill contains 200 milligrams (mg) naproxen and 20 mg sodium. Taking naproxen in occasional doses or short two- to three-day courses is generally considered safe.

Aleve is taken by mouth with or without food. However, you should take it with a full glass of water to reduce the risk of gastrointestinal side effects.

For adults and children 12 and over:

  • Take one Aleve pill every 8 to 12 hours.
  • For the first dose, you can take two pills within the first hour.
  • Do not exceed two pills in any 8- to 12-hour period.
  • Do not exceed three pills in any 24-hour period. 

Do not use Aleve in children under 12 without first speaking with your child's pediatrician.

Missed Dose

If you miss a dose, you can skip the dose or take it as soon as you remember. Then, wait for 12 hours before taking your next dose. Stay as close to your regular dosing schedule as possible.

How to Store Aleve

Store Aleve in its original, light-resistant container. It should be kept at room temperature and well away from heat and moisture. Discard any expired drug. Keep out of reach of children and pets.

Side Effects and Warnings

Aleve is generally regarded as safe if taken as directed. As with all medications, Aleve can cause side effects, most of which are relatively mild and short-lived.

Possible side effects of Aleve include:

  • Heartburn
  • Stomach pain
  • Nausea
  • Constipation
  • Diarrhea
  • Gas
  • Headache
  • Dizziness
  • Drowsiness
  • Difficulty sleeping
  • Bruising
  • Itching
  • Tinnitus (ringing in the ears)

Other more potentially serious side effects can occur. In rare cases, the misuse of Aleve can even cause heart and liver complications.

Allergic Reaction

The risk of an allergic reaction to Aleve is low. Even so, allergies have been known to occur and typically cause symptoms within 30 minutes to four hours of a dose. Some reactions take up to 24 hours before symptoms develop.

All allergic reactions to drugs should be taken seriously as they may be early signs of a potentially life-threatening, whole-body reaction known as anaphylaxis.

Call 911 or seek emergency care if you experience the following signs of anaphylaxis, including:

  • Sudden hives or rash
  • Shortness of breath
  • Wheezing
  • Irregular heartbeat
  • Sudden severe diarrhea
  • Dizziness or lightheaded
  • Swelling of the face, mouth, or throat

If left untreated, anaphylaxis can lead to shock, respiratory failure, cardiac arrest, and death.

Stomach Bleeding

Aleve works by blocking the production of prostaglandins. While this helps ease inflammation, it also affects one of prostaglandin's major functions: blood clotting.

If Aleve is overused or taken at exceptionally high doses, it can cause stomach bleeding and the formation of potentially severe peptic ulcers.

Seek immediate medical care if you have signs and symptoms of a drug-induced peptic ulcer, including:

  • Severe upper abdominal pain
  • Feeling full too soon when eating
  • Nausea or vomiting
  • Bloating
  • Heartburn
  • Belching
  • Dark or tarry stools

Seek emergency care if you are vomiting blood or have dark, coffee-ground-like vomit.

Cardiovascular Risks

There is evidence that the prolonged use of Aleve and other NSAIDs can increase the risk of certain cardiovascular events, often within a few weeks of daily use. The risk is greatest among those with underlying heart diseases.

Because of this, the U.S. Food and Drug Administration (FDA) requires manufacturers to include warnings about the cardiovascular health risks of NSAIDs on packaging and labels.

The risks include:

Seek emergency care if you develop sharp chest pain or tightness, trouble walking or seeing, lightheadedness or fainting, or radiating pain in the shoulder, arm, back, neck, or jaw.

Liver Damage

While uncommon, Aleve and other NSAIDs can cause hepatotoxicity (liver poisoning), leading to drug-induced liver injury. The risk is higher in people with pre-existing liver disease and/or those with alcohol use disorder (formerly known as alcoholism).

Symptoms of drug-induced liver injury include:

  • Severe fatigue
  • Jaundice (yellowing of skin and eyes)
  • Dark urine
  • Clay-colored stool
  • Itching

The immediate discontinuation of the NSAID is required to prevent irreversible liver damage.

Who Should Not Take Aleve?

Aleve is not a good option for everyone. People with certain risk factors or existing health conditions should consider other medications to avoid potentially serious complications.

You should not take Aleve if you have:

  • A history of allergy to naproxen or other NSAIDs
  • Peptic ulcer disease
  • Liver failure
  • Kidney failure
  • Severe heart disease
  • Controlled high blood pressure
  • Blood-clotting disorders, like hemophilia
  • Inflammatory bowel disease (IBD)

Pregnant or Breastfeeding

If you are pregnant or trying to conceive, speak to your healthcare provider before taking Aleve. Some studies suggest that naproxen can cause kidney problems in the unborn child if the drug is taken during the third trimester.

It is unknown if naproxen can be passed in breast milk. To be safe, avoid taking Aleve if you are nursing or pumping breast milk for your baby.

Children

Aleve is not for children under 12 unless directed by their pediatrician. It is important to speak with a healthcare provider as the dose needs to be adjusted based on the child's weight.

There are no liquid formulations of Aleve available for children. You might be better served to use alternatives like Children's Tylenol (acetaminophen) or Children's Advil (ibuprofen) for younger children.

Older Adults

Aleve should be used with caution in adults over 65 who may be more sensitive to the effects of the drug than younger adults and are more likely to have age-related kidney, heart, or stomach problems.

Drug Interactions

Many OTC medications contain NSAIDs, including cold & flu remedies. For this reason, it is crucial to read all medication labels to avoid double-dosing.

Some medications and supplements can interact with naproxen and change how it works. Speak with your pharmacist or healthcare provider about all medications and supplements you take before starting Aleve.

Medications that can interact with naproxen include:

Overdose

It is possible to overdose on Aleve, and the risk varies by your age, weight, and body size. To avoid this, never take more than the recommended dose on the product label.

Possible symptoms of a naproxen overdose include:

  • Agitation
  • Confusion
  • Incoherence
  • Blurred vision
  • Seizures
  • Vomiting blood
  • Shock
  • Coma

If you or someone you know has overdosed on Aleve, call Poison Control at 1-800-222-1222. Do not induce vomiting unless the helpline advises you to do so.

Summary

Aleve is an over-the-counter NSAID used to treat pain and inflammation that contains 220 milligrams of naproxen sodium. You can start by taking two Aleves for your first dose. Thereafter, take one every eight to 12 hours.

Never take more than two Aleves every eight to 12 hours, or three every 24 hours.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.