There are some medicines that can affect the way naproxen works. Tell your doctor if you're taking: Do not take naproxen with ibuprofen or other non-steroidal
anti-inflammatory drugs (NSAIDs). But it's OK to take naproxen with paracetamol or co-codamol that you buy over the counter. This should just be for short periods of time. If you often need to take extra painkillers with naproxen or for
more than a few days, talk to your doctor. Sometimes, taking different painkillers together is a good way to relieve pain, but there may be other treatments you can try. It's OK to take other painkillers with naproxen for longer if your doctor has given them to you on prescription and told you to take them together. If you're unsure, talk to your doctor. There's not enough information to say that complementary medicines and herbal remedies are safe to take with naproxen. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines. Tell your doctor or pharmacist if you're taking any other medicines,
including herbal remedies, vitamins or supplements. Page last reviewed: 20 January 2022
 The first line of treatment for many knee and hip problems includes taking over-the-counter pain medications. Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are the most common pain medication options. However, these pain medications have a variety of side effects, so it's important to discuss your personal health risks with your doctor when considering long-term use for chronic conditions such as osteoarthritis. Acetaminophen (Tylenol and other brands) is usually effective for mild pain and is easy on the stomach. However, it is toxic to the liver at high doses. The recommended maximum per day is generally set at 4 grams (4,000 milligrams), which is the equivalent of eight extra-strength Tylenol tablets. But that dosage can still cause liver problems for some people. To be safe, aim for 3,000 milligrams or less, and be cautious of mixing multiple products containing acetaminophen, such as a pain reliever and a cold medication or a prescribed narcotic. The FDA now recommends using products containing no more than 325 milligrams per pill or capsule (the equivalent of regular-strength Tylenol rather than extra-strength) in order to avoid excessive dosages. Don't take acetaminophen if you drink more than a moderate amount of alcohol on a regular basis or if you have liver disease. NSAIDs such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Anaprox) may be more effective than acetaminophen for certain conditions because they reduce inflammation as well as relieve pain. But NSAID medications have side effects, the most common is stomach irritation. It can also cause stomach and intestinal ulcers, which can lead to internal bleeding. You can ask your
doctor about taking a stomach acid inhibitor to reduce these risks. NSAIDs also carry an increased risk of heart attack, stroke, and kidney failure when taken at high doses or for long periods of time. Image: Finstock/Getty Images As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. If you already have a headache and navigate your way to the pain relief shelf at your pharmacy the headache is likely to get worse. That's because there are a bazillion names on the bottles. Very complicated. But this is only because the manufacturers of analgesics want it that way. In reality, it is very simple. There are only four drugs to choose from despite all the different names (1). So people are perpetually confused about what painkiller they're looking at. And many are also unaware that some of these drugs can be combined while others cannot. First, let's look at the four drugs that are available OTC in the US and some alternate names they are known by. The first three all belong to a class of drugs called NSAIDs (non-steroidal anti-inflammatory drugs). Tylenol does not. It works (but not very well - See Tylenol Isn't So Safe, But At Least It Works, Right?) by blocking pain signals to the brain. OTC PAIN RELIEVERS 1. Aspirin:
2. Ibuprofen:
3. Naproxen:
4. Acetaminophen:
So, why does the OTC pain relief counter at CVS look like this? Analgesic hell. Photo: Wikimedia It's because drug companies have combined the analgesics with other drugs, for example, antihistamines, to help with sleep or allergies, something that I think is pretty scummy and have written about in the past (See Combining Pain, Cold, Cough, And Sleep Meds - Great For Drug Companies, But Unethical) WHICH DRUGS CAN BE COMBINED SAFELY? So, despite all the noise, it's very simple. There are four OTC pain medications. It is safe, even helpful, to take some of them together, but not others. A new article in Medical News Today helps sort this out. Although the article speaks only about Aleve and Tylenol it also applies to Tylenol plus the other NSAIDs - aspirin, and ibuprofen. NSAIDs are generally safe to take with Tylenol, and the two together work better than either one alone. There are three ways to do this:
WHICH DRUGS CANNOT BE COMBINED SAFELY? This is also simple. Aspirin, Advil, and Aleve are all NSAIDs and control pain and inflammation by a common mechanism. But they also produce side effects, most commonly heartburn, gastric bleeding, and ulcers by a common mechanism. So taking Advil plus Aleve is going to mess up your stomach or cause bleeding about the same as taking double the dose or either drug. For this reason, it is not safe to combine NSAIDs (2). American Council friend Dr. Aric Hausknecht, a neurologist and pain management physician explains:
WHAT ABOUT TOPICAL NSAIDs? A number of creams and patches are applied directly to the skin (3) at the affected area. Since they do not go through the stomach or result in high blood levels they are safer than using two different NSAID pills. Dr. Hausknecht says:
Feel better. NOTES: (1) There used to be five. Ketoprofen (Orudis) was sold OTC but is now by prescription only. (2) Kidney damage is also a side effect of NSAIDS. Heart attacks are also linked to NSAID use, but less so for the OTC NSAIDs. (3) Voltaren (diclofenac) is commonly used in a patch. How soon after taking naproxen can I take Tylenol?If you need additional pain relief, you can combine aspirin, naproxen, or ibuprofen with acetaminophen. However, do not take aspirin, naproxen, or ibuprofen within 8-12 hours of each other. Also, watch out for pain medications that might be included in combination products such as those used for cough and cold.
What pain reliever can you take with naproxen?Do not take naproxen with ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs). But it's OK to take naproxen with paracetamol or co-codamol that you buy over the counter.
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What happens if you take naproxen and tylenol together
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