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Can you take Naproxen with Codeine?

2nd April 2019

Naproxen is a drug that is used for the relief of pain from various conditions such as a headache, tendonitis, dental pain, muscle aches, and menstrual cramps. It is also used to reduce swelling, pain, and joint stiffness caused by arthritis, gout attacks, and bursitis. Naproxen is known as a nonsteroidal anti-inflammatory drug or NSAID. It works by blocking the body’s production of certain natural substances that cause inflammation.

Codeine, on the other hand, is a prescription pain medication for the treatment of mild to moderate pain. It comes in tablet form and is the main ingredient in prescription-grade cough suppressants. Codeine is an opiate, also known as a narcotic. It belongs to the same category of other opiates such as oxycodone, heroin, and morphine. A small amount of codeine is converted to morphine in the body. The actual action of codeine is not known, but like morphine, codeine binds to the opioid receptors in the brain that are necessary for transmitting the pain sensation through the body and brain. Codeine increases the body’s tolerance for pain, decreases discomfort, but the underlying reasons behind the pain are still present. In addition to the reduction of pain, codeine also causes drowsiness, sedation, and depresses breathing. Codeine is usually combined with acetaminophen or aspirin for more effective pain relief.

Taking Naproxen with other painkillers

It is alright to take Naproxen with other painkillers such as paracetamol, Codeine, co-codamol, morphine, tramadol, and more.

However, it is not recommended that a person takes a painkilling dose of aspirin and other related NSAIDs like ibuprofen and diclofenac with Naproxen because of the higher risk of side effects on the stomach and the intestines. For the same reasons, people who are taking selective inhibitors of COX-2 such as etoricoxib or celecoxib should not be administered with Naproxen.

People should remember that many cold and flu products and over-the-counter painkillers contain aspirin or ibuprofen and, therefore, should be avoided while taking Naproxen. It is important that people check the ingredients of other medicines before taking them with Naproxen. If you're ever not sure, it is best to ask your doctor or pharmacist for advice.

It is also important to check first with your doctor or pharmacist before you start using an anti-inflammatory gel such as ibuprofen, ketoprofen, or piroxicam together with Naproxen taken by mouth. Such a combination is not safe for everyone.

Combining Naproxen with other medicines

If you are taking other medicines, including non-prescription medications and herbal products, it is important that you check first with your doctor before you start taking Naproxen for pain-relief.

You will have a higher risk of bleeding or ulceration in your intestines if you take Naproxen in combination with steroids such as prednisolone. There is also the great likelihood that you will have an increased risk of bleeding in the intestines if you take Naproxen with other medicines that can increase the risk of bleeding such as the following:

  • Anticoagulant medicines such as warfarin, apixaban, dabigatran, edoxaban, heparin, and rivaroxaban and other low-molecular-weight heparins such as enoxaparin.
  • Antiplatelet medicines to thin the blood such as clopidogrel, dipyridamole, prasugrel, and low-dose aspirin.
  • Ginko biloba, a herbal remedy
  • Erlotinib
  • Iloprost
  • SSRI antidepressants such as paroxetine, fluoxetine, citalopram
  • Venlafaxine

People who are taking alendronic acid should avoid taking Naproxen unless recommended by a doctor because it may increase the irritation to the food pipe, stomach, or guts.

There is a likelihood of increased side effects on the kidneys if you take Naproxen together with the following medicines:

  • ACE inhibitors such as captopril or enalapril
  • Ciclosporin
  • Diuretics such as furosemide
  • Tacrolimus

Naproxen is known to reduce the removal of the following medicines from the human body thus increasing the risk of their side effects:

  • Lithium
  • Digoxin
  • Methotrexate

Naproxen may counteract the blood pressure lowering effects of certain high blood pressure medicines, such as the following:

  • Calcium-channel blocker such as amlodipine
  • ACE inhibitors such as captopril
  • Beta-blockers such as atenolol

Taking Naproxen together with quinolone antibiotics such as ciprofloxacin or norfloxacin may increase the risk of seizures in people with epilepsy.

Taking the medicine probenecid may reduce the body’s removal of naproxen. If you are taking this medicine combination, tell your doctor if you notice that you are getting a lot of side effects from Naproxen. Your doctor may lower your dose.

Interactions between Naproxen and Codeine

Naproxen is not known to interact with Codeine. This does not mean, however, that no interactions exist. It is important to consult your doctor before you start taking Codeine when you are already taking Naproxen.

Based on clinical studies, the combination of Naproxen and Codeine has improved the pain-killing effects of the medicines as compared when taken alone.

Combining Naproxen with Codeine should be done only with the express approval of your doctor who knows your medical history in order to prevent any adverse effects the combined medication could cause your existing medical conditions.