Doctor Answers: What Foods to Avoid When Taking Naproxen?

Almost everyone will reach for an over-the-counter pain medication at some point, whether to treat a muscle ache, headache, or another painful condition. Naproxen is an anti-inflammatory medication (common brand names include Aleve, Anaprox DS, and Mediproxen) known as a non-steroidal anti-inflammatory drug (NSAID). Naproxen comes in various forms (liquid gels, tablets, oral suspension, delayed or rapid release), and the maximum recommended daily dose is around 1,500 milligrams.

If you take naproxen for aches, pains, or even chronic health conditions, you might wonder if there are naproxen foods to avoid. We spoke with Dr. Letsa, a board-certified physician, to better understand which foods support the effects of naproxen and which can potentially interfere. Dr. Letsa also shared practical dietary tips that can help reduce inflammation and promote gut and kidney health during treatment.

Q: What foods should be avoided when taking naproxen (Aleve)?

Dr. Letsa answers: There aren’t any foods that directly interact with naproxen. However, if you’re taking it for an inflammatory condition like arthritis, eating an anti-inflammatory diet and limiting pro-inflammatory foods can help manage the underlying issue and improve overall outcomes. Research, however, shows that taking NSAIDs with food may make them less effective. These foods should generally be limited or avoided:

1) Alcohol

Taking NSAIDs like naproxen can irritate the lining of your stomach and lead to stomach ulcers and bleeding. Alcohol has the same effect. They increase the risk of stomach lining irritation, ulcers, and bleeding.

All forms of alcohol should be avoided, especially if you’re taking naproxen long-term. That includes:

• Beer
• Wine
• Hard liquor
• Alcoholic seltzers/wine coolers
• Sauces or dishes prepared with alcohol (even if cooked)

2) Sugary Beverages

High-sugar diets are linked to inflammation, which is counterproductive when reducing inflammation with naproxen. Research shows that sugary drinks are among Western diets’ most significant sources of added sugar.

Avoid or limit:

• Energy drinks
• Flavored coffees and teas
• Flavored milk or kefir
• Fruit punches
• Sweetened smoothies
• Sodas

3) Foods High in Sugar

Added sugar is also found in processed foods, not just drinks. Eating these foods frequently can exacerbate inflammation.

Common high-sugar foods include:

• Cakes
• Cookies
• Sweet rolls, doughnuts, and pastries
• Ice cream and sweetened yogurts
• Condiments and salad dressings with added sugars
• Sweetened breakfast cereals
• Processed soups and sauces

The U.S. Dietary Guidelines recommend no more than 50 grams of added sugar per day on a 2,000-calorie diet, but aiming for 25 grams or less is ideal when managing inflammation.

4) Gluten (for some people)

If you’re taking naproxen for arthritis or other chronic inflammatory conditions, you might notice symptom relief by cutting gluten, even if you don’t have Celiac disease. This is an individual response, and not everyone benefits.

Gluten is found in:

• Wheat
• Rye
• Barley
• Products made with these grains (bread, pasta, pizza dough, pastries)
• Malt and brewer’s yeast

You may experiment with gluten-free alternatives if symptoms worsen after eating gluten-containing foods.

5) Red & Processed Meats

A study shows that red and processed meats are associated with increased inflammation. You don’t have to cut them out entirely; try to eat them less often.

Processed meats to limit include:

• Bacon
• Sausage
• Hot dogs
• Deli meat
• Salami

Opt for leaner proteins like chicken, turkey, or fish instead.

6) High-Salt Foods

NSAIDs like naproxen can be hard on the kidneys and may lead to fluid retention. A high-sodium diet increases that risk.

40% of sodium intake in a typical Western diet comes from:

• Bread and rolls
• Pizza
• Sandwiches
• Cured meats and cold cuts
• Soups
• Tacos and burritos
• Snack foods (chips, pretzels, jerky)
• Chicken (pre-seasoned or processed)
• Cheese
• Eggs and omelets

Try to stay under 2,300 mg of sodium daily. Read food labels and avoid products with more than 20% of the Daily Value for sodium per serving.

Q: What foods can I eat while taking naproxen?

Dr. Letsa answers: Following an anti-inflammatory diet may reduce the need for higher NSAID doses and help relieve chronic pain. Here are recommended food choices:

1) Fish

Fish are renowned for being a rich source of omega-3 fatty acids, which have well-documented anti-inflammatory properties beneficial for heart health, brain function, and overall well-being. Among the finest choices for omega-3 intake are:

• Salmon: Known for its rich, buttery flavor, salmon is not only delicious but also packed with high levels of EPA and DHA, types of omega-3s that are crucial for cardiovascular health. Including wild-caught varieties can provide even more nutrients.
• Sardines: These small fish are often overlooked, yet they are a powerhouse of omega-3s, vitamin D, and calcium. Sardines are typically available canned, making them a convenient option for a quick meal while still being nutrient-dense.
• Mackerel: This oily fish is highly prized for its intense flavor and high omega-3 content, making it an excellent option for those looking to boost their intake. Mackerel is also a good source of vitamin B12 and selenium, adding to its health benefits.
• Anchovies: These tiny fish are rich in omega-3s and are often used as a flavor enhancer in various dishes. They are a sustainable choice and can be incorporated into numerous meals for their distinctive taste while contributing to your omega-3 intake.

It’s vital to avoid deep-frying when preparing fish, which can negate the health benefits of adding unhealthy fats. Instead, consider healthier cooking methods such as grilling, baking, or steaming. These methods not only preserve the nutrients but also enhance the fish’s natural flavors, allowing you to enjoy a delicious and healthful meal. Experimenting with herbs, spices, and citrus can elevate the taste without compromising health benefits.

2) Nuts and Seeds

Healthy unsaturated fats and omega-3 fatty acids found in nuts and seeds are renowned for their anti-inflammatory properties, making them excellent additions to a balanced diet. Notable options that stand out for their health benefits include:

• Walnuts: Rich in alpha-linolenic acid (ALA), a plant-based omega-3 fatty acid, walnuts help reduce inflammation, support heart health, and improve brain function.
• Chia Seeds: These tiny powerhouses contain omega-3s, fiber, and antioxidants. They can absorb water and swell, aiding in hydration and providing a feeling of fullness, which makes them a great addition to smoothies, yogurts, and baked goods.
• Hemp Hearts: Packed with healthy fats, protein, and essential minerals, hemp hearts are particularly high in gamma-linolenic acid (GLA), another type of omega-6 fatty acid that may assist in regulating inflammation in the body.
• Flaxseeds: Known for their high omega-3 content, flaxseeds also offer lignans, plant compounds that provide antioxidant benefits. Ground flaxseeds are particularly beneficial as they enhance nutrient absorption and can be easily incorporated into oatmeal, baked goods, and salads.

Incorporating these nutrient-dense foods into your daily diet can support overall health, enhance metabolic functions, and potentially reduce inflammation, contributing to improved well-being over time.

3) Plant-Based Proteins

Plant-based proteins are generally gentler on the digestive system and have been shown to help reduce systemic inflammation, making them a beneficial addition to any diet. Incorporating these proteins can support overall health while minimizing the risk of chronic diseases. Here are some excellent choices:

• Lentils: These small legumes are high in protein, fiber, and essential nutrients like iron and folate. They cook quickly and can be used in soups, stews, or salads.
• Chickpeas: Also known as garbanzo beans, chickpeas are versatile and packed with protein and fiber. They are an excellent option for making hummus or adding to salads and grain bowls for added texture and nourishment.
• Black beans: Rich in protein and antioxidants, black beans are ideal for various dishes, from tacos to chili. Their high fiber content also aids in digestion and supports heart health.
• Edamame (soybeans): These young soybeans are a complete protein source, containing all essential amino acids. They can be enjoyed steamed as a snack or added to stir-fries and salads.
• Tofu: Made from soy milk, tofu is a highly adaptable, protein-rich food rich in calcium and iron. It can be grilled, sautéed, or blended into smoothies for a creamy texture.
• Nut and seed butters: Options like almond butter or sunflower seed butter provide healthy fats and protein, making them perfect for smoothies, oatmeal, or spreading on whole-grain bread.
• Quinoa: This ancient grain is a good source of protein and provides a complete set of essential amino acids. It’s gluten-free and can be used as a base for salads, side dishes, or even breakfast bowls.

Incorporating these plant-based protein sources into your diet can promote better health while keeping inflammation and digestive health in mind.

4) Low-Sugar Beverages

Staying properly hydrated is essential for overall health, as it helps prevent strain on the kidneys and supports the optimal function of joints and muscles. When it comes to making better hydration choices, consider the following options:

• Water: The most effective and calorie-free way to stay hydrated. Aim for at least eight glasses daily, adjusting for activity level and climate.
• Sparkling Water: A refreshing alternative to plain water, sparkling water can satisfy cravings for fizzy drinks without added sugars or calories. Just ensure it is free from added sugars or sodium.
• Herbal Teas: Naturally caffeine-free, herbal teas come in various flavors and can be enjoyed hot or cold. Depending on the type you choose, they can provide additional antioxidants and benefits, such as chamomile for relaxation or ginger for digestion.
• Infused Water: Adding slices of citrus fruits like lemons, limes, or oranges, or fresh cucumber to water can enhance flavor without extra calories. This can encourage increased water intake by making it more interesting and enjoyable.
• Diluted Juices: If you enjoy fruit juices, consider diluting them with water to reduce sugar content while enjoying some flavor. This approach helps cut calories and sugar while providing some essential vitamins.

It’s best to avoid sugary drinks, such as sodas and energy drinks, and artificially sweetened beverages. These can lead to dehydration and have various health implications over time. Making conscious hydration choices can promote better health and well-being.er serving – these can add up quickly and put you past the 2,300-milligram daily sodium target!

Q: What medications can interact with naproxen?

Dr. Letsa answers: It is crucial to consult your healthcare provider regarding potential interactions when taking naproxen, particularly if you are also using other prescription medications or dietary supplements. Here are some medications that are known to commonly interact with naproxen, along with the specific risks involved:

• Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as ibuprofen and aspirin can significantly elevate the risk of gastrointestinal ulcers and bleeding when taken in conjunction with naproxen. This is due to their cumulative effects on the gastric mucosa.
• Blood Thinners (Anticoagulants): Medications like warfarin may increase the risk of severe bleeding when used with naproxen. If these drugs are prescribed together, monitoring your blood coagulation levels closely is essential.
• Certain Antihypertensive Medications: Drugs used to manage high blood pressure, such as ACE inhibitors or diuretics, may have their effectiveness diminished when combined with naproxen. This can lead to uncontrolled hypertension in some patients.
• Selective Serotonin Reuptake Inhibitors (SSRIs): Antidepressants like fluoxetine or sertraline can elevate the risk of gastrointestinal bleeding when taken with naproxen. This is particularly critical for individuals with a history of stomach ulcers or other GI issues.
• Lithium: Naproxen can potentially increase plasma lithium levels, leading to toxicity. If these medications are taken simultaneously, regular monitoring of lithium levels is advisable.
• Methotrexate: The combination of naproxen and methotrexate can increase the risk of toxicity from methotrexate, potentially leading to serious side effects, especially in high doses or with prolonged use.

Given these potential interactions, you must inform your healthcare provider about all medications and supplements you are currently taking. Personalized medical advice can help mitigate risks and improve your treatment outcomes.

Q: Should I take naproxen with food?

Dr. Letsa answers: Yes. Naproxen can cause stomach upset, so it is recommended that you take it with food or milk. Never take it on an empty stomach to reduce nausea and protect your lining.

Key FAQs on Naproxen Foods to Avoid

Q: Can you take naproxen with Tylenol?

Dr. Letsa answers: Yes. Since Tylenol (acetaminophen) isn’t an NSAID, it doesn’t interact with naproxen and is generally safe to take together for added pain relief.

Generally, taking naproxen and acetaminophen is considered safe. Still, it’s usually not necessary to take them simultaneously. These medications work differently to relieve pain: Naproxen is an NSAID that reduces inflammation, while acetaminophen is a pain reliever and fever reducer.

Often, it’s more effective to take one medication and then take the other if pain persists before the next scheduled dose of the first. For example, you could take Tylenol and, if needed, take naproxen before the next Tylenol dose, ensuring you don’t exceed the maximum daily dose of either medication.

While they don’t have significant drug interactions, taking them together might increase the risk of specific side effects, although this is generally low for short-term use at recommended doses. It’s always best to start with the lowest effective dose of one medication. If your pain is severe or not well-controlled with a single medication, consult your doctor or pharmacist for guidance on the safest and most effective way to combine them or alternate their use.

Q: Is Aleve the same as naproxen?

Dr. Letsa answers: Yes. Aleve is a brand name for naproxen sodium, and the generic name is naproxen. They function the same. Naproxen sodium is a specific salt form of naproxen. Over-the-counter Aleve typically contains 220 mg of naproxen sodium. Prescription naproxen products like Naprosyn or Anaprox may contain higher doses of naproxen or naproxen sodium.

Q: Can you take naproxen while pregnant?

Dr. Letsa answers: No. Naproxen is not recommended during pregnancy. Acetaminophen (Tylenol) is typically preferred unless otherwise directed by your doctor. This is due to potential risks to the developing baby.

• Early Pregnancy: Some studies suggest a possible increased risk of miscarriage with NSAID use, including naproxen, in early pregnancy. There have also been reports of a slightly increased chance of heart defects, although this is not definitively proven.
• Second Half of Pregnancy (after 20 weeks): Using NSAIDs like naproxen after 20 weeks of pregnancy can lead to serious kidney problems in the unborn baby, resulting in low levels of amniotic fluid (oligohydramnios). This can cause other complications, such as problems with lung development and stiff joints.
• Third Trimester: Naproxen should be avoided in the last 3 months of pregnancy as it can cause premature closure of a blood vessel in the baby’s heart (ductus arteriosus) and may lead to complications during delivery.

Q: How soon can I drink alcohol after stopping naproxen?

Dr. Letsa answers: It’s generally advisable to wait at least 24 hours, and ideally 48 hours, after your last dose of naproxen before consuming alcohol.

Both naproxen and alcohol can irritate the lining of the stomach and increase the risk of gastrointestinal side effects such as stomach upset, heartburn, and even ulcers or bleeding. While the risk is highest when taking them together, some overlap of their effects can still occur shortly after discontinuing naproxen.

The half-life of naproxen is around 12-17 hours, meaning it takes that long for half of the drug to be eliminated from your system. Waiting for a couple of half-lives ensures that most of the naproxen has been cleared, minimizing the potential for interaction with alcohol.

If you were taking naproxen at a higher dose or for a prolonged period, it might be prudent to extend this waiting time. If you have any pre-existing gastrointestinal issues, it’s always best to consult with your doctor or pharmacist for personalized advice on when it’s safe to resume alcohol consumption after stopping naproxen.

Q: Can naproxen affect gut microbiota or digestion?

Dr. Letsa answers: Yes, like other NSAIDs, naproxen can potentially affect both gut microbiota and digestion, although the extent of these effects can vary from person to person.

Regarding digestion, naproxen is known to inhibit the production of prostaglandins, which play a protective role in the stomach lining. This can lead to digestive issues such as:

• Stomach upset and pain: This is a common side effect.
• Heartburn and acid reflux: Naproxen can exacerbate these conditions.
• Gastritis: Inflammation of the stomach lining.
• Ulcers and bleeding: In more severe cases, naproxen can increase the risk of these complications, especially with long-term use or in individuals with a history of gastrointestinal problems.

The impact of naproxen on gut microbiota is an area of ongoing research. Some studies suggest that NSAIDs can alter the composition and diversity of the gut microbiome. These changes could contribute to digestive issues. They may have broader implications for overall health, as the gut microbiota plays a crucial role in immunity, nutrient absorption, and mood regulation.

While the effects on gut microbiota may not be as pronounced as those of antibiotics, individuals taking naproxen, especially for extended periods, should be aware of the potential for digestive disturbances and the possibility of subtle changes in their gut microbiome. In some cases, probiotics or dietary changes might be considered to support gut health, but discussing this with a healthcare professional first is essential.

Q: Does naproxen affect sleep or mood?

Dr. Letsa answers: While naproxen is primarily used to relieve pain and inflammation, it can indirectly affect sleep and, less commonly, mood in some individuals.

• Sleep: The primary way naproxen can impact sleep is through its effect on pain. If naproxen effectively reduces pain that was interfering with sleep, it can lead to improved sleep quality. However, in some cases, naproxen or its side effects might disrupt sleep or cause unusual drowsiness. Gastrointestinal discomfort, such as heartburn or stomach upset, caused by naproxen, can make sleeping difficult. In rare instances, some individuals might experience insomnia as a direct side effect of the medication.
• Mood: The direct effects of naproxen on mood are less common. However, chronic pain itself can significantly impact mood, leading to feelings of irritability, anxiety, or even depression. By alleviating pain, naproxen could indirectly improve mood in such cases. Conversely, if naproxen causes significant gastrointestinal distress or other bothersome side effects, this could negatively impact a person’s mood.

It’s important to note that individual responses to medications can vary. Suppose you experience significant sleep or mood changes while taking naproxen. In that case, discussing these with your doctor to determine if the medication is contributing to these issues is essential.

Q: Can I use collagen or joint supplements with naproxen?

Dr. Letsa answers: More than 400 medications are recognized to have interactions with naproxen, so it’s essential to inform your pharmacist and doctor about all the medicines you are currently taking. This way, they can check for any clinically significant drug interactions with naproxen, even if you purchase it over-the-counter (OTC). 

Generally, there is no known primary interaction between naproxen and common joint supplements like collagen, glucosamine, chondroitin, or MSM. Therefore, it’s often considered safe to use them concurrently. However, it’s crucial to keep a few points in mind:

• Purpose of Supplements: Understand that these supplements and naproxen address different aspects of joint health. Naproxen relieves pain and inflammation, while supplements like collagen often support cartilage health over the long term. They have different mechanisms of action.
• Potential for Overlap: Be mindful of the ingredients in your joint supplements. Some may contain other anti-inflammatory components. While a direct interaction with naproxen is unlikely to be severe, using multiple anti-inflammatory substances could theoretically increase the risk of gastrointestinal side effects. However, this is not well-established with these particular supplements.
• Individual Sensitivities: As with any combination of substances, individual reactions can vary. If you notice any unusual symptoms or increased gastrointestinal discomfort when taking naproxen with joint supplements, it’s wise to discontinue one or both and consult your doctor.
• Inform Your Doctor: It’s always a good practice to inform your doctor about all your medications and supplements, including over-the-counter and nutritional supplements. This will give them a complete picture of your health regimen and identify potential concerns.

Q: Does naproxen affect vitamin or mineral absorption?

Dr. Letsa answers: Naproxen is not known to significantly interfere with most vitamins and minerals. Its primary mechanism involves inhibiting prostaglandin production, which mainly affects pain and inflammation pathways, not nutrient absorption in the small intestine. However, indirect effects are possible:

• Gastrointestinal Upset: If naproxen causes significant gastrointestinal side effects like nausea, vomiting, or diarrhea, this could lead to malabsorption of various nutrients due to disrupting normal digestive processes. However, this is more of a consequence of severe side effects rather than a direct interaction with the absorptive mechanisms.
• Long-Term Use and Gut Health: Long-term use of NSAIDs like naproxen could alter gut microbiota. Since the gut microbiome plays a role in the absorption of some nutrients, significant changes over time might impact nutrient absorption. However, this is not a well-established or primary concern with typical naproxen use.

For most individuals taking naproxen as directed for short-term pain relief, a significant impact on vitamin and mineral absorption is unlikely. However, individuals on long-term naproxen therapy or those experiencing significant gastrointestinal side effects should be mindful of their overall nutritional status and discuss any concerns with their healthcare provider.

By understanding these potential interactions and effects of naproxen, individuals can make more informed decisions about its use, take appropriate steps to minimize possible risks, and manage their health effectively. Always consult a healthcare professional for personalized advice about your health conditions and medication regimen.

Conclusion

If you’re wondering about naproxen foods to avoid, you should know that focusing on an anti-inflammatory diet can support your treatment and minimize side effects. Avoid alcohol, sugary foods and drinks, high-sodium processed items, and red or processed meats. Some people may benefit from eliminating gluten.

On the flip side, include fish, nuts, seeds, whole grains, legumes, and low-sugar drinks. And always take naproxen with food to reduce the risk of stomach upset or ulcers.

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