Naproxen Dosing for Shoulder Strain

Standard Dosing Regimen

The American College of Physicians recommends prescription naproxen 375-500 mg twice daily, with 500 mg twice daily being the standard for acute musculoskeletal conditions like shoulder strain 1
The American College of Physicians also recommends over-the-counter naproxen sodium (Aleve) 440 mg (two 220 mg tablets) twice daily as the equivalent OTC formulation 1

The American College of Physicians recommends an initial treatment period of 2-4 weeks at maximum tolerated dose before evaluating response 1
The American College of Physicians suggests reassessing at 2-4 weeks, and if response is insufficient, consider switching to another NSAID or adding alternative treatments 1
The American Heart Association recommends using the lowest effective dose for the shortest duration to minimize CV risk 3
The American College of Cardiology recommends monitoring blood pressure, as NSAIDs can increase BP by approximately 5 mm Hg 2

The American Gastroenterological Association recommends considering adding a proton pump inhibitor or H2 blocker in high-risk patients (history of peptic ulcer, age >60, concurrent anticoagulant use) 1
The National Kidney Foundation recommends checking renal function (BUN, creatinine) if treatment extends beyond 2 weeks, especially in elderly patients 1, 2
The American College of Cardiology recommends avoiding naproxen in patients with severe renal impairment (GFR <30 mL/min/1.73 m²) 2
The American Heart Association recommends using naproxen with extreme caution in patients with cardiovascular disease, heart failure, or hypertension 1, 3

The American College of Physicians recommends not using NSAIDs indefinitely without reassessment, as continuing NSAID monotherapy beyond 2 months without reevaluation is inappropriate 2
The American College of Cardiology recommends not ignoring cardiovascular risk factors, as long-term use increases cardiac ischemic events 2
The American Gastroenterological Association recommends not failing to provide gastroprotection in high-risk patients, as the risk of GI bleeding increases with age 2
The American Geriatrics Society recommends starting with lower doses (consider 250 mg twice daily initially) and titrating upward as tolerated in elderly patients 2, 3