MAJOR — Use With Caution
FDA-documented interaction. Avoid combination. Naproxen longer half-life means extended period of increased bleeding risk compared to shorter-acting NSAIDs.
Evidence level: STRONG
Naproxen (Aleve) with warfarin is risky for the same reasons as ibuprofen — it further reduces blood clotting and can damage your stomach lining. Naproxen stays in your body longer than ibuprofen, which extends the danger period.
Same dual mechanism as other NSAIDs: COX-1 inhibition reducing platelet function plus GI mucosal damage. Naproxen long half-life (12-17h) extends the risk period. FDA warfarin label warns about NSAIDs.
Do not take Aleve if you are on warfarin unless your doctor specifically approves it. Acetaminophen is a safer pain option. Naproxen effects last longer than ibuprofen, extending your risk.
High bleeding risk combination. NSAIDs impair platelet function and can cause GI bleeding — this is amplified by anticoagulants. If your prescriber approves short-term NSAID use, take with food and use the lowest dose. Consider acetaminophen as a safer alternative for pain.
Higher risk with: older age (65+), history of GI bleeding, concurrent use of multiple blood-thinning agents, liver disease, heavy alcohol use, recent surgery.
Black or bloody stools, stomach pain, vomiting blood, excessive bruising, dizziness from blood loss
Use acetaminophen for pain. If NSAID is truly needed, discuss GI protection with a PPI and plan for more frequent INR checks.
This medication combination requires careful medical oversight. Your doctor or anticoagulation clinic can adjust doses or select alternatives with fewer bleeding risks. Frequent INR monitoring is essential.
Naproxen (Aleve) with warfarin is risky for the same reasons as ibuprofen — it further reduces blood clotting and can damage your stomach lining. Naproxen stays in your body longer than ibuprofen, which extends the danger period.
High bleeding risk combination. NSAIDs impair platelet function and can cause GI bleeding — this is amplified by anticoagulants. If your prescriber approves short-term NSAID use, take with food and use the lowest dose. Consider acetaminophen as a safer alternative for pain.
Black or bloody stools, stomach pain, vomiting blood, excessive bruising, dizziness from blood loss
This medication combination requires careful medical oversight. Your doctor or anticoagulation clinic can adjust doses or select alternatives with fewer bleeding risks. Frequent INR monitoring is essential.
Use acetaminophen for pain. If NSAID is truly needed, discuss GI protection with a PPI and plan for more frequent INR checks.
Or browse the full interaction database (121,000+ pairs).