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Symptoms: Symptoms include headache, nausea, vomiting, indigestion, epigastric pain, gastrointestinal bleeding, abdominal discomfort, rarely diarrhoea, heartburn, disorientation, excitation, drowsiness, dizziness, tinnitus, fainting, transient alterations in liver function, hypoprothrombinemia, metabolic acidosis, apnoea, or disorientation. Because naproxen may be rapidly absorbed, high and early blood levels should be anticipated. In cases of significant poisoning, acute renal failure and liver damage are possible. Hypertension, acute renal failure, respiratory depression and coma may occur after the ingestion of NSAIDs but are rare. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs and may occur following an overdose.
Treatment: Patients should be treated symptomatically as required. Stomach may be emptied and usual supportive measures employed. Prevention of further absorption (e.g. activated charcoal) may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose. Alternatively, in adults, gastric lavage should be considered within one hour of ingestion of a potentially life-threatening overdose. Good urine output should be ensured. Patients should be observed for at least four hours after ingestion of potentially toxic amounts. Frequent or prolonged convulsions should be treated with intravenous diazepam. Forced diuresis, haemodialysis or hemoperfusion does not decrease the plasma concentration of naproxen because of the high degree of protein binding.
