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Naproxen and Pseudoephedrine side effects: what 20,453 FDA adverse event reports show

Naproxen Sodium, Pseudoephedrine Hydrochloride · 1,134 reaction terms · 82,678 drug–reaction co-reports · data 2026-09-14
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Drug class

Nonsteroidal Anti-inflammatory Drug

FDA label (Established Pharmacologic Class) of the closest related product

Label matched

Naproxen (Naproxen)

closest FDA label found for this product string; brand list suppressed because the label is a related product, not an exact match

Who reports

20,453 reports · 47% serious · 1,259 with death outcome · 66% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Naproxen tablets and naproxen sodium tablets are indicated for: the relief of the signs and symptoms of: • rheumatoid arthritis • osteoarthritis • ankylosing spondylitis • Polyarticular Juvenile Idiopathic Arthritis Naproxen tablets and naproxen sodium.

FDA label, Indications and Usage

What it is

Naproxen Tablets, USP and Naproxen Sodium Tablets, USP are nonsteroidal anti-inflammatory drugs available as follows: Naproxen Tablets, USP are available as follows for oral administration: 25.

FDA label, Description section

Boxed warning

RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Cardiovascular Thrombotic Events • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 1Labeled (related wording) 8Likely indication confounding 1Reporting / coding artifact 2Not in label — unassessed 28
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,094 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Increased viscosity of upper respiratory secretion1723.6
14.6–38.2ROR 23.6 · χ² 338 / p 9e-76
22.5 EB05 14.8 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=9not reported in cached trials
Infusion site discharge3320.1
14.3–28.4ROR 20.2 · χ² 570 / p 3e-126
19.5 EB05 14.5 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=25 · ♀ 100% (drug 66%) · 79% consumernot reported in cached trials
Infusion site mass1918.5
11.8–29.2ROR 18.6 · χ² 293 / p 7e-66
17.8 EB05 11.8 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=13NCT00346216: 2/8,030 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Seasonal allergy19914.6
12.7–16.8ROR 14.8 · χ² 2,480 / p <1e-300
14.4 EB05 12.8 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=106 · 76% consumernot reported in cached trials
Pneumonia pseudomonal2114.3
9.3–22.1ROR 14.4 · χ² 244 / p 3e-55
13.6 EB05 8.9 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=21NCT00346216: 1/7,992 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Rhonchi1914.2
9.0–22.4ROR 14.2 · χ² 218 / p 2e-49
13.3 EB05 8.5 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials
Lower respiratory tract congestion2314.0
9.3–21.1ROR 14.0 · χ² 261 / p 4e-59
13.3 EB05 8.9 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=16 · 100% consumernot reported in cached trials
Chronic kidney disease-mineral and bone disorder1413.5
8.0–22.9ROR 13.5 · χ² 148 / p 3e-34
12.1 EB05 7.0 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious n=14not reported in cached trials
Multiple allergies10013.2
10.9–16.1ROR 13.3 · χ² 1,103 / p 4e-242
13.0 EB05 10.9 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=82not reported in cached trials
Nephrogenic anaemia5913.1
10.1–16.9ROR 13.1 · χ² 638 / p 4e-141
12.7 EB05 10.1 · IC025 +3.1
3/3 methods agree
Not in label — unassessedserious n=58not reported in cached trials
Sputum increased2612.7
8.7–18.7ROR 12.8 · χ² 266 / p 4e-60
12.0 EB05 8.3 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=12 · 100% consumernot reported in cached trials
Rebound acid hypersecretion3712.5
9.0–17.3ROR 12.5 · χ² 375 / p 6e-84
12.0 EB05 8.9 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=37not reported in cached trials
Infusion site haemorrhage3711.8
8.5–16.3ROR 11.8 · χ² 352 / p 9e-79
11.3 EB05 8.3 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=21 · 70% consumerNCT00346216: 1/8,030 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Incorrect drug administration duration32411.8
10.5–13.1ROR 11.9 · χ² 3,146 / p <1e-300
11.6 EB05 10.6 · IC025 +3.3
3/3 methods agree
Reporting / coding artifactserious PRR 7.7 · 93% consumernot reported in cached trials
Infusion site bruising2411.7
7.8–17.5ROR 11.7 · χ² 221 / p 2e-50
10.8 EB05 7.3 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=17 · ♀ 100% (drug 66%)not reported in cached trials
Hyperparathyroidism secondary2811.4
7.9–16.6ROR 11.5 · χ² 254 / p 2e-57
10.7 EB05 7.5 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=28NCT00346216: 3/8,030 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Paranasal sinus discomfort4011.0
8.0–15.0ROR 11.0 · χ² 349 / p 3e-78
10.4 EB05 7.8 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=20 · ♀ 87% (drug 66%) · 71% consumernot reported in cached trials
Paranasal sinus hypersecretion4010.8
7.9–14.7ROR 10.8 · χ² 341 / p 2e-76
10.2 EB05 7.6 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=27not reported in cached trials
Upper-airway cough syndrome8510.7
8.7–13.3ROR 10.8 · χ² 733 / p 1e-161
10.4 EB05 8.6 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=48not reported in cached trials
Foreign body in respiratory tract1310.1
5.9–17.5ROR 10.2 · χ² 97 / p 3e-23
8.4 EB05 4.9 · IC025 +2.0
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Respiratory tract congestion1509.7
8.3–11.4ROR 9.8 · χ² 1,158 / p 4e-254
9.5 EB05 8.3 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious PRR 13.7 · 79% consumernot reported in cached trials
Middle ear effusion209.4
6.1–14.6ROR 9.4 · χ² 141 / p 1e-32
8.3 EB05 5.4 · IC025 +2.2
3/3 methods agree
Not in label — unassessedserious n=14 · 75% consumernot reported in cached trials
Productive cough (cough with phlegm)4169.1
8.2–10.0ROR 9.2 · χ² 2,961 / p <1e-300
9.0 EB05 8.2 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious PRR 10.0 · 70% consumernot reported in cached trials
Incorrect product administration duration1748.9
7.6–10.3ROR 8.9 · χ² 1,195 / p 4e-262
8.7 EB05 7.6 · IC025 +2.9
3/3 methods agree
Reporting / coding artifactserious n=23 · 94% consumernot reported in cached trials
Infusion site induration128.7
4.9–15.4ROR 8.7 · χ² 74 / p 4e-18
7.0 EB05 4.1 · IC025 +1.7
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Sinus congestion1118.5
7.0–10.2ROR 8.5 · χ² 718 / p 2e-158
8.2 EB05 7.0 · IC025 +2.7
3/3 methods agree
Not in label — unassessedserious n=64not reported in cached trials
Increased bronchial secretion218.4
5.5–13.0ROR 8.5 · χ² 129 / p 3e-30
7.4 EB05 5.0 · IC025 +2.1
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Obstruction328.3
5.8–11.7ROR 8.3 · χ² 195 / p 1e-44
7.6 EB05 5.5 · IC025 +2.3
3/3 methods agree
Labeled adverse reaction
exact term
serious n=31NCT00346216: 1/7,933 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Infusion site pain1028.2
6.8–10.0ROR 8.3 · χ² 637 / p 8e-141
8.0 EB05 6.7 · IC025 +2.7
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=66 · ♀ 86% (drug 66%)NCT00346216: 13/7,933 (0.2%) on Naproxen and Pseudoephedrine (serious AE)
Breath sounds abnormal398.2
6.0–11.2ROR 8.2 · χ² 236 / p 2e-53
7.6 EB05 5.7 · IC025 +2.4
3/3 methods agree
Not in label — unassessedserious n=32 · 72% consumernot reported in cached trials
Kyphosis148.1
4.8–13.8ROR 8.1 · χ² 80 / p 2e-19
6.7 EB05 4.1 · IC025 +1.8
3/3 methods agree
Not in label — unassessedserious n=13NCT00346216: 1/7,933 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Bronchitis chronic198.0
5.1–12.5ROR 8.0 · χ² 108 / p 1e-25
6.9 EB05 4.6 · IC025 +2.0
3/3 methods agree
Not in label — unassessedserious n=16NCT00346216: 17/7,933 (0.2%) on Naproxen and Pseudoephedrine (serious AE)

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Naproxen and Pseudoephedrine as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (16 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)1,7551.4
1.3–1.4ROR 1.4 · χ² 183 / p 5e-42
1.4 EB05 1.3 · IC025 +0.4Reporting / coding artifactserious PRR 0.8 · 87% consumernot reported in cached trials
Dyspnoea (shortness of breath)1,6513.0
2.9–3.1ROR 3.2 · χ² 2,249 / p <1e-300
3.0 EB05 2.9 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 3.4NCT00346216: 24/7,933 (0.3%) on Naproxen and Pseudoephedrine (serious AE)
Fatigue (tiredness)1,3711.8
1.7–1.9ROR 1.9 · χ² 514 / p 4e-114
1.8 EB05 1.7 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 2.5NCT00346216: 2/7,933 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Nausea1,2721.7
1.6–1.7ROR 1.7 · χ² 340 / p 4e-76
1.7 EB05 1.6 · IC025 +0.6Labeled adverse reaction
exact term
serious PRR 2.2NCT00346216: 6/7,933 (0.1%) on Naproxen and Pseudoephedrine (serious AE)
Cough1,2384.5
4.3–4.8ROR 4.8 · χ² 3,455 / p <1e-300
4.5 EB05 4.3 · IC025 +2.1
3/3 methods agree
Not in label — unassessedserious PRR 5.1 · 71% consumerNCT00346216: 1/8,030 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Diarrhoea (diarrhea)1,2332.0
1.9–2.1ROR 2.0 · χ² 601 / p 4e-133
2.0 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
serious PRR 2.1NCT00346216: 5/7,933 (0.1%) on Naproxen and Pseudoephedrine (serious AE)
Pneumonia (lung infection)1,1753.7
3.5–3.9ROR 3.9 · χ² 2,378 / p <1e-300
3.7 EB05 3.5 · IC025 +1.8
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.6NCT00346216: 2/7,933 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Headache1,1271.8
1.7–2.0ROR 1.9 · χ² 448 / p 8e-100
1.8 EB05 1.8 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 2.3NCT00346216: 4/8,030 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Dizziness1,0122.1
2.0–2.2ROR 2.1 · χ² 583 / p 4e-129
2.1 EB05 2.0 · IC025 +1.0Labeled adverse reaction
exact term
serious PRR 2.3 · 76% consumerNCT00346216: 6/7,933 (0.1%) on Naproxen and Pseudoephedrine (serious AE)
Pain8521.4
1.3–1.5ROR 1.4 · χ² 108 / p 1e-25
1.4 EB05 1.3 · IC025 +0.4Likely indication confounding
term in indications; also in warnings
serious PRR 1.9NCT00346216: 13/7,933 (0.2%) on Naproxen and Pseudoephedrine (serious AE)
Sinusitis7017.0
6.5–7.6ROR 7.2 · χ² 3,612 / p <1e-300
7.0 EB05 6.5 · IC025 +2.7
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 10.0NCT00346216: 1/8,030 (0.0%) on Naproxen and Pseudoephedrine (serious AE)
Asthenia (weakness)6781.8
1.7–2.0ROR 1.9 · χ² 268 / p 2e-60
1.8 EB05 1.7 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 2.4NCT00346216: 4/7,933 (0.1%) on Naproxen and Pseudoephedrine (serious AE)
Fall6532.0
1.9–2.2ROR 2.0 · χ² 337 / p 1e-75
2.0 EB05 1.9 · IC025 +0.9Not in label — unassessedserious PRR 2.5NCT00346216: 10/7,933 (0.1%) on Naproxen and Pseudoephedrine (serious AE)
Vomiting6471.4
1.3–1.5ROR 1.4 · χ² 80 / p 2e-19
1.4 EB05 1.3 · IC025 +0.4Labeled adverse reaction
exact term
serious PRR 1.7NCT00346216: 7/7,933 (0.1%) on Naproxen and Pseudoephedrine (serious AE)
Death6340.8
0.7–0.8ROR 0.7 · χ² 53 / p 2e-13
0.8 EB05 0.7 · IC025 -0.5
PRR-only: not supported by EBGM or IC
Outcome field, not a reaction
boxed warning mentions mortality
serious PRR 0.9 · ♀ 43% (drug 66%)NCT00346216: 1/7,992 (0.0%) on Naproxen and Pseudoephedrine (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Naproxen and Pseudoephedrine?

In FDA FAERS, the most frequently co-reported reaction terms for Naproxen and Pseudoephedrine are dyspnoea, fatigue, nausea, cough, diarrhoea, pneumonia. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Naproxen and Pseudoephedrine have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Cardiovascular Thrombotic Events • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.

Do FAERS signals prove that Naproxen and Pseudoephedrine causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.