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Taken overdose of naproxen for pericarditis. Have gained weight and edema. Does this require attention?
Question: I was prescribed naproxen for an episode of pericarditis a few days ago. I stopped taking the naproxen a day ago, but the first night, I was in an incredible amount of pain from the pericarditis. I took more than the recommended dose. The total dose I took was 1500mg in the span of a couple of hours. I developed some adverse effects from it. So I stopped taking it. Since then, I have noticed an increase in weight gain of around 5lbs. Tonight, I noticed that I have nonpitting edema over my ankles and calves, that I would personally grade at a 1+ or 2+. There are a few bruises on my legs, which I'm going to assume is due to the naproxen's effects on my blood. I am a student nurse so I have some decent knowledge about kidney function and I understand that naproxen can be nephrotoxic. I have been increasing my fluids over the past couple of days, to no less than 112oz of water. I'm concerned that I have severely damaged my kidneys but am wondering if an isolated incident of a toxic dose of a nephrotic drug can cause this? Is it reversible with time? Does this require immediate attention? I also take klonopin 0.5mg t.i.d. as needed for anxiety, and receive 40mg IV solumedrol monthly. I occasionally take a half dose of an herbal ecchinacea supplement for immune support, and benadryl at night to help me sleep.
Brief Answer: Possible drug toxicity Detailed Answer: Hi there Thank you for sending in your query. Naproxen as you might know belongs to a class of drugs called Non steroidal anti-inflammatory drugs or NSAIDs. NSAIDs are known to have various adverse effects on the kidneys. While these are common with long term use, adverse effects have been well described after a few doses of naproxen. So if you have a new onset bipedal edema, it could well be the symptom of naproxen affecting the kidneys. However we should do some tests to confirm our diagnosis one way or the other. I would recommend that you do the following investigations: 1) Urine R/M, UPCR (urine protein/creat ratio) 2) Blood urea, creatinine, electrolytes 3) Ultrasound of the kidneys. It would be advisable to get these tests done as early as possible. Once we have the results we could decide the further course of action. Is this reversible? We need the above reports before I can give a firm answer. However from my experience, majority of the side effects of NSAIDs are usually reversible, once we have stopped the pills. I would recommend that till you see a doctor, restrict your fluid intake as per your thirst and do not push fluids. I hope this was helpful. I will be happy to provide more answers. Regards Dr. Bhabhe
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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