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To the Editor.—
We have recently seen a patient who was reported to have ingested 25 g of naproxen (Naprosyn) as a single dose. This is 50 times the recommended daily therapeutic dose of naproxen in rheumatoid arthritis.In a report on the pharmacokinetics of naproxen overdoses, Runkel and colleagues (Clin Pharmacol Ther 20:269, 1976) reported that, in contrast to the kinetics of salicylate elimination, high doses of naproxen of 1 to 4 g resulted in a disproportionate increase in renal excretion without evidence of saturation of the excretory mechanism.Our clinical experience with the patient reported here appears to confirm their experimental findings. The patient's complete blood cell count, electrolytes, blood chemistries, and urinalysis were within normal limits. His symptoms were limited to mild transient gastrointestinal distress (nausea and indigestion). The serum naproxen concentration approximately 15 hours after ingestion was 414 μg/ml, a high level but one consistent with
Fredell EW, Strand LJ. Naproxen Overdose. JAMA. 1977;238(9):938. doi:10.1001/jama.1977.03280100022010
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