Is Aleve Bad for You Long Term?

October 8, 2025 •

4 min read

According to the U.S. Food and Drug Administration (FDA), all non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) carry a boxed warning for serious cardiovascular and gastrointestinal side effects. For this reason, relying on Aleve for an extended period can be harmful and is generally not recommended without medical supervision.

Quick Summary

Long-term use of Aleve (naproxen) is associated with serious side effects, including increased risk of heart attack, stroke, gastrointestinal bleeding, and kidney damage. The risk increases with higher doses and prolonged duration, especially for individuals with pre-existing health conditions or those over 60. For chronic pain management, safer alternatives and non-pharmacological therapies should be explored under medical guidance.

Key Points

Significant Organ Risks: Long-term Aleve use poses serious risks to the cardiovascular, gastrointestinal, and renal systems.
FDA Black Box Warning: Non-aspirin NSAIDs carry an FDA warning for increased risk of heart attack, stroke, and internal bleeding, with the risk rising with prolonged use.
Gastrointestinal Complications: Chronic use can cause stomach ulcers, bleeding, and perforation by damaging the stomach's protective lining.
Kidney Damage Potential: Aleve can restrict blood flow to the kidneys, leading to decreased function, fluid retention, and potential kidney failure, especially in high-risk individuals.
Consult a Doctor for Chronic Pain: Pain lasting more than 10 days requires medical evaluation to address the underlying cause and determine a safer management strategy.
Explore Safer Alternatives: Options like acetaminophen, topical pain relievers, physical therapy, and other non-drug approaches are available for chronic pain without the long-term systemic risks of oral NSAIDs.
Personalized Risk Assessment: Individuals over 60 or with pre-existing conditions like heart disease or kidney issues face a greater risk from long-term Aleve use.

Understanding Aleve's Mechanism and Long-Term Implications

Aleve, the brand name for naproxen sodium, is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and reduce inflammation. It works by inhibiting enzymes called cyclooxygenases (COX), which play a key role in producing prostaglandins. While blocking prostaglandins helps alleviate pain, fever, and inflammation, these same prostaglandins are vital for other bodily functions, including protecting the stomach lining and regulating blood flow to the kidneys. It is this dual action that leads to the significant health risks associated with chronic, long-term use.

The Short-Term vs. Long-Term Distinction

Over-the-counter Aleve is intended for short-term use only, typically no more than 10 consecutive days for pain or 3 days for fever. When pain persists beyond this timeframe, it warrants a consultation with a healthcare provider to investigate the underlying cause. The potential for serious side effects increases significantly with prolonged use and higher dosages, a pattern that often occurs when people self-medicate chronic conditions like arthritis. The longer the duration of use, the greater the likelihood of developing life-threatening complications.

Serious Long-Term Side Effects of Aleve

Cardiovascular Complications

Consistent, long-term use of Aleve has been linked to a heightened risk of serious cardiovascular events.

Increased Risk of Heart Attack and Stroke: The FDA has issued a strong warning that non-aspirin NSAIDs, including naproxen, can increase the chance of a fatal heart attack or stroke. This risk can occur within the first few weeks of use and becomes greater with longer treatment duration, even in people without a prior history of heart disease.
Worsening High Blood Pressure and Heart Failure: By affecting kidney function, naproxen can cause fluid retention, which can raise blood pressure or exacerbate existing heart failure. This is particularly dangerous for individuals already managing these conditions.

Gastrointestinal Damage

Aleve's effect on prostaglandins disrupts the stomach's protective lining, leading to severe gastrointestinal issues over time.

Ulcers and Bleeding: Long-term use significantly increases the risk of developing stomach ulcers and internal bleeding. In older adults or those with a history of peptic ulcer disease, this risk is particularly high and can be fatal.
Perforation: In the most severe cases, the lining of the stomach or intestines can be perforated, a life-threatening condition requiring immediate medical attention. Signs to watch for include severe stomach pain, black or tarry stools, and vomiting blood.

Kidney Damage and Renal Failure

The kidneys rely on prostaglandins to maintain proper blood flow and function. By blocking these compounds, naproxen can harm these vital organs over the long term.

Reduced Kidney Function: Chronic use can lead to a decrease in blood flow to the kidneys, potentially causing progressive kidney damage or even sudden kidney failure in susceptible individuals.
Fluid and Salt Retention: This effect can be particularly harmful to those with pre-existing kidney problems or those also taking diuretics or ACE inhibitors. Signs of kidney trouble include decreased urine output, swelling in the legs or feet, and fatigue.

Other Potential Side Effects

Beyond the major organ systems, long-term naproxen use has been linked to other adverse effects, including:

Hearing disturbances, such as tinnitus (ringing in the ears).
Skin reactions, such as rashes or increased sensitivity to sunlight.
Cognitive dysfunction, depression, and confusion, particularly in older adults.
Liver damage, though uncommon, can occur, especially in those with pre-existing liver disease.

Safer Alternatives for Long-Term Pain Management

Given the risks, it is crucial to consider safer alternatives for managing chronic pain. A healthcare provider can help design a comprehensive pain management plan tailored to your specific needs.


Alternative Treatment	Mechanism of Action	Best For	Considerations
Acetaminophen (Tylenol)	Non-NSAID analgesic; works by altering pain perception in the brain.	Mild to moderate pain; safer for cardiovascular and kidney health compared to NSAIDs.	Does not reduce inflammation; potential for liver damage with high doses.
Topical NSAIDs	Applied directly to the skin to target localized pain; minimal systemic absorption.	Joint pain, muscle aches, tendonitis.	Much lower risk of systemic side effects compared to oral NSAIDs.
Physical Therapy	Uses exercises and manual techniques to improve mobility, strength, and function.	Chronic back pain, arthritis, musculoskeletal conditions.	Addresses the root cause of pain; can reduce reliance on medication.
Mind-Body Practices	Techniques like yoga, Tai Chi, and meditation to manage the psychological aspects of pain.	Chronic pain conditions like fibromyalgia, stress-related pain.	Improves coping strategies and overall well-being.
Acupuncture	Traditional Chinese medicine practice involving needles to stimulate nerve signals and endorphins.	Back pain, migraines, osteoarthritis.	Drug-free approach; effectiveness varies among individuals.
Other Medications	Prescription options like corticosteroids or non-opioid pain relievers.	Severe chronic pain; inflammatory conditions.	Requires doctor supervision; corticosteroids have their own side effects.

Conclusion: Making an Informed Decision

While Aleve is an effective and safe over-the-counter option for occasional pain, the answer to "Is Aleve bad for you long term?" is a definitive yes. The risks of serious cardiovascular, gastrointestinal, and renal complications increase with prolonged use and higher doses. For managing chronic pain, it is essential to move beyond simply reaching for an NSAID and instead consult a healthcare provider. They can help you explore safer, more sustainable alternatives, from acetaminophen and topical treatments to physical therapy and mind-body practices. The lowest effective dose for the shortest possible time remains the golden rule for NSAID use.

For more information on the FDA's warnings regarding NSAIDs, you can visit their official drug safety communications website.

Frequently Asked Questions

For over-the-counter use, taking Aleve for more than 10 consecutive days for pain or 3 days for fever is considered long-term and is not recommended without a doctor's guidance. The risk of side effects increases significantly with prolonged duration.

Yes, long-term use of Aleve (naproxen), like other non-aspirin NSAIDs, can increase the risk of heart attack and stroke. This risk can begin within the first few weeks of use and rises with continued use.

Yes, chronic use of Aleve can cause irritation to the stomach and intestinal lining, leading to ulcers and potentially life-threatening bleeding or perforation. This risk is higher with long-term use, high doses, and in older adults.

Yes, long-term and high-dose use of Aleve can cause kidney damage. It works by reducing blood flow to the kidneys, which can impair function and lead to fluid retention or, in severe cases, kidney failure.

Safer alternatives for managing chronic pain include acetaminophen (Tylenol), topical pain relievers like capsaicin or arnica creams, physical therapy, acupuncture, and mind-body techniques such as yoga and meditation.

Individuals at the highest risk include those over 60, people with a history of heart disease, stroke, high blood pressure, stomach ulcers, bleeding problems, or existing kidney disease.

To minimize risk, always use the lowest effective dose for the shortest amount of time possible. Take it with food to protect your stomach, stay hydrated, and do not combine it with other NSAIDs.