For general pain or fever, the standard over-the-counter dose of Aleve is one pill (220 mg) every 8 to 12 hours. You can take an initial dose of two pills for the first hour, then drop to one pill at a time after that, but never exceed three pills in a 24-hour period. Each pill stays active in your body for a surprisingly long time compared to other painkillers, which is why the spacing between doses is wider than what you might be used to with ibuprofen or acetaminophen.
Standard Adult Dosing Schedule
Each Aleve tablet contains 220 mg of naproxen sodium (which delivers 200 mg of the active ingredient, naproxen). For your first dose, you can take two tablets. After that, take one tablet every 8 to 12 hours as needed. The maximum for the first day is three tablets total. On every day after that, stick to no more than three tablets (660 mg) in 24 hours.
Prescription-strength naproxen follows a different pattern, with doses of 250 mg or 500 mg and higher daily limits, but those schedules are set by a doctor for specific conditions like arthritis or gout.
Why Aleve Lasts Longer Than Other Painkillers
Aleve has a half-life of roughly 15 hours, meaning it takes that long for your body to clear just half the dose. That’s two to three times longer than ibuprofen’s half-life. This is why one Aleve pill can cover you for 8 to 12 hours, while ibuprofen needs to be re-dosed every 4 to 6 hours. The tradeoff is that if you take too much, the drug accumulates in your system more easily. Respecting the 8-to-12-hour gap between doses matters.
How Many Days You Can Take It
For short-term problems like a sore back, headache, or menstrual cramps, one or two days is often enough. The general guideline for OTC use is no more than 10 consecutive days for pain (or 3 days for fever) without talking to a doctor. If you have a chronic condition like rheumatoid arthritis that requires longer use, a doctor will typically prescribe a stomach-protective medication alongside it, because the risk of gastrointestinal side effects rises with duration.
Adjustments for Age
Children under 12 should not take Aleve unless directed by a doctor. For adults over 65, the recommended limit drops to one tablet (220 mg) every 12 hours. Older adults are more vulnerable to stomach bleeding and kidney strain from this class of drug, so the lower ceiling is a meaningful safety measure, not just a cautious suggestion.
Take It with Food
Aleve can irritate your stomach lining, especially on an empty stomach. Taking it with food, milk, or a full glass of water reduces that risk. This becomes more important the longer you use it. People with any history of stomach ulcers or digestive bleeding carry more than 10 times the normal risk of a serious GI bleed when using drugs in this class, so food isn’t optional for them.
Who Should Avoid or Limit Aleve
Aleve belongs to the NSAID family, which carries a well-documented set of risks for certain groups. People with heart disease, a recent heart attack, or severe heart failure face an increased risk of cardiovascular events like heart attack and stroke. Those with moderate to severe kidney impairment should avoid naproxen-containing products entirely. And anyone with active stomach or intestinal bleeding needs a different pain management approach altogether.
If you take a blood thinner, whether it’s aspirin, warfarin, or one of the newer anticoagulant medications, adding Aleve raises your bleeding risk significantly. NSAIDs interfere with the way your blood clots, and combining that effect with a blood thinner compounds the problem, particularly in the digestive tract. Talk to a doctor before combining these.
Signs You’ve Taken Too Much
Because of its long half-life, naproxen overdose symptoms can creep up. Warning signs include severe headache, confusion, blurred vision, ringing in the ears, nausea, stomach pain, and drowsiness. In serious cases, breathing becomes slow and labored, or seizures can occur. If you suspect an overdose, call 911 or Poison Control (1-800-222-1222) immediately, even if symptoms seem mild at first.