Coffee and Naproxen: What You Need to Know

It is generally acceptable to drink coffee while taking naproxen, but there are a few important cautions. Naproxen (a nonsteroidal anti-inflammatory drug, NSAID) can irritate the stomach and increase the risk of gastrointestinal bleeding, and this risk rises with certain factors like older age, prior ulcers, alcohol use, and higher doses or longer use. ^[1] Caffeine itself is not known to directly increase naproxen’s bleeding risk, but some combination products warn that their dose contains about as much caffeine as a cup of coffee and advise limiting additional caffeine to avoid side effects like nervousness or rapid heartbeat. ^{[2] [3]}

---

How Naproxen Affects Your Stomach

• Stomach bleeding warning: Naproxen and other NSAIDs can cause serious stomach bleeding; the risk is higher if you are age 60 or older, have had ulcers or bleeding, use blood thinners or steroids, take multiple NSAIDs, drink three or more alcoholic beverages daily, or take more or longer than directed. ^[1] These are well-recognized risk factors to keep in mind when deciding whether to add coffee. ^{[4] [5]}

• Typical warning signs: Seek medical help if you develop stomach pain, heartburn, vomit that looks like coffee grounds, blood in your stool, or black tarry stools, as these can be signs of bleeding. ^[6]

---

What About Caffeine and Coffee?

• No direct increase in bleeding risk shown from caffeine with naproxen in official labeling. However, some over-the-counter analgesic products note that their recommended dose already includes caffeine roughly equal to a cup of coffee and advise limiting extra caffeine to reduce side effects like jitteriness, nervousness, or rapid heartbeat. ^{[2] [3]}

• Practical takeaway: Coffee does not appear to directly amplify naproxen’s bleeding risk, but it may worsen heartburn or stomach irritation in sensitive individuals, especially when combined with an NSAID. ^[1] If you notice indigestion or reflux with naproxen, cutting back on coffee often helps. ^[1]

---

Evidence on GI Risk with Naproxen

• Naproxen’s GI risk is real and dose-related. Across population studies, traditional NSAIDs including naproxen raise the risk of upper gastrointestinal bleeding; naproxen’s estimated relative risk is about 5.6 compared with nonuse. ^[7] NSAIDs with longer half-lives or certain formulations may carry greater risk. ^[7]

• Short studies in volunteers show naproxen can cause gastric mucosal injury, particularly at higher doses, sometimes without symptoms. ^[8] Endoscopic comparisons found more severe injury at higher naproxen doses than lower doses. ^[8]

---

Sensible Use: How to Reduce Stomach Irritation

• Use the lowest effective dose for the shortest time. This is a core strategy recommended for minimizing NSAID-related GI risks. ^{[4] [5]}

• Avoid multiple NSAIDs at once. Combining NSAIDs (e.g., ibuprofen plus naproxen) increases GI risk. ^{[1] [4]}

• Limit alcohol. Three or more alcoholic drinks daily while using naproxen markedly increases bleeding risk. ^[1]

• Consider taking with food. While food does not eliminate the bleeding risk, it can lessen dyspepsia (stomach upset) for some people. ^[4] If coffee aggravates your stomach, try water or a small snack instead. ^[1]

• Consider gastroprotection if you have risk factors. People with prior ulcers/bleeding or on blood thinners/steroids may benefit from physician-directed protective strategies (such as acid-suppressing therapy) when NSAIDs are necessary. ^{[4] [5]}

---

When to Seek Help

• Stop naproxen and contact a clinician if you develop stomach pain, heartburn that worsens, vomiting of blood or coffee-ground material, blood in the stool, or black/tarry stools. ^[6] These may be signs of GI bleeding and need prompt evaluation. ^[6]

---

Bottom Line

• Coffee in moderation is usually fine with naproxen for people without GI risk factors, but pay attention to your body’s response. ^[1] If you notice increased heartburn or stomach discomfort, reduce or avoid coffee while on naproxen and consider taking the medication with food. ^[4] If you have GI risk factors (older age, past ulcers/bleeding, alcohol use, anticoagulants/steroids), be extra cautious and discuss protective strategies with your clinician. ^{[1] [4] [5]}