Is it safe to take naproxen with fish oil (omega-3) supplements, or does this combination increase bleeding risk?

Taking naproxen together with fish oil (omega‑3) can modestly increase bleeding tendency, but for most healthy adults the overall risk appears low if doses are typical and there are no other bleeding risks present. ^[1] Some studies and product labels note that omega‑3s can prolong bleeding time, yet this prolongation generally stays within normal limits and has not been linked to clinically significant bleeding by itself. ^[2] However, naproxen is a nonsteroidal anti‑inflammatory drug (NSAID) that can irritate the stomach lining and affect platelet function, so combining it with anything that may lengthen bleeding time warrants some caution, especially in people with additional risk factors. ^[1]

What official information says

• Omega‑3 (fish oil/omega‑3‑acid ethyl esters) products have shown increases in bleeding time in trials, but these increases did not exceed normal ranges and did not produce clinically significant bleeding episodes on their own. ^[2] This precaution appears consistently in official drug information for omega‑3‑acid ethyl esters. ^[1]
• Because omega‑3s may affect bleeding time, labels advise caution when they are used together with anticoagulants or other drugs that affect coagulation. ^[3] Naproxen, while not an anticoagulant, can affect platelet function and increase gastrointestinal bleeding risk, which is why the combination deserves attention in people at higher risk. ^[1]

What clinical studies suggest

• In healthy volunteers, prescription omega‑3 alone did not measurably inhibit platelet aggregation, while its combination with aspirin did enhance antiplatelet effects; even then, prior studies did not report a clinically significant increase in bleeding events. ^[4]
• Another small study found that fish oil slightly increased bleeding time on its own (not statistically significant), and the combination with aspirin increased bleeding time further, suggesting additive effects on bleeding time; still, this did not translate into excess platelet dysfunction beyond aspirin’s effect. ^[5]

Practical risk assessment

• For most people using standard doses of fish oil (for example, 1–2 g/day of combined EPA/DHA) and occasional or short courses of naproxen, the bleeding risk is likely to be small. The main concern is additive effects on bleeding time and gastrointestinal (stomach) bleeding risk, particularly if naproxen is taken regularly or at higher doses. ^{[1] [2]}
• The risk becomes more relevant if you have other bleeding risks: a history of stomach ulcers or GI bleeding, bleeding disorders, kidney or liver disease, heavy alcohol use, advanced age, low body weight, or if you take other drugs that affect clotting (such as aspirin, clopidogrel, warfarin, DOACs, SSRIs/SNRIs, corticosteroids). In these cases, combining fish oil with naproxen may be less safe without medical supervision. ^{[1] [3]}

Sensible precautions if you combine them

• Use the lowest effective naproxen dose for the shortest needed duration, and take it with food to reduce stomach irritation. ^[1]
• Keep fish oil at standard supplement doses rather than high-dose regimens unless prescribed for triglyceride lowering. ^[2]
• Watch for warning signs of bleeding: black or tarry stools, vomiting blood or coffee‑ground material, unusual or easy bruising, nosebleeds that are hard to stop, bleeding gums, or prolonged bleeding from cuts; seek prompt care if these occur. ^{[1] [2]}
• If you need regular NSAID therapy, ask about gastroprotection (for example, a proton‑pump inhibitor) and whether alternatives (acetaminophen/paracetamol for pain that isn’t inflammatory, topical NSAIDs, or non‑drug measures) could reduce risk. ^[1]

Bottom line

• Evidence and official information indicate that omega‑3 supplements can lengthen bleeding time, but this has typically stayed within normal limits and has not been linked to significant bleeding on their own. ^{[2] [1]}
• Pairing omega‑3 with an NSAID like naproxen could modestly increase bleeding tendency, mostly through additive effects, and it may raise gastrointestinal bleeding risk in susceptible individuals. For healthy adults without other bleeding risks, occasional combined use at usual doses is generally considered acceptable with caution and monitoring. ^{[4] [1]}
• If you have any bleeding risk factors or take other blood‑thinning medicines, it’s safer to review this combination with your clinician first. ^{[3] [1]}