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Is An Aleva Dose Of 220mg Per Day Advisable For A 90 Year Old ?
Question: My mother is 90 years old and has Alzheimers. She was put on Hospice when she fell and had a slight fracture to her femur. At first, they put her on 500 mg Tylenol, 2 times a day. The dr. asked for my approval to use Naproxen, 500 mg., 2 times a day. I understand it is like Aleve, but when I read the label on our over the counter Alleve, I am now concerned that, based on the information of not taking more than 2 Alleves per day, at 220 mg., that mom is being given too much. She is between 75-80 lbs.
Brief Answer:
That is a common dosage no worry, but a lower dose can be tried first.
Detailed Answer:
I read your question carefully and I understand your concern.
Naproxen is commonly used at 500mg twice daily, so your doctor is not committing a mistake. I understand for over the counter Aleve they say not to take it more than 2 times (actually I think it's not more than 3 times a day, but might be different in US), but I suppose that is because it's an over the counter product and for bigger doses they would want you to ask a doctor first.
That being said, given your mother's advanced age and the known vulnerability of the elderly to possible drug side effects (in this case gastric ulcer and bleeding, high blood pressure, kidney damage etc), I would consider it more prudent to give a lower dose a try for 1-2 days, say 220mg twice daily.
If that works for her pain then great, if not it can always be increased to the 500mg twice daily regimen. You should talk to the doctor about this option.
I hope to have been of help.
That is a common dosage no worry, but a lower dose can be tried first.
Detailed Answer:
I read your question carefully and I understand your concern.
Naproxen is commonly used at 500mg twice daily, so your doctor is not committing a mistake. I understand for over the counter Aleve they say not to take it more than 2 times (actually I think it's not more than 3 times a day, but might be different in US), but I suppose that is because it's an over the counter product and for bigger doses they would want you to ask a doctor first.
That being said, given your mother's advanced age and the known vulnerability of the elderly to possible drug side effects (in this case gastric ulcer and bleeding, high blood pressure, kidney damage etc), I would consider it more prudent to give a lower dose a try for 1-2 days, say 220mg twice daily.
If that works for her pain then great, if not it can always be increased to the 500mg twice daily regimen. You should talk to the doctor about this option.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. My biggest concern is that since the new medication, she has not been as alert and seems overly tired at each of my visits. The nurses continue to say she is in pain, but I have known my mom for 61 years and do not see the pain in her eyes. She is a strong lady and does I'm sure feel pain when she is moved from bed to wheelchair, during incontinence changing and bathing but does not show signs while sitting in her chair and does not complain when I ask her. Her DNR says no to any narcotic drugs to keep her alive by any artificial means. I am being her advocate and believe I am respecting what my mother wishes.
Brief Answer:
Read below.
Detailed Answer:
I understand your worry. One thing I can say is that neither Tylenol nor Naproxen can be blamed for these changes that you notice in her mental status.
It is often hard to identify the issue when it is a question of such an advanced age. You say that she has Alzheimer's as well, that is a progressive disease and furthermore it is known to have fluctuations with worsening when there are other conditions superimposed such as the femur fracture. As a neurologist I have often had to consult elderly in the orthopedic ward, even without known dementia beforehand, who had delirium when under treatment for femur fracture.
However given the fragility of her body if it hasn't already been done some routine tests should be done such as blood count, blood glucose, liver and kidney function tests and electrolytes, in order to look for other potential factors affecting her mental status.
I remain at your disposal for further questions.
Read below.
Detailed Answer:
I understand your worry. One thing I can say is that neither Tylenol nor Naproxen can be blamed for these changes that you notice in her mental status.
It is often hard to identify the issue when it is a question of such an advanced age. You say that she has Alzheimer's as well, that is a progressive disease and furthermore it is known to have fluctuations with worsening when there are other conditions superimposed such as the femur fracture. As a neurologist I have often had to consult elderly in the orthopedic ward, even without known dementia beforehand, who had delirium when under treatment for femur fracture.
However given the fragility of her body if it hasn't already been done some routine tests should be done such as blood count, blood glucose, liver and kidney function tests and electrolytes, in order to look for other potential factors affecting her mental status.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I realize that the disease is progressive. I just want to make sure that she is not receiving too much medication and that she is still able to be as alert as possible and be engaged with the activities provided for her at the facility for altzheimers she is in. She is and has always been a "people" person and that has always been her best medicine. My dad and mom rarely took an aspirin, which I am sure is where my biggest concerns stem from. I appreciate your candor and help.
Brief Answer:
Read below.
Detailed Answer:
I imagine it must be hard for you watching a dear parent change. If the treatment is only Tylenol and Naproxen though, medication is not to blame. Not directly at least, only if they damaged liver or kidney or caused bleeding which is why I mentioned the tests, but otherwise they can't be blamed.
I thank you for your appreciative words. I hope things will work out for the best
Read below.
Detailed Answer:
I imagine it must be hard for you watching a dear parent change. If the treatment is only Tylenol and Naproxen though, medication is not to blame. Not directly at least, only if they damaged liver or kidney or caused bleeding which is why I mentioned the tests, but otherwise they can't be blamed.
I thank you for your appreciative words. I hope things will work out for the best
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
God bless you for taking your time to help loved ones like me. It is truly a gift from God.
Brief Answer:
Thank you.
Detailed Answer:
Thank you! God bless you too!
Thank you.
Detailed Answer:
Thank you! God bless you too!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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