Nurse educated the patient and caregiver on contraindications for using Aleve as follows:

1. Patients with history of dyspepsia and heartburn must be cautious about using Aleve. Discuss with your doctor regarding your history of the same.
2. Aleve must be used cautiously in individuals with history of gastric ulcers, as intake of this medication can lead to increased exposure of the stomach lining to the action of gastric acid, leading to erosion of gastric mucosa and development of gastric ulcers. Using enteric coated Aleve can help this situation.
3. Aleve must be avoided or used cautiously in individuals with history of compromised renal function. Aleve inhibits the production of prostaglandins in all the tissues, including the renal. Inhibition of prostaglandin synthesis in the kidneys, result in vasoconstriction and reduced blood flow to the renal tissue. Reduced blood flow to the renal tissue can contribute to further compromise of renal function.
4. Aleve must be avoided or used cautiously in individuals with history of hypertension and heart failure. Reduced renal function, secondary to Aleve intake, can contribute towards compromise in filtration of blood, leading to reduced formation of urine and fluid back up in the body. Fluid accumulation in the body can result in edema and weight gain. This backed up fluid can increase the fluid volume and workload on the heart that is already in failure, thus further worsening the cardiac function.
5. Aleve must be avoided or used cautiously in individuals with history of exacerbation of SOB with episodes of asthma and growth of nasal polyps with other NSAIDs.
6. Aleve has the potential to compromise coronary circulation and result in chest pain and myocardial infarction. So, Aleve must be avoided or used cautiously in individuals with history of myocardial infarction. Aleve must also be avoided during immediate post-surgical period, in individuals who underwent coronary artery bypass grafting (CABG).
7. Aleve is mainly metabolized by the liver and Aleve intake can lead to hepatic injury. Individuals with history of compromised liver function cannot metabolize Aleve and this can lead to increased blood levels of Aleve for longer duration, leading to toxicity. Aleve should be avoided or used with extreme caution in such individuals.
8. Aleve is significantly excreted in the urine. Individuals with compromised renal functions tend to retain the drug in the circulation longer, thus resulting in toxicity. Aleve should be avoided or used with extreme caution in such individuals.