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Differences Between Naproxen vs. Diclofenac

Comparison Table: Naproxen vs. Diclofenac

Feature Naproxen Diclofenac
1. Drug Class NSAID (Non-Steroidal Anti-Inflammatory Drug) NSAID (Non-Steroidal Anti-Inflammatory Drug)
2. Chemical Class Propionic acid derivative Acetic acid derivative
3. Prescription Status OTC and prescription Mostly prescription only
4. Common Brand Names Aleve, Naprosyn Voltaren, Cataflam
5. Route of Administration Oral, topical, rectal Oral, topical, rectal, injectable
6. Onset of Action 30–60 minutes 15–30 minutes
7. Duration of Action Longer duration (8–12 hours) Shorter duration (6–8 hours)
8. Dosing Frequency Usually twice daily Usually 2–4 times daily
9. Anti-inflammatory Potency Moderate Higher
10. Pain Relief Potency Moderate Stronger, especially for joint inflammation
11. GI Side Effects Moderate to high High (especially risk of ulcers)
12. Cardiovascular Risk Lower than diclofenac Higher cardiovascular risk
13. Renal Risk Present, especially with long-term use Present, often higher than naproxen
14. Liver Toxicity Risk Rare Higher risk than naproxen
15. Use in Arthritis Commonly used for osteoarthritis and rheumatoid arthritis Highly effective for arthritis (including ankylosing spondylitis)
16. Fever Reduction Effective Less commonly used for fever
17. Availability of Topical Yes (less common) Widely available and effective (e.g., Voltaren Gel)
18. Cost Usually lower Usually higher
19. Interaction with Aspirin May reduce aspirin’s heart benefits Stronger interaction—avoid use with aspirin
20. Pregnancy Use Avoid in 3rd trimester; Category C before then Avoid in pregnancy; Category D in 3rd trimester

📋 Indications

Condition Naproxen Diclofenac
Osteoarthritis ✅ Yes ✅ Yes
Rheumatoid arthritis ✅ Yes ✅ Yes
Ankylosing spondylitis ✅ Yes ✅ Yes
Menstrual cramps ✅ Yes ✅ Yes
Gout flare-ups ✅ Yes ✅ Yes
Muscle and joint pain ✅ Yes ✅ Yes
Post-operative pain ✅ Yes ✅ Yes
Fever ✅ Sometimes ❌ Rarely used
Back pain ✅ Yes ✅ Yes

🚫 Contraindications

Condition or Situation Naproxen Diclofenac
Peptic ulcer disease ❌ Contraindicated ❌ Contraindicated
Severe heart failure ⚠️ Use with caution ❌ Contraindicated
Pregnancy (3rd trimester) ❌ Avoid ❌ Avoid
Kidney disease ⚠️ Use with caution ⚠️ Use with caution
Liver disease ⚠️ Rarely an issue ❌ Use with caution/avoid
Aspirin allergy ❌ Avoid ❌ Avoid
Active bleeding (e.g., GI or brain) ❌ Contraindicated ❌ Contraindicated
Children <2 years ❌ Not recommended ❌ Not recommended

💊 Typical Dosage

Parameter Naproxen Diclofenac
Adult Oral Dose 250–500 mg twice daily 50–75 mg 2–3 times daily
Max Daily Dose 1,000–1,250 mg/day 150 mg/day (oral); 100 mg/day (topical)
Topical Dose Applied to affected area 2–4 times/day Gel: 2–4 g up to 4 times/day
Half-life 12–17 hours 1–2 hours (short, requires more frequent use)

⚠️ Warning Signs to Stop Immediately

Symptom Both Drugs (Applicable)
Severe stomach pain or black stools 🚨 Possible GI bleeding
Chest pain, shortness of breath 🚨 Heart attack risk
Swelling in legs, rapid weight gain 🚨 Heart failure or kidney issues
Yellowing of skin or eyes (jaundice) 🚨 Liver damage
Decreased urination or blood in urine 🚨 Kidney dysfunction
Skin rash, blistering, or allergic reaction 🚨 Hypersensitivity reaction

✅ Which One Is Best and Safe?

Criteria Best Choice
Long-term safety Naproxen (lower heart risks)
Strong anti-inflammatory Diclofenac (especially topical)
Lower gastrointestinal risk Naproxen with PPI (e.g., omeprazole)
Topical use Diclofenac (Voltaren gel)
Heart patient safety Naproxen (preferable)
Budget-friendly Naproxen

Conclusion:

  • Naproxen is safer for long-term use, especially in patients with heart concerns, and is more affordable and widely available.

  • Diclofenac is more potent for inflammation and pain, particularly when used as a topical gel, but comes with higher heart, liver, and GI risks.

  • Always consult a doctor before using either, especially for chronic conditions.

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