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.