Comparison Table: Naproxen vs Etodolac
| Aspect | Naproxen | Etodolac |
|---|---|---|
| 1. Drug Class | NSAID (Non-Steroidal Anti-Inflammatory Drug) | NSAID |
| 2. Brand Names | Aleve, Naprosyn, Anaprox | Lodine |
| 3. Mechanism of Action | Non-selective COX-1 and COX-2 inhibitor | Preferential COX-2 inhibitor |
| 4. Pain Relief Onset | 30–60 minutes | 1–2 hours |
| 5. Duration of Action | 8–12 hours | 6–8 hours |
| 6. Anti-inflammatory Effect | Strong | Moderate to strong |
| 7. Half-Life | 12–17 hours | 6–8 hours |
| 8. Dosing Frequency | Twice daily | 2–3 times daily |
| 9. Common Use | Arthritis, menstrual pain, muscle pain, gout | Osteoarthritis, rheumatoid arthritis |
| 10. GI Side Effects Risk | Higher (due to COX-1 inhibition) | Lower (due to COX-2 preference) |
| 11. Heart Risk | Lower than selective COX-2 inhibitors | Slightly higher cardiovascular risk |
| 12. Renal Risk | Present – can cause kidney damage | Present – similar renal risk |
| 13. Liver Risk | Rare, mild hepatotoxicity possible | Mild to moderate risk |
| 14. Formulations Available | Tablets, suspension, delayed release, topical | Tablets, extended-release tablets |
| 15. Pediatric Use | Yes (over 2 years under medical guidance) | Not typically recommended under 18 years |
| 16. Pregnancy Category | Category C (1st & 2nd trimester), D (3rd trimester) | Category C (1st & 2nd trimester), D (3rd trimester) |
| 17. Cost | Usually cheaper (generic widely available) | Generally more expensive |
| 18. Interactions | Warfarin, ACE inhibitors, diuretics, lithium | Warfarin, methotrexate, lithium |
| 19. COX-2 Selectivity | Low (non-selective) | Moderate (COX-2 preferential) |
| 20. Availability | Widely available OTC and Rx | Rx only |
Indications
| Naproxen | Etodolac |
|---|---|
| Osteoarthritis, rheumatoid arthritis, gout | Osteoarthritis, rheumatoid arthritis |
| Ankylosing spondylitis | Postoperative pain |
| Dysmenorrhea (menstrual cramps) | General pain and inflammation |
| Tendonitis, bursitis, muscle sprains | Musculoskeletal pain |
| Fever (in some off-label uses) | Not commonly used for fever |
Contraindications
| Naproxen | Etodolac |
|---|---|
| Hypersensitivity to naproxen or NSAIDs | Hypersensitivity to etodolac or other NSAIDs |
| History of asthma, urticaria, or allergic reaction with aspirin/NSAIDs | History of NSAID-induced asthma or allergy |
| Active GI bleeding or peptic ulcer disease | Active peptic ulcer or GI bleeding |
| Severe heart failure | Severe heart failure |
| Renal or hepatic impairment | Advanced renal disease or hepatic dysfunction |
Typical Adult Dosage
| Drug | Initial Dose | Maintenance Dose | Max Daily Dose |
|---|---|---|---|
| Naproxen | 250–500 mg twice daily | 250–500 mg every 12 hours | 1000–1500 mg/day |
| Etodolac | 200–400 mg every 6–8 hours | 300–400 mg twice daily | 1200 mg/day |
Warning Signs (Stop and See Doctor)
| Naproxen | Etodolac |
|---|---|
| Black/tarry stools or blood in stool | Stomach pain, nausea, vomiting with blood |
| Chest pain or shortness of breath | Chest tightness or difficulty breathing |
| Sudden weight gain or swelling in legs | Unusual fatigue or yellowing of skin (liver issues) |
| Severe rash or itching | Allergic reaction: swelling, wheezing |
| Decreased urination or signs of kidney dysfunction | Abdominal pain with loss of appetite |
Which One is Best and Safe?
| Criteria | Preferred Drug |
|---|---|
| Lower GI Risk | Etodolac (more COX-2 selective, less GI toxicity) |
| Lower Cardiovascular Risk | Naproxen (safer for heart patients compared to other NSAIDs) |
| Better for Long-term Use | Depends – Etodolac for GI sensitivity, Naproxen for heart-safe profile |
| Cost and Accessibility | Naproxen (cheaper and available OTC) |
| Overall Best for General Use | Naproxen for most patients; Etodolac for GI-sensitive users |
| Safety in Children | Naproxen (approved in children over 2 years) |
