Differences Between Naproxen vs Etoricoxib

Feature	Naproxen	Etoricoxib
1. Drug Class	Non-selective NSAID	Selective COX-2 inhibitor
2. Mechanism of Action	Inhibits both COX-1 and COX-2 enzymes	Selectively inhibits COX-2 enzyme
3. Brand Names	Aleve, Naprosyn	Arcoxia
4. Prescription Required	OTC for low doses; Rx for high doses	Prescription-only
5. Anti-inflammatory Effect	Strong	Strong
6. Analgesic Effect	Effective	Effective
7. Antipyretic Effect	Yes	Yes
8. Onset of Action	Within 1 hour	Within 1 hour
9. Duration of Action	8–12 hours	Up to 24 hours
10. Dosing Frequency	2–3 times/day	Once daily
11. Half-life	12–17 hours	22 hours
12. Gastric Risk	High (due to COX-1 inhibition)	Lower (due to COX-2 selectivity)
13. Cardiovascular Risk	Lower than COX-2 inhibitors	Higher risk of heart attack and stroke
14. Renal Risk	Moderate	Moderate to high
15. Use in Hypertension	Caution needed	Not recommended
16. Use in Peptic Ulcer	Avoid unless taken with PPI	Safer than naproxen, but still caution needed
17. Use in Asthma	Can trigger NSAID-induced asthma	Safer in aspirin-sensitive patients
18. Cost	Generally cheaper	More expensive
19. Availability	Widely available globally	Limited availability in some countries
20. Long-term Use	Higher risk of GI complications	Higher risk of cardiovascular complications

Condition	Naproxen	Etoricoxib
Active peptic ulcer	❌ Contraindicated	❌ Contraindicated
Severe heart failure	⚠️ Use with caution	❌ Contraindicated
Severe liver or kidney disease	❌ Contraindicated	❌ Contraindicated
History of stroke or MI	⚠️ Use with caution	❌ Contraindicated
Pregnancy (especially 3rd trimester)	❌ Contraindicated	❌ Contraindicated

Drug	Initial Dose	Maintenance Dose	Max Daily Dose
Naproxen	250–500 mg twice daily	250 mg every 6–8 hrs	1250 mg/day (Rx); 660 mg/day (OTC)
Etoricoxib	60–120 mg once daily	Depends on condition	120 mg/day

Both Drugs:
- Severe stomach pain or black tarry stools (GI bleed)
- Shortness of breath or chest pain (cardiac risk)
- Swelling of legs (edema)
- Yellowing of eyes/skin (liver damage)
- Decreased urine output (kidney damage)
- Skin rash, especially with fever (hypersensitivity)

Criteria	Preferred Drug	Explanation
Short-term pain (e.g., dental)	Naproxen	Fast-acting, cost-effective, widely available
Long-term joint pain (arthritis)	Etoricoxib (short-term)	Better GI tolerance but monitor heart risk
High cardiovascular risk	Naproxen	Lower heart-related complications
History of GI ulcers	Etoricoxib + PPI	Less stomach irritation
Cost-conscious patients	Naproxen	Cheaper and available over-the-counter
Convenience (once-daily dosing)	Etoricoxib	Long half-life allows once-a-day dosing