Comparison Table: 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 |
Indications
| Condition | Naproxen | Etoricoxib |
|---|---|---|
| Osteoarthritis |  Yes |
Yes |
| Rheumatoid arthritis | Yes |
Yes |
| Ankylosing spondylitis | Yes |
Yes |
| Acute gout | Yes |
Yes |
| Dental pain | Yes |
Yes |
| Menstrual pain | Yes |
 Off-label |
| Postoperative pain | Yes |
Yes |
| Fever | Yes |
Not standard use |
Contraindications
| 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 |
Dosage (Typical Adult)
| 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 |
Warning Signs to Stop the Drug
-
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)
-
Which is Best and Safer?
| 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 |
