Naproxen vs. Mefenamic Acid: Comparison Table
| Category | Naproxen | Mefenamic Acid |
|---|---|---|
| 1. Drug Class | NSAID (Non-Steroidal Anti-Inflammatory Drug) | NSAID (Non-Steroidal Anti-Inflammatory Drug) |
| 2. Common Brand Names | Aleve, Naprosyn | Ponstel (USA), Mefspas, Meftal |
| 3. Mechanism of Action | Inhibits COX-1 and COX-2, reducing prostaglandin synthesis | Primarily COX-2 inhibition, some COX-1, reduces prostaglandin synthesis |
| 4. Use Duration | Suitable for long-term use under supervision | Recommended for short-term use only (≤7 days) |
| 5. Approved Indications | Arthritis, gout, menstrual pain, muscle pain, tendonitis, backache | Primary dysmenorrhea (menstrual pain), mild to moderate pain |
| 6. Pain Intensity | Used for moderate to severe pain | More effective for mild to moderate pain |
| 7. Onset of Action | 30–60 minutes | 15–30 minutes |
| 8. Half-Life | Long (12–17 hours) | Short (2–4 hours) |
| 9. Dosing Frequency | 1–2 times daily | 3–4 times daily |
| 10. Adult Dosage | 250–500 mg twice daily (max 1000–1250 mg/day) | 250–500 mg every 6 hours (max 1500 mg/day, ≤7 days) |
| 11. Pediatric Use | Approved for use in children (age-specific dosing) | Not recommended in children under 14 years |
| 12. Pregnancy Category | Category C (1st & 2nd trimester); D (3rd trimester) | Category C (1st & 2nd trimester); D (3rd trimester) |
| 13. Renal Safety | Can affect kidney function with long-term use | May cause nephrotoxicity if overused |
| 14. GI Side Effects | Common: stomach ulcers, gastritis, bleeding | More likely to cause stomach cramps and diarrhea |
| 15. Liver Toxicity Risk | Low to moderate | Slightly higher risk of liver enzyme elevation |
| 16. Drug Interactions | Interacts with anticoagulants, ACE inhibitors, diuretics | Similar interactions but more cautious with warfarin |
| 17. Menstrual Pain Use | Effective, but not first-line | Specifically effective for menstrual cramps |
| 18. Anti-Inflammatory Power | Strong anti-inflammatory effect | Mild to moderate anti-inflammatory effect |
| 19. Cost & Availability | Widely available, inexpensive | Slightly more expensive, less widely available |
| 20. Duration of Therapy | Chronic pain conditions – can be used long-term under supervision | Limited to short-term use due to GI & liver side effects |
✅ Indications
| Naproxen | Mefenamic Acid |
|---|---|
| – Osteoarthritis, rheumatoid arthritis | – Dysmenorrhea (menstrual pain) |
| – Gout and bursitis | – Mild to moderate general pain |
| – Tendonitis, back pain | – Muscle aches, dental pain (short use) |
| – Fever, migraine | – Post-operative pain (short-term) |
❌ Contraindications
| Naproxen | Mefenamic Acid |
|---|---|
| – Peptic ulcer, GI bleeding history | – Active ulcer or GI bleeding |
| – Severe renal or hepatic impairment | – Inflammatory bowel disease |
| – Asthma triggered by NSAIDs | – Severe renal dysfunction |
| – Pregnancy (3rd trimester), breastfeeding | – Pregnancy (3rd trimester), children <14 |
💊 Recommended Dosage
| Drug | Adult Dose | Max Daily Dose | Duration of Use |
|---|---|---|---|
| Naproxen | 250–500 mg every 12 hours | 1000–1250 mg | Can be used long-term |
| Mefenamic Acid | 250–500 mg every 6–8 hours | 1500 mg | Max 7 days |
⚠️ Warning Signs (Stop Use and See Doctor)
For Both Drugs:
Black, tarry stools (GI bleeding)
Severe abdominal pain
Yellowing of skin/eyes (liver issue)
Unusual bruising or bleeding
Shortness of breath, chest pain
Skin rash or swelling of face/lips
High blood pressure symptoms
Changes in urination (kidney dysfunction)
💡 Which is Best and Safer?
| Aspect | Naproxen | Mefenamic Acid |
|---|---|---|
| Safety in Long-Term Use | ✅ Safer under supervision | ❌ Not recommended for long-term use |
| Menstrual Pain Relief | ✅ Effective, but not targeted | ✅ Specifically effective for dysmenorrhea |
| GI Tolerability | ❌ Risk of ulcer, but less diarrhea | ❌ More diarrhea and cramps |
| Chronic Pain Conditions | ✅ Suitable (arthritis, gout) | ❌ Not suitable |
| Dosing Convenience | ✅ 1–2 times/day | ❌ 3–4 times/day |
🟢 Conclusion:
Naproxen is better and safer for long-term use, chronic pain, arthritis, and general inflammation.
Mefenamic Acid is best suited for short-term relief of menstrual pain in young, healthy adults without GI or kidney problems.
