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Differences Between Naproxen vs. Mefenamic Acid

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.

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