Comparison Table: Naproxen vs Rofecoxib
| Feature | Naproxen | Rofecoxib |
|---|---|---|
| 1. Drug Class | NSAID (Non-selective COX inhibitor) | COX-2 selective NSAID |
| 2. Brand Name | Aleve, Naprosyn | Vioxx (withdrawn from market) |
| 3. COX Inhibition | Inhibits both COX-1 and COX-2 | Selectively inhibits COX-2 |
| 4. Pain Relief Type | General pain, inflammation, fever | Pain & inflammation with less GI upset |
| 5. GI Risk | Higher risk of ulcers & stomach bleeding | Lower GI risk but higher heart risk |
| 6. Heart Risk | Lower risk of heart attack or stroke | High risk; linked to cardiovascular events |
| 7. Availability | Available OTC and prescription | Withdrawn in most countries since 2004 |
| 8. Anti-inflammatory Power | Strong | Strong |
| 9. Fever Reduction | Effective | Less used for fever |
| 10. Onset of Action | 30–60 minutes | 1–2 hours |
| 11. Half-Life | 12–17 hours | ~17 hours |
| 12. Duration of Effect | Long-lasting | Long-lasting |
| 13. Use in Arthritis | Common for osteoarthritis & rheumatoid arthritis | Was used in same conditions |
| 14. Use in Cardiovascular Disease | Safer option | Not safe due to high heart risk |
| 15. FDA Status | Approved and widely used | Withdrawn due to safety concerns |
| 16. Drug Interactions | Interacts with blood thinners, diuretics | Fewer GI interactions, but CV risks |
| 17. Use in Children | Approved for some pediatric uses | Not recommended |
| 18. Dose Flexibility | Multiple strengths & forms | Limited options |
| 19. Formulation | Tablets, gel, liquid, extended-release | Tablets only (before withdrawal) |
| 20. Market Presence | Globally available | Withdrawn from most markets |
Indications
| Drug | Indications |
|---|---|
| Naproxen | Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, tendinitis, bursitis, menstrual pain, general pain, fever |
| Rofecoxib | Previously used for osteoarthritis, rheumatoid arthritis, acute pain, dysmenorrhea (before withdrawal) |
Contraindications
| Drug | Contraindications |
|---|---|
| Naproxen | History of GI ulcers or bleeding, severe kidney/liver disease, allergy to NSAIDs, pregnancy (3rd trimester) |
| Rofecoxib | History of cardiovascular disease, stroke, uncontrolled hypertension, severe liver disease, pregnancy, sulfa allergy |
Dosage (Adults)
| Drug | Typical Dose |
|---|---|
| Naproxen | 250–500 mg twice daily (max: 1000–1250 mg/day) |
| Rofecoxib | 12.5–25 mg once daily (when it was in use) |
Warning Signs (Stop Use & See Doctor)
| Drug | Warning Signs |
|---|---|
| Naproxen | Black/tarry stools, vomiting blood, chest pain, shortness of breath, swelling, high blood pressure |
| Rofecoxib | Chest pain, shortness of breath, weakness on one side, vision changes, sudden headache (stroke/MI signs) |
Which One is Better and Safer?
| Aspect | Verdict |
|---|---|
| For long-term arthritis pain | Naproxen is better due to availability and lower heart risk |
| For patients with GI issues | Rofecoxib was preferred but no longer safe due to heart risks |
| For cardiovascular safety | Naproxen is significantly safer |
| Market status | Naproxen is approved and available; Rofecoxib is banned in most countries due to risk of heart attack and stroke |
Conclusion:
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Naproxen is safer and more widely recommended for most people due to its balanced pain relief and manageable side effect profile, especially for long-term use.
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Rofecoxib had fewer stomach issues but posed a serious risk of heart attacks and strokes, leading to its withdrawal from the market.
