Differences Between Naproxen vs Tolmetin

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
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Difference Between

Comparison Table: Naproxen vs Tolmetin

Aspect Naproxen Tolmetin
1. Drug Class NSAID (Nonsteroidal Anti-inflammatory Drug) NSAID (Nonsteroidal Anti-inflammatory Drug)
2. Common Brand Names Aleve, Naprosyn Tolectin
3. Mechanism of Action Inhibits COX-1 and COX-2 enzymes to reduce prostaglandins Same – inhibits COX-1 and COX-2
4. Pain Relief Duration Long-acting (8–12 hours) Shorter-acting (4–6 hours)
5. Dosage Frequency 2 times per day (BID) 3 times per day (TID)
6. Onset of Action 30–60 minutes 30–60 minutes
7. Half-life ~12–17 hours ~4–6 hours
8. Indications Arthritis, gout, menstrual pain, muscle pain, fever Osteoarthritis, rheumatoid arthritis, juvenile RA
9. FDA Approval Approved for multiple types of arthritis and pain Mostly approved for arthritis only
10. Pediatric Use Approved for children (above 2 years in some forms) Limited pediatric use
11. Pregnancy Category C (D in 3rd trimester) C (D in 3rd trimester)
12. GI Risk Moderate GI irritation, ulcers Higher GI adverse effects (more common)
13. Cardiovascular Risk May increase risk (especially long-term) Similar risk as other NSAIDs
14. Kidney Risk Can impair renal function Can impair renal function
15. Liver Metabolism Metabolized by liver Metabolized by liver
16. Drug Interactions Interacts with warfarin, lithium, diuretics Similar interactions
17. Availability Widely available (OTC and Rx) Less commonly available
18. Formulations Tablets, gel, suspension, delayed release Capsules, tablets
19. Tolerability Better tolerated by most patients More GI complaints reported
20. Cost Inexpensive, generic widely available Less commonly used, cost may vary

✅ Indications

Drug Indications
Naproxen Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, bursitis, tendonitis, dysmenorrhea, general pain
Tolmetin Osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis

🚫 Contraindications

Drug Contraindications
Naproxen Hypersensitivity to NSAIDs, active GI bleeding or ulcers, late pregnancy, severe renal impairment
Tolmetin Hypersensitivity to tolmetin or NSAIDs, active GI bleeding, asthma triggered by NSAIDs, advanced renal disease

💊 Dosage (Adults)

Drug Initial Dose Maintenance Max Daily Dose
Naproxen 250–500 mg twice daily Adjust based on need 1000–1500 mg
Tolmetin 400 mg three times daily Adjust based on response 1800 mg

⚠️ Warning Signs (Stop and See Doctor)

  • Both drugs share many warning signs. If any of these occur, stop and consult a doctor immediately:

Warning Signs
Severe stomach pain or black/tarry stools
Vomiting blood or material like coffee grounds
Chest pain, shortness of breath
Sudden weight gain or swelling
Yellowing of eyes or skin (jaundice)
Skin rash or blistering
Unusual bruising or bleeding
Severe headache, confusion
Vision changes
Signs of allergic reaction (hives, swelling, trouble breathing)

🧠 Which One is Best and Safer?

Criteria Preferred Drug Why?
Ease of Use Naproxen Longer duration (twice daily vs. three times)
Safety Profile Naproxen Fewer GI complaints, better tolerability
Availability Naproxen Widely available OTC and Rx
Cost Naproxen Cheaper due to availability of generics
Chronic Arthritis Use Tie Both effective, but naproxen may be easier to maintain compliance

Verdict: Naproxen is generally considered safer, more accessible, and better tolerated, especially for long-term use. However, individual response and doctor’s recommendation are essential in deciding the best option.

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