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)
| 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.
