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.
