Naproxen vs Celecoxib Comparison Table
| Feature | Naproxen | Celecoxib |
|---|---|---|
| 1. Drug Class | Non-selective NSAID | COX-2 selective NSAID |
| 2. COX Inhibition | Inhibits both COX-1 and COX-2 | Selectively inhibits COX-2 |
| 3. Brand Names | Aleve, Naprosyn, Anaprox | Celebrex |
| 4. Prescription Status | OTC (low dose), RX (higher doses) | Prescription only |
| 5. Indications | Pain, inflammation, arthritis, fever, dysmenorrhea | Osteoarthritis, RA, acute pain, dysmenorrhea, FAP |
| 6. GI Side Effects | Higher risk due to COX-1 inhibition | Lower GI risk |
| 7. Cardiovascular Risk | Lower compared to COX-2 inhibitors | Higher CV risk (heart attack, stroke) |
| 8. Renal Toxicity | Yes, with long-term use | Yes, similar risk |
| 9. Onset of Action | 30-60 minutes | Within 1 hour |
| 10. Half-Life | 12-17 hours | 11 hours |
| 11. Dosing Frequency | 2-3 times daily (BID/TID) | Once or twice daily (OD/BID) |
| 12. Formulations | Tablet, capsule, suspension | Capsule |
| 13. Metabolism | Liver (CYP450 enzymes) | Liver (CYP2C9 enzyme) |
| 14. Use in Sulfa Allergy | Safe | Contraindicated (contains sulfonamide group) |
| 15. Pregnancy Category | Avoid in 3rd trimester | Avoid in 3rd trimester |
| 16. Cost | Generally cheaper | More expensive |
| 17. Approval Date | 1976 (FDA) | 1998 (FDA) |
| 18. Interaction with Aspirin | May interfere with aspirin’s cardioprotection | Less interference |
| 19. Effect on Platelets | Inhibits platelet aggregation | Minimal effect on platelets |
| 20. Chronic Use Monitoring | Renal, GI, cardiovascular | Cardiovascular, renal, sulfa sensitivity |
Indications
| Drug | Common Indications |
|---|---|
| Naproxen | Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, tendonitis, bursitis, menstrual cramps, mild to moderate pain, fever |
| Celecoxib | Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, juvenile RA, primary dysmenorrhea, acute pain, familial adenomatous polyposis (FAP) |
Contraindications
| Drug | Contraindications |
|---|---|
| Naproxen | History of asthma, urticaria, or allergic-type reactions after aspirin/NSAIDs; active GI bleeding or ulcers; severe renal or liver impairment |
| Celecoxib | Sulfa allergy, history of allergic reactions to NSAIDs, recent coronary artery bypass surgery (CABG), severe hepatic impairment, GI bleeding |
Dosage (Typical Adult)
| Drug | Dosage Range |
|---|---|
| Naproxen | 250–500 mg orally twice daily; max 1000–1250 mg/day |
| Celecoxib | 100–200 mg once or twice daily depending on condition; max 400 mg/day |
Warning Signs (Seek Medical Help If)
| Drug | Serious Warning Signs |
|---|---|
| Naproxen | Black/tarry stools, severe stomach pain, vomiting blood, chest pain, shortness of breath, sudden weight gain, swelling in limbs |
| Celecoxib | Chest pain, shortness of breath, slurred speech, vision changes, black stools, allergic reaction (rash, swelling, breathing) |
Which is Best and Safer?
| Criteria | Best Option |
|---|---|
| Lower GI Risk | Celecoxib (COX-2 selective, fewer ulcers) |
| Lower CV Risk | Naproxen (less risk of heart attack/stroke) |
| Pain Control | Both effective—celecoxib may be better tolerated |
| Chronic Use | Celecoxib preferred for GI protection if CV risk low |
| Cost-Effectiveness | Naproxen (available OTC, generally cheaper) |
| Best Overall | Depends on patient profile: |
| – GI problems? Celecoxib is safer | |
| – Heart problems? Naproxen is safer |
