Naproxen vs Celecoxib Comparison

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

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)

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

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

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)

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