Naproxen vs. ibuprofen: Similarities and differences

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Naproxen and ibuprofen are both nonsteroidal anti-inflammatory drugs (NSAIDs). They reduce pain, stiffness, swelling, and fever connected with inflammation.

Naproxen (Aleve) and ibuprofen (Advil) are available at higher strengths as prescriptions and lower strengths when purchased over the counter.

In this article, we provide an overview of the similarities and differences between naproxen and ibuprofen, including:

• how they work
• their uses
• how to take them
• side effects
• interactions
• costs
• use in pregnancy and breastfeeding

Share on PinterestNaproxen and ibuprofen may reduce pain, stiffness, and swelling.

Naproxen and ibuprofen reduce inflammation by preventing an enzyme from making prostaglandins. Prostaglandins are a critical factor for inflammation.

Inflammation is the body’s natural response to injury or infection. Doctors link chronic inflammation with various health conditions, including inflammatory bowel disease (IBD) and some forms of arthritis.

Heat, redness, pain, and swelling are signs of inflammation. People may experience pain relief that can occur shortly after taking an NSAID, but it can take weeks for the inflammation to go away.

When prostaglandins reach the brain, they can cause fever that naproxen and ibuprofen can also treat.

By blocking the enzyme that produces prostaglandins, NSAIDs can impair platelet activity, hindering blood clots from forming.

Naproxen and ibuprofen can have different uses, some of which overlap.

Experts approve naproxen for the following:

• ankylosing spondylitis
• bursitis
• gout attacks
• osteoarthritis
• body aches, minor muscle aches, and pains in bones and joints
• menstrual cramps and other menstrual pain
• rheumatoid arthritis
• tendonitis

People take ibuprofen for the following:

• fever
• headache
• migraine
• osteoarthritis
• pain
• menstrual cramps
• rheumatoid arthritis

The American College of Rheumatology recommend NSAIDs for the initial management of osteoarthritis of the hands, hips, and knees but do not list one NSAID as more effective than another.

However, some people should not take ibuprofen, such as those who are taking aspirin for heart protection.

Although approving for rheumatoid arthritis use, the American College of Rheumatology’s 2015 recommendations do not list NSAIDs as a long term treatment option because of their side effects. People may use NSAIDs for a short period early in rheumatoid arthritis, while other medications take effect.

People can take an NSAID to treat menstrual cramps, which can be effective in reducing pain, but researchers do not know whether one NSAID is better than another.

Naproxen is available in two forms: Naproxen and naproxen sodium. The body absorbs naproxen sodium better than naproxen. Doses are in milligrams (mg) in the table below:

Share on PinterestSide effects of naproxen and ibuprofen may include nausea and heartburn.

The most common side effects of naproxen and ibuprofen are:

• heartburn
• constipation
• abdominal pain
• nausea
• headache
• dizziness
• drowsiness
• itching
• rash
• difficulty breathing
• fluid retention
• ringing in ears or tinnitus
• skin discoloration

Although available over the counter, naproxen and ibuprofen may not be safe for people with the following conditions:

• heart disease
• peptic ulcers
• stroke

In 2015, the Food and Drug Administration (FDA) strengthened an existing warning about non-aspirin NSAIDs, increasing the risk of heart attack or stroke.

People who take prescription naproxen or ibuprofen may have increased risks for:

• stroke
• heart attack
• hemorrhagic death
• gastrointestinal inflammation, bleeds, and ulcers

The risk of cardiovascular events, clots, heart attack, and stroke may be higher in people with a history of cardiovascular disease or risk factors for cardiovascular disease.

If taking NSAIDs within 2 weeks after heart surgery, people may be at an increased risk for heart attack and stroke.

People who take naproxen or ibuprofen may have a greater risk of developing high blood pressure, heart failure, and water retention. Older adults are more vulnerable to these severe side effects.

People who take over-the-counter naproxen and ibuprofen at the labeled dose for 7–10 days may not have an increased risk of adverse effects.

To minimize the risk for these adverse effects, people should take naproxen or ibuprofen at the lowest dose for the shortest length of time.

Both ibuprofen and naproxen may interact with several other drugs:

• Ibuprofen may interact with aspirin, making the aspirin less effective in protecting the heart and preventing strokes.
• Ibuprofen may interact with antidepressants and blood thinners and so increase the risk of bleeding.
• Ibuprofen may slow the elimination of lithium or methotrexate, which could result in dangerous levels of these drugs.
• Naproxen interacts with alcohol, antidepressants, steroids, and blood thinners, so raising the risk of gastrointestinal bleeding and ulcers.
• People should avoid taking naproxen and ibuprofen together. Also, they should avoid taking more than one NSAID at a time because this may increase the risk of side effects.

Before starting naproxen or ibuprofen, a person must have their medication list checked by a doctor or pharmacist to identify any potential interactions.

People can find these drugs at drug stores, supermarkets, and online markets:

• Shop for naproxen.
• Shop for naproxen sodium.
• Shop for ibuprofen.

The costs vary between brands. Cost estimates for prescription strengths include the following:

• 60 tablets of naproxen 250 mg are $25.50
• 60 tablets of naproxen 500 mg are $35.67
• 30 tablets of ibuprofen 400 mg are $11.83
• 30 tablets of ibuprofen 800 mg are $13.89

People in the third trimester of pregnancy should avoid taking naproxen, as it may lead to heart development problems in the fetus.

Doctors do not recommend naproxen or ibuprofen for people who are breastfeeding because the nursing baby may develop side effects.

Naproxen and ibuprofen are prescription and nonprescription NSAIDs that people can use to treat pain they experience with a wide variety of inflammatory conditions. The main differences between the two NSAIDs are their uses, frequency of doses, doses, and drug interactions.

Despite their availability, these drugs may not be safe for everyone because of existing health conditions and potential interactions with other medications.

People with gastrointestinal, cardiac, or kidney disease should talk to their doctor before starting an NSAID. A doctor or pharmacist will check for drug interactions before having someone start an NSAID.

People who are in their third trimester or breastfeeding should not take an NSAID.

Typically, when people use them at the correct dose and for the right time, naproxen and ibuprofen are safe and effective drugs for the treatment of inflammatory pain.

Q:

What happens if you take naproxen and ibuprofen together?

A:

The most likely side effects would be heartburn, nausea, and some bleeding in your stomach if only done once. Continued use together would increase your risk of vomiting, developing an ulcer, abdominal pain, prolonged bleeding in your stomach, fluid retention, and other severe side effects. Always read the label on the bottle to avoid combining the two, and do not exceed the recommended doses.

Alan Carter, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Naproxen vs ibuprofen: What’s the difference?

Medically reviewed by Drugs.com. Last updated on March 20, 2023.

Naproxen and ibuprofen are both NSAIDs, but which one is more effective or more likely to cause side effects?

Ibuprofen is short acting, while naproxen is long acting and more likely to cause an upset stomach.

Naproxen and ibuprofen are both NSAIDs so they are similar in many ways, but there are important differences.

Effectiveness of Naproxen and Ibuprofen

Naproxen and ibuprofen are called nonselective NSAIDs because they block COX-2 enzymes (involved in pain signalling and inflammation) and also COX-1 enzymes (associated with a protective effect on stomach lining). This makes them effective at relieving pain and reducing inflammation, but there is a risk of stomach-related side effects. As far as effectiveness goes, a dose of 440mg naproxen is approximately equivalent to a dose of 400mg ibuprofen.

Naproxen is Long Acting and Ibuprofen is Short Acting

One of the most important differences is the length of time they act for. Ibuprofen is considered a short-acting NSAID, with a relatively quick onset of action. It is better suited for the treatment of acute pain and is the most appropriate NSAID for children. Ibuprofen tablets or capsules (such as Advil, Motrin) need to be given every four to six hours. Naproxen is considered long-acting, and can be given twice daily. It has a slower onset of effect and is better suited for the treatment of chronic conditions.

Naproxen is More Likely to Cause Gastrointestinal Side Effects Because it is Long Acting

Research has discovered that the risk of gastrointestinal (GI) side effects such as stomach ulcers and stomach bleeding increases the longer somebody takes NSAIDS. Naproxen is more likely than ibuprofen to cause GI side effects because it is longer acting. To reduce the risk of GI side effects, NSAIDS should only be taken at their lowest effective dose, for the shortest possible time. Doubling up on NSAIDs (for example taking naproxen and ibuprofen at the same time) is unnecessary, and to be avoided as it increases the risk of both GI and cardiovascular side effects. If you are prescribed low-dose aspirin to reduce your risk of a heart attack or stroke, then talk to your doctor BEFORE taking NSAIDs, as these may negate the protective effects of aspirin.

NSAIDs Increase the Risk Of Cardiovascular Side Effects

Another worrying side effect of some NSAIDs is an increased risk of cardiovascular events such as a heart attack. Research has identified that those NSAIDs that have more of a tendency to block COX-2 compared to COX-1 have an increased risk of thrombosis (blood clotting). Naproxen (at dosages up to 1000mg per day) does not appear to be associated with an increased risk of detrimental vascular events, and experts tend to prefer naproxen for this reason. Low-dose ibuprofen (dosages up to 1200mg per day) is considered an alternative to naproxen; however, higher dosages of ibuprofen (up to the recommended maximum of 2400mg/day) are associated with a higher risk of cardiovascular events. People who have already had a heart attack or stroke must use NSAIDs with caution. One study showed that even one or two doses of ibuprofen or diclofenac (another NSAID) increased the risk of another event. During the 14 weeks of the study, naproxen did not appear to increase this risk. However, NSAIDS should not be used after coronary artery bypass graft (CABG) surgery and all NSAIDS carry a warning that they can increase the risk of cardiovascular events, so should only be used under a doctor’s supervision, particularly in people with a history of heart disease. Reassuringly, the risk of a cardiovascular event such as a heart attack, stroke, or death is extremely small when NSAIDs are prescribed for short periods of time – such as for a musculoskeletal injury – in people at low cardiovascular risk.

Other Side Effects Common to all NSAIDs

All NSAIDs have been associated with kidney toxicity and allergic-type reactions. NSAIDs also interact with other medications including angiotensin converting enzyme (ACE) inhibitors, angiotensin-II receptor blockers (ARBs), diuretics, clopidogrel, warfarin, dabigatran, and aspirin.

In summary

Naproxen (in dosages up to 1000mg/day) or low-dose ibuprofen (in dosages up to 1200mg/day) are preferred if NSAIDs are deemed necessary in adults. At these dosages, risk of cardiovascular events in people with no pre-existing risk factors is low, although risk of GI side-effects may be higher with naproxen.

Important Guidance

When taking any NSAID, the following guidance is given:

• Acetaminophen is preferred over NSAIDs, when appropriate
• If a NSAID is deemed necessary, take only the lowest possible dose for the shortest possible time
• Naproxen (in dosages up to 1000mg/day) and ibuprofen (in dosages up to 1200mg/day) are the preferred NSAIDs. Ibuprofen is the most appropriate NSAID for children
• Avoid using long-acting formulations of NSAIDs as these have a higher risk of GI side effects
• Do not take any other NSAID-containing products while being treated with a NSAID
• Doctors should review the need for continued NSAID administration at each consultation
• In people with pre-existing heart disease or who have suffered a heart attack or stroke, NSAIDS should only be used with caution and only under a doctor’s supervision
• Older patients, patients with type 2 diabetes or with a history of stomach ulcers, kidney problems or at risk for heart disease are more likely to suffer from NSAID-related complications such as GI side effects, cardiovascular events, and kidney toxicity. NSAIDS should be avoided, but if deemed necessary, their usage should be monitored by a doctor.

References

1. Laura Dean, MD. Comparing NSAIDs. Pubmed Clinical Q & A. http://www.ncbi.nlm.nih.gov/books/NBK45590/
2. Non-steroidal anti-inflammatory drugs (NSAIDs): Making safer treatment choices BPAC NZ http://www.bpac.org.nz/BPJ/2013/October/nsaids.aspx
3. Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A, et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013 Aug 31;382(9894):769-79. doi: 10.1016/S0140-6736(13)60900-9. Epub 2013 May 30. http://www.ncbi.nlm.nih.gov/pubmed/23726390
4. Naproxen [Package Insert]. Revised 03/2016. Genentech, Inc https://www.drugs.com/dosage/naproxen.html
5. Ibuprofen [Package Insert] Revised 07/2015 Alivio Medical Products, LLC https://www. drugs.com/pro/alivio.html
6. Ong CKS, Lirk P, Tan CH, Seymour RA. An Evidence-Based Update on Nonsteroidal Anti-Inflammatory Drugs. Clin Med Res. 2007 Mar; 5(1): 19–34. doi: 10.3121/cmr.2007.698. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855338/#

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Medical Disclaimer

Naproxen and ibuprofen: what’s the difference?

28/07/2019 12:42 News

Naproxen and ibuprofen are non-steroidal anti-inflammatory drugs (NSAIDs) that relieve pain, stiffness, swelling and fever associated with inflammation.

How do these drugs work?

Naproxen and ibuprofen reduce inflammation by inhibiting the enzyme that produces prostaglandins. Prostaglandins are an inflammatory factor. Inflammation is the body’s natural response to injury or infection. Doctors have linked chronic inflammation to a variety of conditions, including inflammatory bowel disease and some forms of arthritis. Fever, redness, pain, swelling, and dysfunction are the main signs of inflammation. The pain may go away soon after taking NSAIDs, but the inflammation does not go away until a few weeks later. When prostaglandins reach the brain, they can cause fever, which naproxen and ibuprofen can also relieve. By blocking the enzyme produced by prostaglandins, NSAIDs reduce the activity of platelets, preventing the formation of blood clots.

Differences in use

Naproxen and ibuprofen may have different uses. Naproxen can be used for conditions such as:

• ankylosing spondylitis;
• bursitis;
• attack of gout;
• osteoarthritis;
• muscle and joint pains;
• menstrual cramps and other menstrual pains;
• rheumatoid arthritis;
• tendonitis.

Ibuprofen is used for:

• fever;
• headache;
• migraines;
• osteoarthritis;
• pain;
• menstrual cramps;
• rheumatoid arthritis.

Rheumatologists recommend NSAIDs for the initial treatment of osteoarthritis. However, ibuprofen should not be given if the person is taking aspirin. Doctors do not recommend taking NSAIDs for a long time because of their side effects.

How to take naproxen and ibuprofen

Naproxen is available in two forms: naproxen and naproxen sodium. The body absorbs naproxen sodium better than naproxen.

Indications for naproxen and naproxen sodium

• Pain, menstrual pain, bursitis and tendonitis 550 mg every 12 hours or 275 mg every 6-8 hours;
• Ankylosing spondylitis, osteoarthritis, rheumatoid arthritis 250-500 mg twice daily or 275-550 mg twice daily;
• Acute gout 750 mg followed by 250 mg every 8 hours until attack subsides 825 mg followed by 275 mg every 8 hours.

Indications for use Ibuprofen

Mild or moderate pain – 400 mg every 4-6 hours;

Osteoarthritis, rheumatoid arthritis – 400 mg, 600 mg or 800 mg 3-4 times a day;

Menstrual pain 400 mg every 4 hours as needed.

Minor side effect

The most common side effects of naproxen and ibuprofen are:

• heartburn;
• constipation;
• abdominal pain;
• nausea;
• headache;
• dizziness;
• drowsiness;
• itching;
• rash;
• difficult breathing;
• fluid retention;
• ringing or noise in the ears;
• skin discoloration.

Severe side effects

Although naproxen and ibuprofen are available, they may not be safe for people with the following conditions:

• heart disease;
• gastric ulcer;
• stroke.

Naproxen or ibuprofen may increase the risk of:

• stroke;
• heart attack;
• gastrointestinal inflammation, bleeding and ulcers.

The risk of cardiovascular events, thrombosis, heart attack and stroke is higher in people with a history of cardiovascular disease or risk factors for cardiovascular disease. Taking NSAIDs within 2 weeks of heart surgery may increase your risk of heart attack and stroke. People who take naproxen or ibuprofen have an increased risk of developing high blood pressure, heart failure, and water retention. Older people are more vulnerable to these serious side effects. In order to reduce the risk of these negative effects, it is necessary to take naproxen or ibuprofen at a low dose for a short period of time.

Drug interactions

Ibuprofen and naproxen may interact with certain drugs:

• Ibuprofen interacts with aspirin, making aspirin less effective in protecting the heart and preventing strokes.
• Ibuprofen may interact with antidepressants and blood thinners and increase the risk of bleeding.
• Ibuprofen can slow the elimination of lithium or methotrexate, which can lead to dangerous levels of these drugs.
• Naproxen interacts with alcohol, antidepressants, steroids and blood thinners, increasing the risk of gastrointestinal bleeding and ulcers.

People should avoid taking naproxen and ibuprofen together as this may increase the risk of side effects.

Conclusion

People with gastrointestinal, heart, or kidney disease should talk to a doctor before starting an NSAID. Women who are in their third trimester of pregnancy or who are breastfeeding should not take NSAIDs. Generally, when people use them at the right dose and at the right time, naproxen and ibuprofen are both safe and effective drugs for treating inflammation and pain.

Related article: Asthma and ibuprofen: what are the consequences?

Khusainov Ruslan Khalilovich

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Naproxen or Ibuprofen? — Comparison of drugs

The drugs are similar in many ways: they belong to the group of NSAIDs, have similar efficacy and approximately the same 40-year experience in pain relief and the treatment of inflammatory non-communicable diseases. However, Naproxen and Ibuprofen differ greatly in terms of the time of onset of effect and the overall duration of action. From this difference follows the likelihood of the risk of associated side effects that are common to most of these anti-inflammatory drugs.

Difference in effectiveness

Ibuprofen and Naproxen are non-selective (non-selective) NSAIDs because they block both COX enzymes. COX-1 is involved in the creation of pain and inflammation, and COX-2 protects the gastric mucosa from hydrochloric acid, which it produces for digestion. Because these enzymes are produced by a similar mechanism, non-selective anti-inflammatory drugs, including ibuprofen and naproxen, inhibit both enzymes. As a result, drugs are about equally good at relieving pain with inflammation, but at the same time there is a risk of side effects associated with the stomach.

A dose of 440mg of naproxen is roughly equivalent to 400mg of ibuprofen , so in terms of pain-relieving potential they can be called similar with a slight margin of error.

Difference in action and safety

Due to the almost identical efficacy of compared drugs in similar dosages, the most important difference between Naproxen and Ibuprofen is the speed and duration of action.

Ibuprofen is considered a short-acting agent with a relatively rapid onset. It is better suited for the treatment of acute pain and is the most suitable NSAID for children. Ibuprofen tablets or capsules (Nurofen, Ibklin and others) must be taken every 4-6 hours if a long-term effect is needed.

Naproxen is a long-acting (long-acting) pain reliever and can only be taken twice a day with the same result, but has a slower onset of effect. Better for chronic conditions, but more likely to cause gastrointestinal distress with long-term use. Contraindicated in children under one year old.

Moderate doses of ibuprofen (up to 1200 mg per day for adults) may be a safer alternative to 1100 mg naproxen sodium (1000 mg as pure naproxen) per day, but if this is insufficient, the higher amount loses the safety benefit . Thus, the following dosage ranges will provide approximately the same pain relief effect:

• naproxen up to 1 g/day (equal to four tablets of Motrin or Nalgesin or 2 tablets of Nalgesin Forte)
• ibuprofen up to 1.2 g/day (6 tablets of 200 mg or 3 of 400 mg).

Motrin based on naproxen (10 tablets)

In case of household injuries of the musculoskeletal system and chronic diseases of the joints with moderate pain syndrome , it is better to manage half the amount of .