Naproxen vs. Ibuprofen: Key Differences & Similarities, Side Effects, Possible Drug Interactions

Naproxen and ibuprofen are both medications that belong to a class of drugs known as non-steroidal anti-inflammatory drugs, or NSAIDs. They are popularly known by their brand names – Aleve (naproxen) and Advil (ibuprofen). Both these medications are so much alike that many people often wonder if they are simply a marketing tactic of pharmaceutical companies to sell the same drug under different names. However, this is not so because there are some differences between both the medicines. Take a look at naproxen vs. ibuprofen and which one is right for you.

How Do Non-steroidal Anti-inflammatory Drugs (NSAIDS) Work?

Naproxen and ibuprofen are non-steroidal anti-inflammatory drugs (NSAIDs). In order to understand the similarities and differences between these medications, it is necessary to first understand how NSAIDs work.(1)

Both naproxen and ibuprofen work by reducing inflammation in the body. They do so by preventing a certain enzyme from manufacturing prostaglandins. Prostaglandins are the body’s main compound responsible for inflammation. (2, 3)

Inflammation is the body’s natural response to any type of injury or infection. People simply assume that all inflammation is harmful. However, temporary inflammation caused by the body to heal an injury or infection is not a dangerous type of inflammation. Chronic inflammation or prolonged inflammation in the body is what is associated with many health conditions, such as many forms of arthritis, inflammatory bowel disease (IBD), and even some types of cancers.

Swelling, pain, redness, and heat are some of the most common indications of inflammation. People tend to experience pain relief shortly after taking non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen. However, the inflammation can continue to last for weeks, even after the pain disappears.

Once the prostaglandins associated with inflammation reach the brain, they can also cause fever, which can be treated temporarily by naproxen and ibuprofen.

Ibuprofen and naproxen work by blocking the very enzyme that produces the prostaglandins. They also disrupt the platelet activity in the body, thus prevent the formation of blood clots.

By blocking the production of prostaglandins, both ibuprofen and naproxen are able to treat aches and pains from the following conditions:

Naproxen vs. Ibuprofen: Key Differences & Similarities

Naproxen and ibuprofen are very similar to each other, but there are certain differences as well. The biggest difference between the two drugs is that ibuprofen is short-acting, meaning that pain relief from ibuprofen does not last for too long. Naproxen, on the other hand, is long-acting, and therefore, the pain relief lasts for a longer time. This fundamental difference is also what makes doctors prescribe naproxen for treating pain in chronic health conditions.(5)

Naproxen is more likely to lead to an upset stomach, but ibuprofen has relatively lesser side effects.

Ibuprofen, though, can be prescribed to young children as well, but naproxen can only be used in children who are 12 years and older. Some forms of ibuprofen are manufactured in a manner that they are easier for smaller children to take.

Ibuprofen and naproxen also have different uses, though some of them even overlap.

Naproxen

Doctors prescribe naproxen in the treatment of the following:

Ibuprofen

Doctors prescribe ibuprofen in the following conditions:

As per the recommendations of the American College of Rheumatology (13), NSAIDs should be used for the early stage management of symptoms in osteoarthritis of the knees, hips, and hands. However, they do not list any one of the NSAIDs to be more effective than the other.
However, some people, such as those who are taking aspirin for heart-related problems, should not be using ibuprofen.

Even though NSAIDs are approved for treating rheumatoid arthritis, the American College of Rheumatology’s 2015 guidelines does not recommend NSAIDs for use as long-term treatment due to their side effects.(14)

Instead, people should be taking this class of medications only for a short period of time during the early stages of rheumatoid arthritis, while they wait for the other drugs to start working.(15)

Both ibuprofen and naproxen are also commonly prescribed for the treatment of menstrual cramps, and both are effective in alleviating pain.

However, research has not shown whether one of these drugs is better than the other at treating menstrual cramps.(16)

Naproxen vs. Ibuprofen: Side Effects

There are many side effects associated with both naproxen and ibuprofen. Since both these medications belong to the same class of drugs, it is obvious that they have more or less the same side effects. However, naproxen is associated with a higher risk of blood pressure and heart-related side effects.

Here are some of the common side effects of both these drugs:

Some of the serious side effects of both these drugs are:

The risk of the following side effects is higher when taking naproxen:

Even though both naproxen and ibuprofen are easily available over-the-counter, they might not be safe for people with the following health conditions:

  • Stroke
  • Peptic ulcers
  • Heart disease

The US Food and Drug Administration (FDA) in 2015 revised and strengthened its existing warning about non-aspirin NSAIDs.(17)

People who take prescription ibuprofen or naproxen are known to have a higher risk of developing the following:

  • Heart attack
  • Stroke
  • Gastrointestinal inflammation, ulcers, and bleeds
  • Hemorrhagic death

People with a history of heart disease or risk factors for heart disease are at a greater risk of clots, heart attack, and stroke.

People taking ibuprofen or naproxen are also at a higher risk of developing hypertension, water retention, and heart failure. Elderly patients, especially, are susceptible to these severe side effects of ibuprofen and naproxen.

In order to lower the risk of these side effects, people should take ibuprofen or naproxen at the lowest dosage possible for the least amount of time required.

Naproxen vs. Ibuprofen: Possible Drug Interactions

Both naproxen and ibuprofen are known to interact with many other drugs. These include:

  • Naproxen interacts with antidepressants, steroids, blood thinners, and alcohol, increasing the risk of gastrointestinal ulcers and bleeding.
  • Ibuprofen interacts with aspirin, reducing the effectiveness of aspirin in protecting the heart, thus increasing the risk of strokes.
  • Ibuprofen interacts with blood thinners and antidepressants, increasing the risk of bleeding.
  • Avoid taking naproxen and ibuprofen together as it increases the risk of side effects.

Before taking either of these two medications, it is recommended to have your current medication list checked by a doctor to identify if there can be any potential interactions.

Conclusion

Naproxen and ibuprofen are types of non-steroidal anti-inflammatory drugs (NSAIDs) that people use for getting relief from pain in a wide range of inflammatory conditions. The primary difference between the two drugs is their uses and drug interactions. Even though they are available over-the-counter, these medications may not be safe to use for everyone, especially if they have an existing health condition and also due to the potential interactions with other medications.

References:

  1. Day, R.O. and Graham, G.G., 2013. Non-steroidal anti-inflammatory drugs (NSAIDs). Bmj, 346, p.f3195.
  2. Wallace, J.L., 1992. Prostaglandins, NSAIDs, and cytoprotection. Gastroenterology Clinics of North America, 21(3), pp.631-641.
  3. Selinsky, B.S., Gupta, K., Sharkey, C.T. and Loll, P.J., 2001. Structural analysis of NSAID binding by prostaglandin H2 synthase: time-dependent and time-independent inhibitors elicit identical enzyme conformations. Biochemistry, 40(17), pp.5172-5180.
  4. Lethaby, A., Duckitt, K. and Farquhar, C., 2013. Non‐steroidal anti‐inflammatory drugs for heavy menstrual bleeding. Cochrane database of systematic reviews, (1).
  5. Kivitz, A.J., Gimbel, J.S., Bramson, C., Nemeth, M.A., Keller, D.S., Brown, M.T., West, C.R. and Verburg, K.M., 2013. Efficacy and safety of tanezumab versus naproxen in the treatment of chronic low back pain. PAIN®, 154(7), pp.1009-1021.
  6. Sturge, R.A., Scott, J.T., Hamilton, E.B., Liyanage, S.P., Dixon, A.S., Davies, J. and Engler, C., 1977. Multicentre trial of naproxen and phenylbutazone in acute gout. Annals of the rheumatic diseases, 36(1), pp.80-82.
  7. BOWERS, D.E., DYER, H.R., FOSDICK, W.M., KELLER, K.E., ROSENBERG, A.L., SUSSMAN, P. and VANCIL, M.E., 1975. Naproxen in rheumatoid arthritis: a controlled trial. Annals of internal medicine, 83(4), pp.470-475.
  8. Husby, G., Holme, I., Rugstad, H.E., Herland, O.B. and Giercksky, K.E., 1986. A double-blind multicentre trial of piroxicam and naproxen in osteoarthritis. Clinical rheumatology, 5(1), pp.84-91.
  9. Chan, W.Y., Fuchs, F.R.I.T.Z. and Powell, A.M., 1983. Effects of naproxen sodium on menstrual prostaglandins and primary dysmenorrhea. Obstetrics and gynecology, 61(3), pp.285-291.
  10. Havanka‐Kanniainen, H., 1989. Treatment of acute migraine attack: ibuprofen and placebo compared. Headache: The Journal of Head and Face Pain, 29(8), pp.507-509.
  11. Altman, R.D., 1984. Review of ibuprofen for osteoarthritis. The American journal of medicine, 77(1), pp.10-18.
  12. Grennan, D.M., Ferry, D.G., Ashworth, M.E., Kenny, R.E. and Mackinnon, M., 1979. The aspirin‐ibuprofen interaction in rheumatoid arthritis. British journal of clinical pharmacology, 8(5), pp.497-503.
  13. Hochberg, M.C., Altman, R.D., April, K.T., Benkhalti, M., Guyatt, G., McGowan, J., Towheed, T., Welch, V., Wells, G. and Tugwell, P., 2012. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis care & research, 64(4), pp.465-474.
  14. Rheumatology.org. 2020. Rheumatoid Arthritis (RA). [online] Available at: <https://www.rheumatology.org/Practice-Quality/Clinical-Support/Clinical-Practice-Guidelines/Rheumatoid-Arthritis> [Accessed 10 March 2020].
  15. Abbasi, M., Mousavi, M.J., Jamalzehi, S., Alimohammadi, R., Bezvan, M.H., Mohammadi, H. and Aslani, S., 2019. Strategies toward rheumatoid arthritis therapy; the old and the new. Journal of cellular physiology, 234(7), pp.10018-10031.
  16. Latthe, P.M. and Champaneria, R., 2014. Dysmenorrhoea. BMJ clinical evidence, 2014.
  17. U.S. Food and Drug Administration. 2020. FDA Drug Safety Communication. [online] Available at: <https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-strengthens-warning-non-aspirin-nonsteroidal-anti-inflammatory> [Accessed 10 March 2020].

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