Naproxen vs Ibuprofen: Which Is Better?

Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of medication most commonly prescribed in hospital settings and outpatients. 

Many NSAIDs do not require a medical prescription and are available as over-the-counter medications sold in pharmacies. 

By reducing inflammation, NSAIDs work well as a fever reducer and pain reliever. 

It is common for primary care doctors or family medicine specialists to prescribe NSAIDs for your general body aches, muscle soreness, back pain, headaches, earaches, or even toothaches.

In this article, we compare two NSAIDs, Naproxen vs Ibuprofen. 

What is Naproxen?

Naproxen falls under the class of non-steroidal anti-inflammatory drugs (NSAIDs). It is beneficial in reducing inflammation-induced swelling and pain in joints and muscles. 

Due to its longer half-life (time taken for a drug to be half cleared out from the body), Naproxen is helpful in long-term pain control compared to other pain management options.

What is Ibuprofen?

Like Naproxen, Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It is FDA-approved for treating inflammatory diseases and rheumatoid disorders. Besides chronic pain, Ibuprofen is also indicated for mild to moderate pain.

Is Naproxen the same as Ibuprofen?

Both Naproxen and Ibuprofen are classified under non-steroidal anti-inflammatory drugs (NSAIDs), but they are not the same. Continue reading to know their similarities and differences in the later part.  

How do they work?

Non-steroidal anti-inflammatory drugs (NSAIDs) are broadly classified into two groups: selective or non-selective inhibitors of cyclooxygenase (COX) 1 and 2. Naproxen and Ibuprofen are non-selective COX inhibitors.

COX 1 and 2 are involved in synthesizing prostaglandins, the culprit of causing pain, inflammation, and fever. By blocking COX 1 and 2, Naproxen and Ibuprofen suppress the inflammation and pain.

Naproxen vs Ibuprofen uses

Naproxen has been FDA-approved to treat a wide range of health conditions, including:

• Acute gout
• Osteoarthritis
• Period pain
• Musculoskeletal pain
• Ankylosing spondylitis
• Bursitis
• Polyarticular juvenile idiopathic arthritis
• Tendonitis
• Rheumatoid arthritis
• Migraines and migraine prophylaxis

Meanwhile, the indications of Ibuprofen are:

• Rheumatoid arthritis
• Osteoarthritis
• Mild to moderate pain
• Period pain
• Closure of patent ductus arteriosus (a hole in the heart) in premature babies

Naproxen vs Ibuprofen side effects

Naproxen and Ibuprofen cause adverse effects on many organs, including the heart, gut, kidneys, and blood. People taking long-term NSAIDs are prone to cardiovascular events such as heart attack and stroke. 

Common side effects

Below are some common side effects of Naproxen and Ibuprofen:

• Confusion
• Headache
• Ringing in the ears
• Visual changes
• Low energy or sleepiness
• Dizziness
• Rashes

Symptoms listed above happen in more than 1 in 100 people. 

Rare side effects

Although rare, some people may develop serious consequences after taking Naproxen and Ibuprofen. The presentations of these severe Naproxen side effects include:

Gastrointestinal symptoms

This includes severe indigestion, heartburn, abdominal pain, nausea, vomiting, or diarrhea. They may indicate an ulcer or inflammation in the stomach or gut.

Vomit blood or blood in stools

Fresh blood in the vomitus or stools, dark coffee grounds like vomitus, or black tarry stool suggest bleeding from the stomach or gut due to ulcer or perforation.

Frequent sore throat, nosebleeds, and infections

These can be signs of a blood cell disorder known as agranulocytosis, which causes an extremely low number of white blood cells among the affected individuals.

Dizziness, tiredness, or shortness of breath

These are signs of anemia.

Swollen ankle, blood in the urine, and reduced amount of urine

These symptoms suggest kidney injury.

Jaundice

This hints at an injury or inflammation of the liver. The sclera (white part of your eyes) or your skin can turn yellow.

Slow or irregular heartbeats (bradycardia or arrhythmia)

This is caused by excessive blood potassium.

Fever, stomach pain, nausea, and vomiting

These can be signs of pancreas inflammation (acute pancreatitis)

Chest pain

This is alarming for a heart attack.

Fever, nausea, vomiting, confusion, headache, neck stiffness, irritation by light

These are classical features of meningitis, the inflammation of the fluid and membranes surrounding the brain and spinal cord.

Skin rash or blisters, wheezing, chest or throat tightness, difficulty breathing, and swelling of the mouth, face, lips, tongue, or throat

This condition is an absolute medical emergency— anaphylaxis (severe allergic reaction).

Call your local emergency number or go to the hospital as soon as possible if you have any of these warning symptoms.

Similarities and differences

Naproxen and Ibuprofen have the same mechanism of action, therefore, have the same side effects and contraindications. However, they do have a few distinctive differences:

1. Timing of onset. Ibuprofen acts faster than Naproxen. It takes 20 to 30 minutes for the effect of Ibuprofen to kick in, while Naproxen needs around 1 hour. 
2. Duration of effect. Ibuprofen is short-acting, so it is more suitable for acute pain relief for a shorter period. Naproxen is long-acting and needs a longer time to start working. Therefore, it qualifies better as a chronic pain reliever.
3. Prevalence of gastrointestinal side effects. Due to a more extended period of stay in our body, Naproxen is more likely to cause gastrointestinal symptoms than Ibuprofen.

Naproxen vs Ibuprofen effectiveness

In comparing the effectiveness of Naproxen vs Ibuprofen for period pain, a team of researchers analyzed thirty-five trials that involved 4383 participants who took different over-the-counter pain medications. 

The study revealed a significantly higher efficacy of Ibuprofen (83.7%) than Naproxen (48.3%). Ibuprofen is also recommended as the best choice of painkiller, considering its exceptional effectiveness and safety.

Another study reviewed the performance of Naproxen vs Ibuprofen for knee pain due to osteoarthritis. Among 33,243 patients, 61.6% in the Ibuprofen group showed improvement in pain control, compared to 50.1% in those taking Naproxen. 

Is Naproxen stronger than Ibuprofen?

Based on the two examples illustrated above, it seems like Ibuprofen is more effective than Naproxen. But does being more effective equivalent to being stronger?

Now, let’s look at the third research paper comparing Naproxen vs Ibuprofen for headaches. Again, Ibuprofen is more effective than Naproxen. 

1 in 3 patients experienced pain relief 2 hours after taking Ibuprofen. In contrast, only 1 in 6 patients had lesser pain 2 hours after Naproxen. 

However, Naproxen (half-life of 14 hours) continues to perform longer than Ibuprofen (half-life of 2 hours). 

In short, Ibuprofen generally has a higher efficacy as a pain reliever, but Naproxen has the advantage of exerting its therapeutic effect for a more extended period. 

More studies are needed to compare the performance of these drugs in different pharmacology effects, such as bringing down fever and reducing inflammation.

How quickly do they work?

Usually, your symptoms should improve in about 1 hour after taking Naproxen. However, if you are on long-term Naproxen treatment, you will need to take Naproxen regularly for up to 3 days for it to work properly.

For Ibuprofen, the effect kicks in much faster than Naproxen. You should start to feel better in 20 to 30 minutes after taking Ibuprofen in edible forms. 

Topical Ibuprofen (spray or stick pack) will begin to work within 1 to 2 days. For chronic pain, it might take up to 3 weeks to achieve the full action of the medication.

Which medication lasts longer?

Despite having slower action, the effect of Naproxen lasts much longer than Ibuprofen. Naproxen has a longer half-life (time taken for a drug to reduce to half of its original amount) of 12 to 17 hours than Ibuprofen, which has 1.8 to 2 hours of half-life. 

This means Naproxen will stay in our body longer and require less dose frequency.

You should always take Naproxen or Ibuprofen with food or just after a meal to maximize the absorption of medications by your body. Also, remember to start with the lowest possible dose; only step up if your symptoms are failed to be controlled.

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Which medication is cheaper?

The price of medications differs greatly depending on the patent status. Brand medications are much more expensive than generic medications, despite having similar formulations and efficacy. Here, we compare only the generic versions.

Based on a study, 250 mg of Naproxen is comparable to 400 mg of Ibuprofen in osteoarthritis pain relief. The average price of Naproxen sold at major pharmacies in the U.S. is $13.53 for 20 tablets of 250 mg. In contrast, 20 tablets of 400 mg Ibuprofen cost $11.45. 

The cost of these medications may fluctuate further depending on the number of tablets bought and your health insurance coverage percentage. Therefore, it is best for you to purchase medicine based on your doctor’s advice instead of looking for a lower price.

Naproxen and Ibuprofen interactions

Drugs

The action of Naproxen and Ibuprofen can affect or be affected by more than 300 types of drugs. Below is a list of widely used medication types that have significant interaction with Naproxen and Ibuprofen:  

• Other non-steroidal anti-inflammatory drugs (NSAIDs)
• Steroids
• Anti-blood clotting medicines
• Medications that increase urination (diuretics)
• Heart and high blood pressure medications
• Antidepressants
• Rheumatoid arthritis medications
• Antibiotics

If Naproxen or Ibuprofen alone does not work for you, topping up with Tylenol or paracetamol for a short period should be safe. Otherwise, do not take two or more types of painkillers at once unless instructed by your doctor.  

Herbs and supplements

Gingko biloba, commonly known as maidenhair, can slow down our blood coagulation process. Therefore, it is best not to take gingko together with Naproxen or Ibuprofen, which can also impede blood clotting, to prevent the risk of bleeding. 

Other herbs, supplements, or complementary medicines have insufficient information to prove their safety when used together with Naproxen or Ibuprofen. Therefore, always tell your doctor if you are taking any additional remedies.

Food and drinks

It is generally safe to eat any food or drink while on Naproxen or Ibuprofen treatment, including alcohol. However, ​​do not consume the medications while drinking alcohol. 

Also, bear in mind that drinking too much alcohol can irritate your stomach and cause vomiting, thus reducing your body’s absorption of the medications.

Health conditions

Naproxen and Ibuprofen need to be used with caution. You may not be able to use them if you have below health conditions:

• History of allergy to any non-steroidal anti-inflammatory drugs (NSAIDs)
• Stomach ulcers, bleeding in the stomach or gut, or stomach perforation
• High blood pressure
• Severe liver or kidney failure
• Heart failure or other heart diseases
• History of stroke
• Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis
• Lupus
• Blood coagulation disorder
• Pregnancy, preparing for pregnancy or breastfeeding
• Asthma, hay fever or allergies (Ibuprofen only)
• Chickenpox or shingles (Ibuprofen only)

What is the strongest anti-inflammatory drug?

Besides Naproxen and Ibuprofen, there are a few other main types of NSAIDs, such as:

• Diclofenac
• Celecoxib
• Mefenamic acid
• Etoricoxib
• Indomethacin
• Aspirin

They are all effective in reducing inflammation in different health conditions. A blanket recommendation like “the best NSAID for inflammation” or “the best pain relief medicine” is not valid. Nevertheless, some people may find a particular NSAID works magic in improving their symptoms.

Natural tips for pain relief

Aside from pharmacological interventions, you may consider these natural pain management options. They are particularly beneficial for those living with chronic pain.  

1) Do gentle exercises

Simple activities like walking, gardening, and dancing can help block pain signaling to the brain, thus relieving pain. Gently stretching your muscles and joints can improve the pain caused by stiffness and tension. 

2) Deep breathing

When you are in pain, take a deep breath and concentrate on your breathing– you may notice your pain is lesser and more bearable. 

Deep breathing activates our body’s parasympathetic response, a “relaxation” mechanism which can slow down the heart rate and blood pressure and regulate the pain perception by our brain. 

3) Distract yourself

Keep your focus on something else, so the pain is not dominating your thoughts. Indulge in activities you enjoy, like watching a movie, reading a book, or even chit-chatting with friends or family. 

All these are simple, practical ways of pain control, especially for people with limited mobility, such as severe knee arthritis or post-operative recovery.

Conclusion

This article compared Naproxen vs Ibuprofen. Naproxen and Ibuprofen are common medications that can be easily obtained. They can improve our quality of life, but they also pose many risks of side effects. 

Be responsible for your health by taking these medications cautiously. If you are unsure how to improve your health condition, consult your healthcare provider to look for the best solution.

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