Diclofenac vs. naproxen: Differences & similarities explained

In this article:

• Key differences
• Conditions treated
• Is diclofenac better than naproxen?
• Coverage & cost
• Side effects
• Drug interactions
• Drug warnings
• Bottom line

In this article

• Key differences
• Conditions treated
• Is diclofenac better than naproxen?
• Coverage & cost
• Side effects
• Drug interactions
• Drug warnings
• Bottom line

For many people with pain or inflammation, healthcare providers often prescribe medications like diclofenac or naproxen. These drugs belong to a group called nonsteroidal anti-inflammatory drugs (NSAIDs). Diclofenac and naproxen may help reduce inflammation and relieve pain caused by conditions like arthritis, menstrual cramps, or migraines.

While both medications can help people relieve pain and discomfort that interferes with daily activities, they may differ in various ways. Each drug offers different benefits depending on a person’s needs, making the choice between them a personal decision made with the advice of a healthcare provider.

Diclofenac vs. naproxen: Key differences

Diclofenac and naproxen are nonselective NSAIDs that help block the activity of cyclooxygenase (COX) enzymes. By doing so, these drugs block the production of prostaglandins, chemicals responsible for inflammation and pain in the body. 

Diclofenac and naproxen differ mainly in their dosage forms. Diclofenac is typically used or taken as an oral tablet or topical gel, while naproxen is generally taken as an oral tablet, capsule, or liquid. Both medications are taken two or three times daily, depending on the dosage form and condition being treated. 

Diclofenac is known under different brand names that include Voltaren, Cataflam, Cambia, and Zipsor. Naproxen is known under brand names that include Aleve, Anaprox-DS, and Naprosyn. Both medications are available in prescription and over-the-counter (OTC) versions. For example, Voltaren topical gel is the OTC version of diclofenac, while Aleve is the popular brand name for OTC naproxen tablets.

Compare diclofenac vs. naproxen key differences
	Diclofenac	Naproxen
Drug class	NSAID	NSAID
Brand/generic status	Brand and generic available	Brand and generic available
What is the brand name?	Voltaren, Cataflam, Cambia, Zipsor	Aleve, Anaprox-DS, Naprosyn
What form(s) does the drug come in?	Tablet, capsule, extended-release tablet, topical gel, topical solution	Tablet, capsule, delayed-release tablet, oral suspension
What is the standard dosage?	50 mg 2 to 3 times per day or 75 mg twice daily	220 mg every 8–12 hours in adults taking the OTC form, 250–500 mg twice daily in adults taking the prescription-strength version
How long is the typical treatment?	Short-term or long-term, as instructed by a healthcare provider	Short-term or long-term, as instructed by a healthcare provider
Who typically uses the medication?	Adults	Adults and children over 2 years old

 

Diclofenac vs. naproxen: Conditions treated

While naproxen targets pain and swelling, it might be more familiar to some as a remedy for everyday aches. However, both diclofenac and naproxen are NSAIDs that can be used for many of the same conditions. 

Both drugs are often used to relieve pain and inflammation from conditions like arthritis, including osteoarthritis, rheumatoid arthritis, and rheumatoid arthritis in children (juvenile rheumatoid arthritis). People with ankylosing spondylitis, a type of arthritis affecting the spine, also use these NSAIDs. In addition, both diclofenac and naproxen are used for mild to moderate pain and discomfort from menstrual cramps (primary dysmenorrhea) and back pain. 

NSAIDs are typically used as part of a broader pain management plan that includes rest and physical therapy. 

Compare diclofenac vs. naproxen conditions treated
Condition	Diclofenac	Naproxen
Osteoarthritis	Yes	Yes
Rheumatoid arthritis	Yes	Yes
Ankylosing spondylitis	Yes	Yes
Juvenile rheumatoid arthritis	Yes	Yes
Primary dysmenorrhea	Yes	Yes
Migraine	Yes	Yes
Tendonitis	Yes	Yes
Bursitis	Yes	Yes
Gout	Yes	Yes

 

Is diclofenac better than naproxen?

Both diclofenac and naproxen are popular choices for pain relief since they’re both relatively accessible. The better choice will depend on different factors, such as dosage and the person’s response to treatment.

Naproxen generally lasts longer than other NSAIDs and is available as an OTC tablet, which may be more useful for everyday aches and pains. However, diclofenac and naproxen are both available in extended-release forms. Diclofenac also comes as an OTC topical gel that may be more suitable for targeting specific areas, such as the knees or hands, for pain. 

Between diclofenac and naproxen, diclofenac may be considered the more potent NSAID. One study found that ibuprofen and diclofenac are the most effective pain relievers for tension-type headaches. In contrast, naproxen was less effective than these medications and did not significantly outperform a placebo in relieving pain. 

Another study looked at various NSAIDs and found that diclofenac is effective in reducing pain in osteoarthritis. However, NSAIDs might not be ideal for long-term use due to potential side effects. Still, topical diclofenac is effective and generally safer than oral diclofenac, making it a potential first choice for knee osteoarthritis. 

Diclofenac vs. naproxen: Insurance coverage and cost comparison

Diclofenac and naproxen are available in generic forms, making them more affordable than brand-name versions. Many insurance plans and Medicare often cover these medications when they’re prescribed by a healthcare provider. However, coverage can differ, so it’s important to check insurance plans.

When it comes to retail costs, prices can depend on the form and amount purchased. Pharmacies can have different pricing structures, so shopping around may be beneficial. The average retail cost of 60, 75 mg diclofenac tablets is around $103, while the average retail cost of 60, 500 mg naproxen tablets is around $75.

Patients looking to save on prescription drugs may find the SingleCare prescription discount card helpful. The card provides access to coupons that can be used at local pharmacies to help people save over 80% on their prescriptions.  

Compare diclofenac vs. naproxen cost and coverage
	Diclofenac	Naproxen
Typically covered by insurance?	Yes (prescription version)	Yes (prescription version)
Typically covered by Medicare Part D?	Yes (prescription version)	Yes (prescription version)
Quantity	60, 75 mg tablets	60, 500 mg tablets
SingleCare cost	$5	$6
Savings options	Diclofenac coupon	Naproxen coupon

 

Diclofenac vs. naproxen: Side effects

As NSAIDs, diclofenac and naproxen share many of the same side effects. The most common side effects include gastrointestinal reactions, such as indigestion, stomach pain, heartburn, and nausea. Other side effects may include dizziness, drowsiness, dry mouth, rash, high blood pressure, and swelling of the hands, legs, or feet (edema).

Serious side effects of drugs like diclofenac and naproxen can include allergic reactions, stomach ulcers, and heart problems. These medications can cause bleeding in the stomach or ulcers. They also increase the risk of having a heart attack or stroke, especially if you take them in high doses or for a long time.

Compare diclofenac vs. naproxen side effects
	Diclofenac		Naproxen
Side effect	Applicable?	Frequency	Applicable?	Frequency
Indigestion	Yes	1–10%	Yes	1–10%
Stomach pain	Yes	1–10%	Yes	1–10%
Heartburn	Yes	1–10%	Yes	1–10%
Headache	Yes	1–10%	Yes	1–10%
Nausea	Yes	1–10%	Yes	1–10%
Edema	Yes	1–10%	Yes	1–10%
Dizziness	Yes	1–10%	Yes	1–10%
Rash	Yes	1–10%	Yes	1–10%
Dry mouth	Yes	N/A	Yes	<1%
Drowsiness	Yes	N/A	Yes	1–10%
High blood pressure	Yes	N/A	Yes	<1%

This may not be a complete list of adverse effects that can occur. Please refer to your healthcare provider to learn more.

Source: DailyMed (Diclofenac), DailyMed (Naproxen)

Diclofenac vs. naproxen: Drug interactions

Diclofenac and naproxen interact with many of the same medications. Taking diclofenac or naproxen with certain medications can lead to an increased risk of adverse events, some of which can be serious.

Aspirin and other NSAIDs

Combining diclofenac or naproxen with aspirin or other NSAIDs increases the risk of stomach irritation and bleeding. Using both at the same time is not generally recommended unless monitored by a healthcare provider.

Blood thinners and anticoagulants

Both medications can increase the risk of bleeding when taken with blood thinners like warfarin or drugs that affect serotonin, such as antidepressants. People taking these combinations should be closely monitored for signs of bleeding.

ACE Inhibitors, ARBs, and diuretics

Diclofenac and naproxen may reduce the effectiveness of blood pressure medications like ACE inhibitors, angiotensin II receptor blockers (ARBs), and diuretics. In some cases, combining these drugs can also strain the kidneys. 

Lithium and methotrexate

Both NSAIDs can increase levels of lithium or methotrexate in the body, raising the risk of toxicity. Regularly monitoring drug levels is recommended if these medications are used together.

These are just some potential drug interactions that can occur. It’s important to consult a healthcare provider about any medications you take, including prescription drugs, OTC medicines, and herbal supplements. 

Compare diclofenac vs. naproxen drug interactions
Drug	Drug class	Diclofenac	Naproxen
Plavix (clopidogrel) Aspirin (acetylsalicylic acid) Brilinta (ticagrelor) Effient (prasugrel)	Antiplatelet	Yes	Yes
Coumadin (warfarin) Eliquis (apixaban) Xarelto (rivaroxaban) Pradaxa (dabigatran)	Anticoagulant	Yes	Yes
Prozac (fluoxetine) Zoloft (sertraline) Lexapro (escitalopram) Paxil (paroxetine)	SSRIs	Yes	Yes
Effexor XR (venlafaxine) Cymbalta (duloxetine) Pristiq (desvenlafaxine) Fetzima (levomilnacipran)	SNRIs	Yes	Yes
Zestril (lisinopril) Altace (ramipril) Vasotec (enalapril) Lotensin (benazepril)	ACE inhibitors	Yes	Yes
Cozaar (losartan) Diovan (valsartan) Avapro (irbesartan) Benicar (olmesartan)	ARBs	Yes	Yes
Lopressor (metoprolol) Tenormin (atenolol) Inderal (propranolol) Coreg (carvedilol)	Beta blockers	Yes	Yes
Lasix (furosemide) Hydrodiuril (hydrochlorothiazide) Aldactone (spironolactone) Bumex (bumetanide)	Diuretics	Yes	Yes
Rheumatrex (methotrexate)	Antimetabolite	Yes	Yes
Lanoxin (digoxin)	Cardiac glycoside	Yes	Yes

Consult a healthcare professional for other possible drug interactions. 

Naproxen vs. diclofenac: Drug warnings

Diclofenac and naproxen share many warnings and precautions due to their shared drug class. Some of these warnings include:

• Heart risks: Both medications can increase the risk of serious cardiovascular events like heart attack and stroke, especially at higher doses or with long-term use. Avoid using these drugs after recent heart surgery or if you have known heart disease unless absolutely necessary. Monitor for symptoms like chest pain, shortness of breath, or sudden weakness.
• Stomach and gut problems: Diclofenac and naproxen may cause ulcers, bleeding, or holes in the stomach or intestines. These risks are higher in older adults, people who heavily consume alcohol, and people with a history of stomach ulcers or GI bleeding. Watch for symptoms like black stools, stomach pain, or vomiting blood.
• Kidney problems: Long-term use can harm the kidneys, especially in people with dehydration, existing kidney disease, or other health conditions like heart failure or liver issues. Symptoms of kidney problems include reduced urination and swelling in the legs.
• Liver damage: Both drugs can increase liver enzyme levels or cause serious liver problems, though this is rare. Watch for signs like nausea, yellowing of the skin or eyes, and fatigue. Regular monitoring is recommended for long-term use.
• Skin reactions: Rare but serious skin reactions, such as Stevens-Johnson Syndrome or toxic epidermal necrolysis, may occur. Discontinue use if a rash or skin irritation develops.
• Pregnancy concerns: These drugs should be avoided late in pregnancy as they can harm the baby’s kidneys. Use during earlier stages of pregnancy only if absolutely necessary, and consult a healthcare provider.
• Anaphylaxis and allergies: Severe allergic reactions, including breathing difficulties, swelling, or rash, may occur even in people without a known history of allergies to NSAIDs.
• Fluid retention: Diclofenac may increase the risk of fluid retention and worsening heart failure. Monitor for signs of swelling or weight gain.
• Sodium content: Certain formulations of diclofenac and naproxen contain sodium, which may be a concern for individuals on a low-sodium diet or with high blood pressure. Therefore, caution may be recommended while taking naproxen or diclofenac sodium tablets. 

Always take the lowest effective dose for the shortest duration possible, and consult a healthcare provider for medical advice. If serious symptoms occur, stop the medication and seek medical attention immediately.

Bottom line 

Diclofenac and naproxen are common NSAID pain relievers often used for pain from arthritis, headaches, and menstrual cramps. Diclofenac comes as an oral tablet and a topical gel that might be better for pain in specific areas. Naproxen generally works for a longer time and is often used for a wider range of everyday aches and pains. Both medications can have side effects, such as heart and stomach problems, and they might not mix well with other drugs. Therefore, it’s important to talk to a healthcare provider to find out which is safest and best for you.