Diclofenac vs. ibuprofen: Differences, similarities, and which is better for you

In this article:

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Interactions
• Warnings
• Dosages
• FAQs

In this article

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Interactions
• Warnings
• Dosages
• FAQs

With so many treatment options for arthritis, it can be overwhelming to choose the best medication. If you experience regular pain from arthritis, a healthcare provider may recommend an NSAID like diclofenac or ibuprofen. These medications decrease prostaglandins—natural substances that cause pain and inflammation.

Both diclofenac and ibuprofen are nonselective NSAIDs that block COX-1 and COX-2 enzymes, which are responsible for producing prostaglandins. However, COX-1 also protects the stomach lining, so blocking it may lead to gastrointestinal issues. Here’s how these medications compare.

What are the main differences between diclofenac vs. ibuprofen?

Diclofenac is a prescription and over-the-counter (OTC) drug that also goes by the brand name Voltaren. It is available as a generic medication used to treat osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis (arthritis that affects the spine). Diclofenac sodium comes in the form of a delayed-release tablet, extended-release tablet, and topical gel or solution. It is approved by the U.S. Food and Drug Administration (FDA) for adults 18 years and older. 

Ibuprofen is a commonly used NSAID analgesic that can be purchased over the counter as an oral tablet, capsule, suspension, or topical gel. Brand names for OTC ibuprofen include Advil and Motrin, which can be used for mild pain and fever in adults and children six months and older. However, for moderate to severe pain from arthritis and other chronic pain conditions, prescription-strength ibuprofen is needed. Prescription-strength ibuprofen comes in higher doses and is typically reserved for more severe pain in adults. 

Conditions treated by diclofenac and ibuprofen

Diclofenac is FDA-approved to treat osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It can also help treat migraines, general mild to moderate pain, and dysmenorrhea, or pain from menstrual cramps. Topical diclofenac can be applied directly to the joint areas to relieve pain and swelling. 

Ibuprofen can be used in higher doses than those commonly found in OTC forms to treat osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It can also be used to treat menstrual cramps (dysmenorrhea), migraines, mild pain, and fever.

Is diclofenac or ibuprofen more effective?

Diclofenac is a prescription NSAID painkiller often considered more potent than ibuprofen. A meta-analysis from Arthritis Research & Therapy found oral diclofenac more effective for arthritis pain. Diclofenac, especially at a dose of 150 mg per day, was likely more effective at relieving pain than other NSAIDs like celecoxib, naproxen, and ibuprofen.

Another study compared the topical forms of diclofenac and ibuprofen. It found that while ibuprofen was absorbed into the skin more quickly and to a greater extent, diclofenac showed stronger overall anti-inflammatory effects. 

The effectiveness of these medications can depend on their doses and your response to the medications. The best pain management option can also be influenced by your overall health condition and other medications you’ve tried in the past. 

Coverage and cost comparison of diclofenac vs. ibuprofen

Most Medicare and health insurance plans cover the generic version of diclofenac when given as a prescription drug. The average retail cost of a month’s supply of oral diclofenac can be around $100 for 60, 75 mg tablets, but this cost can be lowered to around $7 with a SingleCare coupon card. 

Most Medicare and insurance plans often cover prescription-strength ibuprofen. Without insurance, the average retail cost for a month’s prescription-strength ibuprofen tablets is around $78 for 30, 800 mg tablets. However, with a SingleCare ibuprofen coupon, the price could be as low as around $3.

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in zip code 23666 as of Oct. 20, 2025. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available.

Side effects of diclofenac and ibuprofen

As NSAIDs, diclofenac and ibuprofen share similar side effects. Common side effects of NSAIDs include:

• Diarrhea
• Indigestion
• Gas
• Stomach pain
• Heartburn
• Constipation
• Dizziness
• Headache
• Itching
• Swelling in the hands, legs, or feet

Both drugs may also cause serious side effects like stomach ulcers and kidney or liver problems, especially with long-term use or preexisting conditions. Talk to a healthcare provider for a complete list of possible side effects

Drug interactions of diclofenac vs. ibuprofen

NSAIDs can decrease the blood pressure-lowering effects of antihypertensive medications like angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, and diuretics. 

Taking NSAIDs with blood thinners can increase the risk of bleeding. Drugs with blood-thinning effects include anticoagulants, antiplatelet agents, and antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

See the table below for examples of drugs that can interact with diclofenac and ibuprofen. 

This may not be a complete list of all possible drug interactions. Consult a doctor about all medications you may be taking. 

Warnings of diclofenac and ibuprofen

Using NSAIDs can lead to an increased risk of cardiovascular events such as heart attack and stroke, especially if you have a history of them. One study found that starting diclofenac increased the risk of major heart problems by 20% compared to those using ibuprofen.

NSAIDs can also increase the risk of gastrointestinal events such as bleeding or ulcers in the stomach and intestines. One study found that using diclofenac increases the risk of gastrointestinal bleeding about four times compared to not using it. In contrast, taking ibuprofen increases the risk by about 2.7 times.

Diclofenac and ibuprofen should be avoided or monitored in people with liver or kidney problems. Taking NSAIDs can increase the risk of toxicity in the liver and kidneys. 

NSAIDs should not be used during late pregnancy. Taking NSAIDs after 30 weeks of gestation can cause premature closure of the ductus arteriosus, a blood vessel in the fetal heart. Talk to your doctor about using NSAIDs during the early stages of pregnancy.

Diclofenac and ibuprofen dosages

Diclofenac and ibuprofen differ in how they’re dosed. The dosages can vary based on the type of pain being treated and the dosage form being given. The following are some of the most common dosages of diclofenac and ibuprofen. 

Diclofenac dosages

• Osteoarthritis: When taken orally, the dosage is 50 mg two to three times daily or 75 mg twice daily. The topical dosage is 40 mg or two pump actuations directly on the knee and spread evenly around the front, back, and sides of the knee
• Rheumatoid arthritis: 50 mg two to three times daily or 75 mg twice daily taken orally
• Ankylosing spondylitis: 25 mg four times daily taken orally, with an additional 25 mg dose at bedtime if necessary
• Dysmenorrhea: 50 mg three times daily
• Mild to moderate pain: 50 mg three times daily

Ibuprofen dosages

• Osteoarthritis: 300 mg four times daily or 400, 600, or 800 mg three to four times daily. 
• Rheumatoid arthritis: 300 mg four times daily or 400 to 800 mg three to four times daily
• Dysmenorrhea: 400 mg every four hours as needed
• Fever: 200 to 400 mg every four to six hours as needed
• Migraine: 200 to 400 mg once
• Mild to moderate pain: 400 mg every four to six hours as needed

Consult a healthcare provider for the appropriate dosage based on the condition you’re treating. 

Frequently asked questions about diclofenac vs. ibuprofen

Are diclofenac and ibuprofen the same?

No, diclofenac and ibuprofen are not the same medication. Diclofenac is often taken as a prescription oral drug that is stronger than ibuprofen, although it’s available as an OTC topical gel. Ibuprofen is available as a prescription and OTC drug but is generally used for milder pain relief.

Is diclofenac vs. ibuprofen better?

Diclofenac may be more effective for severe pain. However, ibuprofen is generally considered safer for regular use, as it has a lower risk of serious cardiovascular events and stomach ulcers. 

Can I use diclofenac vs. ibuprofen while pregnant?

NSAIDs, including both diclofenac and ibuprofen, should be avoided during pregnancy, especially in the third trimester, due to potential complications for the mother and unborn child. Consult a healthcare provider for medical advice on safe alternatives during pregnancy.

Can I use diclofenac vs. ibuprofen with alcohol?

It’s best to avoid alcohol when taking either diclofenac or ibuprofen. Combining these medications with alcohol can increase the risk of side effects, such as gastrointestinal bleeding and liver damage. If you do choose to drink alcohol, it’s important to do so in moderation and to speak with your doctor about potential risks.

Is diclofenac better than ibuprofen for back pain?

The choice between diclofenac and ibuprofen for back pain often depends on the dosage and dosage form. Diclofenac is generally a stronger NSAID than ibuprofen, but real-world studies suggest these NSAIDs are comparable in effectiveness for back pain when used short-term and taken by mouth. 

Is diclofenac safer than ibuprofen?

Oral diclofenac requires a doctor’s assessment and prescription for use, as it has a higher risk of side effects than ibuprofen. Oral ibuprofen is available OTC and is considered safer for treating general ailments like pain or fever. However, side effects are possible with both medications.

Can I take diclofenac and ibuprofen?

No, diclofenac and ibuprofen should not be used together, as taking both medications at the same time can increase the risk of side effects. However, you may be able to use topical diclofenac with oral ibuprofen or oral diclofenac with topical ibuprofen with medical guidance.