Diclofenac vs. Aspirin
See how Diclofenac and Aspirin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Diclofenac is a prescription-strength NSAID for arthritis and moderate pain, while aspirin is an over-the-counter option also used to help prevent heart attack and stroke.
Diclofenac carries a boxed warning for cardiovascular risk in addition to the stomach bleeding risk both drugs share, since it works differently in the body at anti-inflammatory doses.
Diclofenac is dosed by prescription two to three times daily for arthritis, while aspirin dosing ranges from occasional pain relief to a once-daily low dose for heart protection.
Diclofenac vs. Aspirin Drug Summary
Diclofenac
Diclofenac is a prescription NSAID used to relieve pain and inflammation from osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and menstrual cramps. It comes as a delayed-release oral tablet taken two to three times a day, with dosing adjusted based on the condition being treated.
Aspirin
Aspirin is an over-the-counter NSAID and salicylate used for pain, fever, and inflammation, and at low daily doses to help prevent heart attack and stroke. It comes in regular, chewable, and enteric-coated tablets, with dosing that ranges from occasional pain relief to once-daily cardiovascular protection.
Diclofenac vs. Aspirin Side Effects
Diclofenac
Aspirin
Diclofenac vs. Aspirin Dosage
Diclofenac
Aspirin
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg two-three x daily | At the start |
| Maximum dose | 150 mg/day maximum | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 325-650 mg every 4 hrs | At the start |
| Maximum dose | 75-325 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Diclofenac
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg two-three x daily | At the start |
| Maximum dose | 150 mg/day maximum | If needed |
| Dose changes | 3 increases | As tolerated |
Aspirin
| STAGE | DOSE | WHEN |
| Starting dose | 325-650 mg every 4 hrs | At the start |
| Maximum dose | 75-325 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Diclofenac vs. Aspirin Indications
Diclofenac
Diclofenac is FDA-approved for painful inflammatory conditions like osteoarthritis and rheumatoid arthritis, as well as ankylosing spondylitis and primary dysmenorrhea. It is also approved for short-term treatment of mild to moderate acute pain. It is not approved for use in children or for pain around CABG heart surgery.
Osteoarthritis pain and inflammation
Rheumatoid arthritis pain and inflammation
Ankylosing spondylitis
Primary dysmenorrhea
Aspirin
Aspirin is FDA-approved for temporary relief of minor aches, pain, and fever, and for reducing the risk of heart attack and stroke in people with cardiovascular disease. It is also used for rheumatologic conditions such as rheumatoid arthritis. It is not approved for children or teens with viral illnesses due to Reye's syndrome risk.
Minor aches, pain, and fever relief
Secondary prevention of heart attack and stroke
Reducing risk in unstable angina and acute MI
Rheumatologic conditions like rheumatoid arthritis
Diclofenac vs. Aspirin Pros and Cons
Diclofenac
Diclofenac provides stronger, more targeted anti-inflammatory relief for arthritis and related conditions than standard aspirin doses, but it carries boxed warnings for cardiovascular and gastrointestinal risk. Most oral formulations require a prescription, and periodic liver monitoring is often recommended.
Pros
Stronger anti-inflammatory effect for arthritis pain
Available in oral, topical, ophthalmic, and injectable forms
FDA-approved specifically for rheumatoid arthritis and ankylosing spondylitis
Once or twice daily dosing options for steadier symptom control
Cons
Boxed warning for heart attack and stroke risk
Requires a prescription for oral tablets
Needs periodic liver enzyme monitoring
Roughly $7 to $110 per month without insurance, more than aspirin
Aspirin
Aspirin is inexpensive, available without a prescription, and is the only common OTC pain reliever with an FDA-recognized use for preventing heart attack and stroke. It is generally less potent for chronic inflammatory arthritis pain, and frequent dosing is needed for pain relief.
Pros
Available over the counter without a prescription
Only OTC analgesic FDA-approved for cardiovascular event prevention
Decades of established safety data
Roughly $2 to $15 per month, much less than diclofenac
Cons
Less potent for chronic inflammatory arthritis pain at OTC doses
Needs dosing every 4 hours for ongoing pain relief
Risk of Reye's syndrome in children and teens with viral illness
Tinnitus (ringing in ears) can occur at higher doses
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