Naproxen vs. Aspirin
See how Naproxen and Aspirin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Naproxen and aspirin are both NSAIDs for pain, fever, and inflammation, but only aspirin has an FDA-approved use for preventing heart attack and stroke.
Naproxen is usually taken once or twice a day, while aspirin for pain relief may need dosing every four hours.
Naproxen carries a boxed warning for cardiovascular and GI risks, and aspirin's long-term use raises bleeding risk because it permanently blocks platelet function.
Naproxen vs. Aspirin Drug Summary
Naproxen
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that treats pain, inflammation, and fever from conditions like arthritis, tendinitis, and menstrual cramps. It comes in over-the-counter 220 mg tablets and prescription strengths up to 500 mg, usually taken twice daily with food.
Aspirin
Aspirin is an NSAID and salicylate used for pain, fever, and inflammation, and it is also FDA-approved to lower the risk of heart attack and stroke in people with cardiovascular disease. It is taken as low-dose 81 mg tablets for heart protection or higher doses up to 650 mg every four hours for pain.
Naproxen vs. Aspirin Side Effects
Naproxen
Aspirin
Naproxen vs. Aspirin Dosage
Naproxen
Aspirin
| STAGE | DOSE | WHEN |
| Starting dose | 220 mg every 8-12 hrs | At the start |
| Maximum dose | Up to 1500 mg once daily | 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 |
Naproxen
| STAGE | DOSE | WHEN |
| Starting dose | 220 mg every 8-12 hrs | At the start |
| Maximum dose | Up to 1500 mg once daily | 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 |
Naproxen vs. Aspirin Indications
Naproxen
Naproxen is FDA-approved for pain and inflammation from arthritis and related conditions, as well as short-term use for mild-to-moderate pain, menstrual cramps, and acute gout flares. It is available over the counter at lower doses and by prescription at higher, more anti-inflammatory doses.
Osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis
Juvenile idiopathic arthritis (ages 2 and up)
Acute gout flares
Tendinitis, bursitis, and mild-to-moderate pain
Primary dysmenorrhea (menstrual cramps)
Aspirin
Aspirin is FDA-approved for temporary relief of minor aches, pain, and fever, and separately for secondary prevention of heart attack and stroke in people with known cardiovascular disease. It is also approved to reduce risk after unstable angina or a heart attack, and for certain rheumatologic conditions.
Temporary relief of minor aches, pains, and fever
Secondary prevention of heart attack and stroke
Risk reduction in unstable angina and acute MI
Rheumatologic conditions like rheumatoid arthritis
Primary CV prevention in select adults (off-label)
Naproxen vs. Aspirin Pros and Cons
Naproxen
Naproxen offers stronger, longer-lasting anti-inflammatory relief than standard aspirin doses, and its twice-daily dosing suits chronic conditions like arthritis. It carries the same NSAID boxed warning for cardiovascular and GI risks that applies to prescription-strength use.
Pros
Longer-acting; often dosed just twice daily for chronic pain
Stronger anti-inflammatory effect at prescription strengths
Available in extended-release and delayed-release forms
Approved for juvenile idiopathic arthritis in children 2+
Cons
No FDA-approved role in preventing heart attack or stroke
Contraindicated around CABG heart surgery
Not appropriate as an emergency heart attack treatment
Aspirin
Aspirin is the only common OTC pain reliever with an FDA-recognized role in preventing heart attack and stroke, thanks to its irreversible antiplatelet effect. That same effect raises long-term bleeding risk, and aspirin is not safe for children or teens with viral illnesses.
Pros
Only OTC analgesic with FDA-approved heart attack/stroke prevention use
Can be chewed for fast antiplatelet effect during a suspected heart attack
Available in chewable, enteric-coated, and suppository forms
Decades of safety data as one of the most studied drugs ever made
Cons
Irreversible platelet effect raises long-term bleeding risk
Unsafe for children/teens with viral illness (Reye's syndrome risk)
Standard pain-relief dosing may require dosing every 4 hours
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