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

Most common
Headache (up to 15%)
Dyspepsia (up to 14%)
Flu-like symptoms (up to 10%)
Nausea (up to 9%)

Aspirin

Most common
Stomach upset (up to 10%)
Heartburn (up to 6%)
Easy bruising/bleeding (up to 5%)
GI bleeding (up to 1%)

Naproxen vs. Aspirin Dosage

Naproxen

Dosage
Dosage Table
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

Dosage
Dosage Table
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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