Naproxen vs. Celebrex
See how Naproxen and Celebrex compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Naproxen and Celebrex are both NSAIDs for pain and inflammation, but Celebrex is COX-2 selective and tends to cause fewer stomach-related side effects.
Naproxen is available over the counter at lower doses and as an inexpensive generic, while Celebrex requires a prescription.
Both drugs carry an FDA boxed warning for increased risk of heart attack and stroke with long-term use, so neither is automatically the safer choice for the heart.
Naproxen vs. Celebrex Drug Summary
Naproxen
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that relieves pain, swelling, and stiffness from arthritis, gout, and other conditions. It comes in immediate-release and extended-release tablets, usually taken twice a day, and lower doses are sold over the counter as Aleve.
Celebrex
Celebrex (celecoxib) is a COX-2 selective NSAID that relieves pain and inflammation from osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It is taken as a prescription capsule, usually once or twice a day, and works with less impact on the stomach lining than older NSAIDs.
Naproxen vs. Celebrex Side Effects
Naproxen
Celebrex
Naproxen vs. Celebrex Dosage
Naproxen
Celebrex
| STAGE | DOSE | WHEN |
| Starting dose | 250-500 mg twice daily | At the start |
| Maximum dose | 500 mg, then 250 mg q6-8h | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 100-200 mg twice daily | At the start |
| Maximum dose | 200 mg twice daily | If needed |
| Dose changes | 4 increases | As tolerated |
Naproxen
| STAGE | DOSE | WHEN |
| Starting dose | 250-500 mg twice daily | At the start |
| Maximum dose | 500 mg, then 250 mg q6-8h | If needed |
| Dose changes | 3 increases | As tolerated |
Celebrex
| STAGE | DOSE | WHEN |
| Starting dose | 100-200 mg twice daily | At the start |
| Maximum dose | 200 mg twice daily | If needed |
| Dose changes | 4 increases | As tolerated |
Naproxen vs. Celebrex Indications
Naproxen
Naproxen is FDA-approved for a range of pain and inflammatory conditions and is one of the most widely used NSAIDs in both prescription and over-the-counter forms. It's often chosen for its relatively long-lasting relief compared to shorter-acting NSAIDs like ibuprofen.
Osteoarthritis and rheumatoid arthritis
Ankylosing spondylitis
Juvenile idiopathic arthritis
Acute gout flares
Mild to moderate pain, tendinitis, bursitis, and menstrual cramps
Celebrex
Celebrex is FDA-approved for arthritis pain and several other inflammatory conditions, and its COX-2 selectivity was designed specifically to lower gastrointestinal risk compared to older NSAIDs. It also has a niche approved use in reducing colon polyps in a rare hereditary condition.
Osteoarthritis and rheumatoid arthritis
Ankylosing spondylitis
Juvenile rheumatoid arthritis (ages 2 and up)
Acute pain and primary dysmenorrhea
Reducing colorectal polyps in familial adenomatous polyposis
Naproxen vs. Celebrex Pros and Cons
Naproxen
Naproxen has decades of real-world use and is available both by prescription and over the counter, which keeps it accessible and affordable. Its main tradeoff is a higher rate of stomach-related side effects than COX-2-selective options like Celebrex.
Pros
Available over the counter at lower doses
Inexpensive generic pricing
Long-acting, so often dosed just twice a day
Decades of safety data across many populations
Cons
Higher rate of GI side effects like ulcers and bleeding than celecoxib
More likely to interfere with low-dose aspirin's heart-protective effect
Not COX-2 selective, so it affects platelets more than Celebrex
Celebrex
Celebrex's COX-2 selectivity was designed to reduce stomach irritation while still controlling arthritis pain and inflammation. It requires a prescription and carries the same class-wide cardiovascular warning as other NSAIDs, including naproxen.
Pros
Lower rate of GI ulcers and bleeding than naproxen
Once- or twice-daily dosing for most indications
No significant effect on platelet function at approved doses
Additional approved use for a hereditary polyp condition
Cons
Requires a prescription; not sold over the counter
Contains a sulfonamide group, so it's avoided in sulfa allergy
Interacts with fluconazole, requiring dose adjustment
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