Naproxen vs. Indomethacin
See how Naproxen and Indomethacin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Naproxen and indomethacin are both NSAIDs for arthritis and gout pain, but naproxen is usually taken twice a day while indomethacin often needs two to three doses daily.
FDA-reviewed studies found naproxen caused less stomach upset, dizziness, and ringing in the ears than indomethacin in arthritis patients treated long-term.
Indomethacin carries stronger warnings about worsening depression, epilepsy, or Parkinson's symptoms, warnings that are not on naproxen's label to the same degree.
Naproxen vs. Indomethacin Drug Summary
Naproxen
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used for arthritis, gout, tendinitis, bursitis, menstrual cramps, and general pain and fever. It comes in immediate-release, delayed-release, and extended-release tablets, most often taken twice a day with food.
Indomethacin
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) used for arthritis, acute gout flares, and painful shoulder bursitis or tendinitis. It comes as capsules or a sustained-release form, typically taken two to three times a day and adjusted until symptoms improve.
Naproxen vs. Indomethacin Side Effects
Naproxen
Indomethacin
Naproxen vs. Indomethacin Dosage
Naproxen
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 500 mg first dose | Day 1 |
| Maximum dose | Up to 1500 mg/day | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg 2-3 times daily | At the start |
| Maximum dose | 50 mg 3 times daily | If needed |
| Dose changes | 3 increases | As tolerated |
Naproxen
| STAGE | DOSE | WHEN |
| Starting dose | 500 mg first dose | Day 1 |
| Maximum dose | Up to 1500 mg/day | If needed |
| Dose changes | 3 increases | As tolerated |
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg 2-3 times daily | At the start |
| Maximum dose | 50 mg 3 times daily | If needed |
| Dose changes | 3 increases | As tolerated |
Naproxen vs. Indomethacin Indications
Naproxen
Naproxen is FDA-approved for rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, juvenile idiopathic arthritis, tendinitis, bursitis, acute gout, and primary dysmenorrhea. It is also approved for general mild to moderate pain. Lower-dose versions are sold over the counter for short-term aches and fever.
Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis
Juvenile idiopathic arthritis in children
Tendinitis, bursitis, and acute gout
Mild to moderate pain and primary dysmenorrhea
Available over-the-counter at lower doses (Aleve)
Indomethacin
Indomethacin is FDA-approved for rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute gouty arthritis, and acute painful shoulder from bursitis or tendinitis. A separate injectable form is approved to close a specific heart vessel in premature infants. It is available only by prescription.
Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis
Acute gouty arthritis
Acute painful shoulder (bursitis or tendinitis)
Patent ductus arteriosus closure in premature infants (IV form)
Prescription only, no over-the-counter version
Naproxen vs. Indomethacin Pros and Cons
Naproxen
Naproxen's long half-life allows twice-daily dosing for most conditions, and FDA-reviewed trial data found it caused less stomach and nervous system irritation than indomethacin. Both drugs carry the same class warnings for heart and GI risk, and both are widely available as low-cost generics.
Pros
Only needs to be taken twice daily for most conditions
Available over-the-counter at lower doses
Trial data show fewer GI and CNS side effects than indomethacin
Cons
Not approved for acute painful shoulder
No injectable formulation exists
Still carries standard NSAID heart and GI risks at higher doses
Indomethacin
Indomethacin is a more potent anti-inflammatory often chosen for acute gout flares and shoulder bursitis, but it usually requires two to three doses a day. Its label carries added warnings for headache, dizziness, and psychiatric or CNS reactions that stand out even among NSAIDs.
Pros
Specifically approved for acute painful shoulder (bursitis/tendinitis)
Injectable form available for a specialized newborn heart condition
Often chosen for rapid relief during acute gout attacks
Cons
Usually requires two to three doses a day
Higher rates of headache and dizziness than naproxen in trial data
Added warnings for worsening depression, epilepsy, or Parkinson's symptoms
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