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

Most common
headache (up to 15%)
dyspepsia (up to 14%)
nausea (up to 9%)
flu-like symptoms (up to 10%)

Indomethacin

Most common
headache (up to 16%)
dyspepsia (up to 9%)
nausea (up to 9%)
dizziness (up to 9%)

Naproxen vs. Indomethacin Dosage

Naproxen

Dosage
Dosage Table
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

Dosage
Dosage Table
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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