Is naproxen 500 mg strong painkiller

Naproxen is from a class of medicines called non-steroidal anti-inflammatory drugs, or NSAIDs. 

It is known for effective pain relief and reduces swelling in a variety of musculoskeletal conditions, commonly used in arthritis. NSAIDs are a group of medicines which bring pain relief so it is useful to compare them against other NSAIDs (e.g. ibuprofen, diclofenac, celecoxib) to understand its potency better.

At a glance:

• Naproxen may provide better long-term pain relief compared to ibuprofen but ibuprofen works faster
• All NSAIDs are similar in terms of ‘strength’ of pain relief
• The decision between one NSAID over another is based on the side effect profile

What is Naproxen?

To get a better idea of naproxen’s potency, we need to briefly look at how it works. Like many NSAIDs, naproxen targets cyclooxygenase (COX) enzymes. It does so because COX enzymes produce chemicals called prostaglandins which result in pain and inflammation. 

By blocking these enzymes, naproxen reduces prostaglandin levels and therefore pain and inflammation are reduced.

Because of this pain-relieving effect, it can be used for many different conditions such as headaches, joint and muscle pains and even period cramps.

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• Used to provide pain relief 
• Nonsteroidal anti-inflammatory
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Is Naproxen ‘strong’ compared to other painkillers?

Naproxen comes in two different strengths, 250mg and 500mg. At 500mg, it should be taken at most twice a day.

Naproxen 500mg VS Ibuprofen

When naproxen is taken, peak levels of the drug are reached in the body after 2-4 hours. Ibuprofen, however, only takes 1-2 hours. This means that ibuprofen works faster i.e. a faster onset of action. So for acute pain relief, ibuprofen is the better option. However, ibuprofen is also cleared from the body a lot quicker.

The half-life of a drug is the time it takes for the drug concentration in the body to halve – it is used to give a measure of how fast a drug is cleared from the body. The half-life of ibuprofen is about 2 hours whereas naproxen is considerably longer, between 12-15 hours.

This means that naproxen gives ‘longer-lasting’ pain relief, hence why naproxen 500mg is taken twice a day whereas ibuprofen 400mg is taken up to 3 times daily. Note that two different drugs may have different strengths but does not mean the higher strength of one drug is more potent. E.g. 600mg of Drug X may be less potent than 25mg of Drug Y.

From this, naproxen may be better suited towards ‘long-term’ chronic pain such as muscle aches whereas ibuprofen may be better for acute, short-term pain like headaches.

Which is the strongest NSAID?

There is no definitive ‘strongest’ NSAID as they all work in a similar way i.e. inhibiting COX enzymes. They differ on how selective they are for COX enzymes (there are different ones e.g. COX-1, COX-2 etc.) which can result in variability in individual responses and likelihood of side effects.

Naproxen 500mg compared to other NSAIDs

With the above said, the reason behind one NSAID over another is often due to the side effect profile. All NSAIDs can cause gastrointestinal side effects (stomach upsets), hence why they are advised to be taken with food to reduce this risk.

Likelihood of gastro-intestinal side effects:

• Medium risk: naproxen, diclofenac
• Low risk: ibuprofen

Some NSAIDs are more selective towards COX-2 enzymes (e.g. Celecoxib) which have a lower risk of serious stomach and upper belly side effects e.g. stomach pain, nausea and vomiting.

NSAIDs can lead to a slightly increased risk of cardiovascular events. Naproxen (1g daily) and up to 1.2g of ibuprofen are considered low-risk. However, the maximum dose of ibuprofen is 2.4g daily which would increase this risk.

Can anyone take Naproxen?

Naproxen is not suitable for everyone. As an NSAID, it interacts with certain medicines. This includes some medicines which can be bought over the counter in a pharmacy (e.g. pseudoephedrine) so it is worth mentioning to your pharmacist during purchase.

It may not be suitable for individuals with specific conditions. These include asthma, high blood pressure (hypertension) and kidney/liver problems. Some individuals are allergic to NSAIDs so if any of the above apply, it is important to speak to your doctor or pharmacist first.

Conclusion

You may find more benefits in a particular NSAID compared to somebody else. In fact, roughly 60% of individuals will respond to any NSAID. 

Even though they work in a similar way, your body may respond better to a particular one. Therefore, if you have found naproxen to be ineffective, speak to your doctor. A straightforward switch may be all that is required for some much-needed pain relief!

Authored By

Dr Giuseppe Aragona

Doctor

Dr. Giuseppe utilises his extensive experience in general practice to ensure the accuracy and safety of the website's content.

Published on: 31/01/2023

Reviewed By

Mohamed Imran Lakhi

MPharm - Lead Pharmacist

Imran Lakhi is the superintendent pharmacist and founder at Prescription Doctor. He has been at the core of our team.

Reviewed on: 12/07/2024