Aleve (naproxen) vs. Celebrex (celecoxib)

• Aleve (naproxen) and Celebrex (celecoxib) are nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat arthritis, pain, menstrual cramps, and fever.
• One difference between Aleve and Celebrex is that Aleve is available without a prescription from your doctor (over-the-counter, OTC) and Celebrex is not. You do need one to obtain Celebrex.
• Side effects of Aleve and Celebrex that are similar include:
  • Headache
  • Abdominal pain
  • Nausea
  • Indigestion/heartburn
  • Diarrhea
• Side effects of Celebrex that do not occur with Aleve include gas (flatulence) and insomnia.
• Side effects of Aleve that do not occur with Celebrex include:
  • Rash
  • Ringing in the ears (tinnitus)
  • Dizziness
  • Drowsiness
  • Constipation
  • Fluid retention
  • Shortness of breath
• Like other NSAIDS, Celecoxib and Aleve may cause stomach and intestinal ulcers that may occur at any time during treatment.
• Celecoxib is different from other NSAIDs in that it does not interfere with the function of the blood platelets and, as a result, it does not reduce clotting and lead to increased bleeding time like other NSAIDs.

• Celebrex, brand name celecoxib, is a nonsteroidal anti-inflammatory drug (NSAID) used for the treatment of arthritis, pain, menstrual cramps, and colon polyps.
  • Prostaglandins are chemicals that contribute to arthritis pain, fever, swelling, and tenderness caused by inflammation. Celebrex blocks the enzyme that makes prostaglandins (cyclooxygenase 2), which results in lower concentrations of prostaglandins.
  • Consequently, inflammation, pain, fever, swelling, and tenderness are reduced. Celebrex is different from other NSAIDs in that it causes less inflammation, and stomach and intestinal ulcers (at least with short-term use), and does not interfere with blood clotting.
• Aleve (naproxen) is a nonsteroidal anti-inflammatory drug (NSAID). Other NSAIDs include ibuprofen (Motrin), indomethacin (Indocin), nabumetone (Relafen) and others. These drugs are used for the management of mild to moderate pain, fever, and inflammation.

Aleve (naproxen) uses

• Naproxen is used for the treatment of mild to moderate pain, inflammation, and fever.

Celebrex (celecoxib) uses

• Celecoxib is used for the relief of pain, fever, swelling, and tenderness caused by osteoarthritis, juvenile arthritis, rheumatoid arthritis, and ankylosing spondylitis.
• Celecoxib does not prevent the progression of either type of arthritis. It reduces only the symptoms and signs of arthritis. Celecoxib is also approved for patients with familial FAP who have not had their colons removed.
• Celebrex also is also used for the relief of acute pain and the pain of menstrual cramps (primary dysmenorrhea).

Aleve side effects

The most common side effects from Aleve are

• rash,
• ringing in the ears,
• headaches,
• dizziness,
• drowsiness, abdominal pain, nausea,
• diarrhea,
• constipation,
• heartburn,
• fluid retention, and
• shortness of breath.

Other important side effects include

• fluid retention,
• blood clots,
• heart attacks,
• hypertension, and
• heart failure.

Celebrex side effects

The most common adverse effects of Celebrex are

• headache,
• abdominal pain,
• indigestion
• (dyspepsia),
• diarrhea,
• nausea,
• flatulence, and
• insomnia.

Other side effects include

• fainting,
• kidney failure,
• heart failure,
• aggravation of hypertension,
• chest pain,
• ringing in the ears,
• deafness,
• stomach and intestinal ulcers,
• bleeding,
• blurred vision,
• anxiety,
• photosensitivity,
• weight gain,
• water retention,
• flu-like symptoms,
• drowsiness and
• weakness.

Celecoxib, like other NSAIDs may cause serious stomach and intestinal ulcers that may occur at any time during treatment. Celecoxib does not interfere with the function of the blood platelets and, as a result, does not reduce clotting and lead to increased bleeding time like other NSAIDs.

Allergic reactions can occur with celecoxib. Individuals who have developed allergic reactions (rash, itching, difficulty breathing) from sulfonamides (for example, sulfamethoxazole and trimethoprim [Bactrim]), aspirin or other NSAIDs may experience an allergic reaction to celecoxib and should not take celecoxib.

NSAIDs (except for low-dose aspirin) may increase the risk of heart attacks, stroke, and related conditions, which can be fatal. This risk may increase with duration of use and in patients who have underlying risk factors for heart and blood vessel conditions. NSAIDs should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.

NSAIDs cause an increased risk of serious, even fatal, stomach and intestinal adverse reactions such as bleeding, ulcers, and perforation of the stomach or intestines. These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these types of reactions.

Aleve dosage

• Naproxen should be given with food to reduce upset stomach.
• The usual adult dose for pain is 250 every 6 to 8 hours or 500 mg twice daily using regular naproxen tablets.
• The usual dose for Naprelan controlled release tablets is 750 to 1000 mg given once daily.
• For EC-Naprosyn, the usual dose is 375-500 mg twice daily.
• The dose for rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis is 500 to 1000 mg every 12 hours.
• Menstrual cramps are treated with 250 mg every 6 to 8 hours after an initial dose of 500 mg.

Celebrex dosage

• The lowest effective dose should be used for each patient.
• For the management of osteoarthritis, the dose usually is 100 mg twice daily or 200 mg as a single dose.
• For rheumatoid arthritis, the dose usually is 200 mg twice daily.
• For acute pain or menstrual cramps, the dose is 400 mg as a single dose on the first day followed by an additional 200 mg if needed, then 200 mg twice daily as needed.
• For FAP, the recommended dose is 400 mg twice daily.

Aleve drug interactions

Naproxen is associated with several suspected or probable interactions that affect the action of other drugs. The most common drug interactions include.

• Naproxen may increase the blood levels of lithium (Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.
• Naproxen may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins play a role in the regulation of blood pressure.
• When naproxen is used in combination with methotrexate (Rheumatrex, Trexall) or aminoglycosides (for example, gentamicin) the blood levels of the methotrexate or aminoglycoside may increase, presumably because the elimination from the body of these drugs is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.
• Individuals taking anticoagulants, for example, warfarin, (Coumadin), should avoid naproxen because naproxen also thins the blood, and excessive blood thinning may lead to bleeding.
• Naproxen increases the negative effect of cyclosporine on kidney function and reduces the effect of furosemide (Lasix) and thiazide diuretics because of prostaglandin inhibition.
• Naproxen should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. If aspirin is taken with naproxen, there may be an increased risk for developing an ulcer.
• People who have more than three alcoholic drinks per day may be at increased risk of developing stomach ulcers when taking naproxen or other NSAIDs.

Celebrex drug interactions

• Combining Celebrex with aspirin or other NSAIDs (for example, ibuprofen, naproxen, etc.) may increase the occurrence of stomach and intestinal ulcers. It may be used with low dose aspirin.
• Fluconazole (Diflucan) increases the concentration of celecoxib in the body by preventing the elimination of celecoxib in the liver. Therefore, treatment with celecoxib should be initiated at the lowest recommended doses in patients who are taking fluconazole.
• Celecoxib increases the concentration of lithium (Eskalith, Lithobid) in the blood by 17% and may promote lithium toxicity. Therefore, lithium therapy should be closely monitored during and after therapy with celecoxib.
• Persons taking the anticoagulant (blood thinner) warfarin (Coumadin) should have their blood tested when initiating or changing celecoxib treatment, particularly in the first few days, for any changes in the effects of the anticoagulant.
• NSAIDs may reduce the blood pressure-lowering effects of drugs that are given to reduce blood pressure. This may occur because prostaglandins play a role in the regulation of blood pressure.
• Persons who drink more than three alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking NSAIDs, this also may happen with celecoxib.

Aleve safety

• NSAIDs may cause a fetal birth defect called ductus arteriosus (early closure of two major blood vessels of the heart and lung) in the third trimester of pregnancy. Therefore, NSAIDs should be avoided during this last part of pregnancy.
• A small amount of naproxen is excreted in breast milk. Because the concentration in breast milk is low, breastfeeding while taking naproxen probably is not harmful to the infant.

Celebrex safety

• Celecoxib has not been studied in pregnant women. In animal studies, doses that were twice the maximally recommended dose were harmful to the fetus. It should not be used in late pregnancy because there is a risk of heart defects in the newborn. Celecoxib should only be used in pregnant women when the benefits outweigh the potential risk to the fetus.
• Available evidence suggests that celecoxib is secreted in breast milk. Nursing mothers should avoid celecoxib or discontinue breastfeeding.