Comparing Ibuprofen, Naproxen and Celebrex

Ibuprofen is an over-the-counter medication used to relieve pain, inflammation and fever. It belongs to the class of medications known as nonsteroidal anti-inflammatory drugs or NSAIDs. Naproxen and Celebrex are also NSAIDs and share some of the same indications for use. However, there are important differences between ibuprofen, naproxen and Celebrex. These differences can be used to help an individual understand which NSAID may be appropriate for his or her specific health issues.

Ibuprofen is also the active ingredient in Motrin and Advil. It is specifically a non-selective reversible inhibitor of the enzymes cyclooxygenase 1 and 2 (COX-1 and COX-2). This means that ibuprofen can inhibit the activity of both COX-1 and COX-2 for a period of time, but eventually the ability to suppress the enzymatic activity will cease.

COX 1 and 2 are key enzymes in the inflammatory cascade of the body. When these two enzymes are inhibited, the production of arachidonic acid is blocked, thereby decreasing the amount of prostaglandin G2 (PGG2). As a result of decreased PGG2, there is a decrease in the production of prostaglandins, important factors in inflammation, pain and fever, as well as a decrease in the production of thromboxanes which normally activate platelets and cause constriction of blood vessels.

Like Ibuprofen, Naproxen works by inhibiting both cyclooxygenase enzymes. However, Naproxen is a prescription medication. It is also known by the brand name Naprosyn. Another important difference between ibuprofen and naproxen is the length of time that these two medications exert their effects. Ibuprofen is a short-acting NSAID, while Naproxen continues to act longer and is known as an intermediate-acting NSAID.

Celebrex is the brand name for the medication celecoxib. This medication is similar to naproxen in that it is also available only by prescription. However, unlike Naprosyn, Celebrex is a long-acting NSAID. Celebrex belongs to the group of NSAIDs which are the longest acting. These include nabumetone (Relafen), meloxicam (Mobic), oxaprozin (Daypro) and piroxicam (Feldene).

Celebrex also differs from ibuprofen and naproxen in another important way. Celebrex is a selective reversible inhibitor of cyclooxygenase-2 (COX-2) only. This medication does not inhibit the COX-1 enzyme like ibuprofen and naproxen. This difference in mechanism of action likely results in less potential for adverse gastric side effects such as gastric bleeding and ulceration when Celebrex is used instead of a nonselective NSAID.

Though ibuprofen, naproxen and celecoxib all belong to the class of anti-inflammatory medications known as NSAIDs, significant differences exist between these three drugs. Individuals should work with their physician to determine which NSAID is best for them.

Source: Johannsen, E. MD. Pharmcards. 2nd Ed. LW&W. 2002.