Aspirin vs. Aleve (Naproxen)

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) used to treat fever, pain, and inflammation. It also prevents blood clots. Other NSAIDs include ibuprofen, indomethacin, and nabumetone. NSAIDs work by reducing levels of prostaglandins, chemicals released in inflammation that cause pain and fever. NSAIDs block the enzyme that makes prostaglandins, resulting in a reduction of inflammation, pain, and fever. Inhibition of prostaglandins also reduces platelet function and the blood’s clotting ability. Aspirin is used to reduce the risk of stroke or heart attack in people who have already had one.

Naproxen is used for mild to moderate pain, inflammation, and fever. It is also a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs work by reducing levels of prostaglandins, chemicals responsible for pain, fever, and inflammation. Naproxen blocks the enzyme that makes prostaglandins, resulting in lower concentrations of prostaglandins. This reduces inflammation, pain, and fever.

QUESTION

What are the side effects of aspirin and Aleve?

Aspirin

Most patients benefit from aspirin and other NSAIDs with few side effects. However, serious side effects can occur and tend to be dose-related. It is advisable to use the lowest effective dose to minimize side effects.

The most common side effects of aspirin involve the gastrointestinal system and ringing in the ears.

Gastrointestinal side effects include:

• ulcerations,
• abdominal burning,
• pain,
• cramping,
• nausea,
• gastritis, and
• serious gastrointestinal bleeding and
• liver toxicity.

Sometimes, ulceration and bleeding can occur without abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding.

• Ringing in the ears may occur, and the daily dose should be reduced.

Other side effects include:

Aspirin should be avoided by patients with peptic ulcer disease or poor kidney function, as it can aggravate both conditions. It may also exacerbate asthma and raise blood uric acid levels in patients with hyperuricemia and gout. Aspirin is not recommended for children and teenagers with the flu or chickenpox, as it may cause Reye’s Syndrome. It can increase the effect of diabetes medications, resulting in abnormally low blood sugars if not monitored. NSAIDs should be discontinued prior to elective surgery. Aspirin should be discontinued at least ten to fourteen days in advance of the procedure due to its prolonged effect on platelets.

The most common side effects from naproxen 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.

What is the dosage of aspirin vs. Aleve?

Aspirin

Aspirin should be taken with food. Doses range from 50 mg to 6000 mg daily depending on the use.

• Usual doses for mild to moderate pain are 350 or 650 mg every 4 hours or 500 mg every 6 hours.
• Doses for rheumatoid arthritis include 500 mg every 4-6 hours; 650 mg every 4 hours; 1000 mg every 4-6 hours; 1950 mg twice daily.
• Heart attacks are prevented with 75, 81, 162 or 325 mg daily.
• 160 to 325 mg of non-enteric coated aspirin should be chewed immediately when experiencing symptoms of a heart attack.
• The dose for preventing another stroke is 75 to 100 mg daily.

Aleve

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.

Naproxen should be given with food to reduce upset stomach. The dose for rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis is 500 to 1000 mg every 12 hours. Dysmenorrhea is treated with 250 mg every 6 to 8 hours after an initial dose of 500 mg.

What drugs interact with aspirin and Aleve?

Aspirin

• Aspirin is associated with several suspected or probable interactions that affect the action of other drugs. The following examples are the most common.
• NSAIDs may increase blood levels of lithium by reducing its excretion by the kidneys.
• Aspirin may reduce the blood pressure lowering effects of blood pressure medications.
• When aspirin is used with methotrexate or aminoglycoside antibiotics, blood levels of these drugs may increase.
• Oral blood thinners or anticoagulants should be avoided with aspirin to prevent excessive blood thinning.

Aleve

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

• Naproxen may increase blood levels of lithium by reducing its excretion by the kidneys.
• Naproxen may reduce the blood pressure lowering effects of blood pressure medications.
• When naproxen is used with methotrexate or aminoglycosides, blood levels of these drugs may increase.
• Anticoagulants should be avoided with naproxen to prevent bleeding.
• Naproxen increases the negative effect of cyclosporine on kidney function and reduces the effect of furosemide and thiazide diuretics.
• Naproxen should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. If taken with aspirin, there may be an increased risk for developing an ulcer.
• Persons who have more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking naproxen or other NSAIDs.

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Are aspirin and Aleve safe to use while pregnant or breastfeeding?

Aspirin

Aspirin is generally avoided during pregnancy because it may adversely affect the fetus. Low doses have been safely used for the prevention of complications.

Aspirin is excreted into breast milk and may cause adverse effects in the infant.

Aleve

NSAIDs may cause a fatal birth defect called ductus arteriosus 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. Breastfeeding while taking naproxen probably is not harmful to the infant.

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Summary

Aspirin and Aleve (naproxen) are nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat fever, pain, and inflammation. Aspirin is also used to prevent blood clots. Both aspirin and Aleve are available over-the-counter (OTC) and as generics.