NSAIDs comparison: pick the right over‑the‑counter or prescription pain reliever

Feeling sore and wondering which NSAID to use? NSAIDs are a family of drugs that reduce pain, fever, and inflammation. Common names you’ll see are ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin, diclofenac, and celecoxib (Celebrex). They work similarly but differ in how fast they act, how long they last, and how safe they are for you.

Key differences that matter

Speed and duration: Ibuprofen starts working fast (30–60 minutes) but wears off sooner — usually 4–6 hours. Naproxen takes a bit longer to kick in but lasts up to 12 hours, which is handy for overnight pain. Diclofenac and some prescription formulas can be stronger for severe joint pain. Celecoxib is a COX‑2 selective NSAID: it targets inflammation with less stomach upset for some people.

GI risk and bleeding: Traditional NSAIDs (ibuprofen, naproxen, diclofenac) block COX‑1 and COX‑2. That lowers stomach protection and raises the risk of ulcers and bleeding, especially with long‑term use or if you take blood thinners. Aspirin also thins blood and is used for heart protection at low doses, but it carries GI risk at higher doses.

Heart and kidney effects: All NSAIDs can raise blood pressure and stress kidneys. If you have heart disease, recent heart surgery, or chronic kidney disease, avoid regular NSAID use unless your doctor says it’s safe. Naproxen may have a slightly lower heart‑attack risk than some others, but the safest choice depends on your history.

Practical guidance: when to choose which one

For a headache or short‑term fever: ibuprofen is fast and effective. For longer pain spikes or menstrual cramps where you don’t want to dose often: naproxen is convenient. For osteoarthritis or chronic joint pain: discuss diclofenac or celecoxib with your doctor — celecoxib may be easier on your stomach for long‑term use. For heart protection, low‑dose aspirin is the standard, but don’t mix that with higher NSAID doses without checking with a clinician.

How to take them more safely: use the lowest effective dose for the shortest time. Take with food to reduce stomach upset. Avoid mixing NSAIDs with alcohol or other blood thinners unless directed. If you’re over 65, have a history of ulcers, heart disease, high blood pressure, or kidney problems, check with your healthcare provider first.

Red flags — stop and call a doctor if you notice black stools, severe belly pain, unusual swelling, sudden shortness of breath, chest pain, or a sharp drop in urine output. Those can be signs of serious side effects.

If you’re unsure, ask: What condition am I treating? How long do I need this? What other meds do I take? Simple answers often point to the safest choice for you. When in doubt, talk to a pharmacist — they can help match an NSAID to your needs and warn about interactions.

Want a quick rule of thumb? Short problem, pick ibuprofen. Need longer coverage, try naproxen. Have stomach issues, ask about celecoxib. Always aim for the smallest effective dose and check with a clinician for chronic use.