Diclofenac vs. Ibuprofen: Which is Right For You?

There are so many over-the-counter and prescription medicines available to treat pain that it can be difficult to select the best one. A group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat mild to moderate pain. In this article, we will compare two medications — diclofenac and ibuprofen. Both are NSAIDs and are frequently used by patients with arthritis and other illnesses subjected to chronic pain with no evidence of renal impairment.

What are nonsteroidal anti-inflammatory drugs? How do they work?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for treating pain and reducing inflammation. They work by reducing hormones called prostaglandins which play a critical role in the body by eliciting a pain response and causing inflammation.

A nonsteroidal anti-inflammatory drug can either be selective for COX-1 or COX-2 enzyme, thereby blocking a portion of prostaglandin synthesis or nonselective by blocking both COX-1 and COX-2, thereby diminishing prostaglandin synthesis to an even greater degree. Why not always block prostaglandin synthesis? Well, prostaglandins also help dilate blood vessels, which is important for organs, particularly the kidneys. This is why variety is so appreciated when dealing with complex patients.

Both diclofenac and ibuprofen are non-selective NSAIDs, meaning they block both COX-1 and COX-2 enzymes. Therefore, these drugs work in the same way.

Notably, COX-1 protects the stomach lining, so when you block this enzyme with drugs like diclofenac and ibuprofen, it can lead to gastrointestinal symptoms such as stomach pains, ulcers, etc.

What is diclofenac?

Diclofenac is an FDA-approved prescription NSAID used to treat rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis in adults since these diseases at their foundation are caused by inflammatory processes.

What is ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory drug that can be purchased over the counter and is also available by prescription. Over-the-counter ibuprofen is used to treat fever and minor aches and pains in children and adults, such as headache, muscle ache, backache, toothache, and menstrual pain. Ibuprofen prescription strength is used to treat arthritic pain and inflammation in adults.

Are diclofenac and ibuprofen the same?

No, diclofenac and ibuprofen are not the same medication. They are both nonsteroidal anti-inflammatory drugs, but there are some key differences between them.

What are the main differences between diclofenac vs. ibuprofen?

Availability and Brand Names

Diclofenac (brand name Voltaren) is a prescription NSAID. Ibuprofen (Advil, Motrin, and other trademarks) is available OTC or with a prescription.

Age Range

Diclofenac is approved for use in adults over the age of 18, whereas Ibuprofen can be used by adults and children over 6 months.

Conditions Treated

Diclofenac is used to treat rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. It is also used to relieve migraines and menstrual cramps. OTC ibuprofen provides temporary relief from symptoms such as fever and mild pain, including headache, backache, muscle pain, and menstrual pain. Prescription-strength ibuprofen is used to treat severe pain from arthritis.

Forms

Diclofenac comes in the form of a delayed-release tablet, extended-release tablet, and topical gel or solution. Ibuprofen is available as a tablet, chewable tablet, suspension, and drops.

Typical Dosage

The dose of diclofenac for arthritis pain is typically 25 mg to 50 mg, taken 2-3 times a day with a maximum dose of 150 mg a day. Prescription ibuprofen dose is 800 mg up to 4 times a day with a maximum dose of 3,200 mg daily.

Cost and Coverage

Most health insurance plans cover the generic versions of diclofenac and ibuprofen. Diclofenac costs approximately $60. Ibuprofen costs approximately $5. You can get these two drugs at significantly lower prices with BuzzRx discount coupons.

Side Effects

Diclofenac, ibuprofen, and other NSAIDs can cause common side effects like heartburn, gas, indigestion, stomach pain, diarrhea, and constipation. They can also cause you to feel dizzy or have itchy skin or swelling.

NSAIDs can also cause more severe side effects such as stomach ulcers, liver problems, and kidney problems.

Drug Interactions

NSAIDs such as diclofenac and ibuprofen can interact with the following medications:

Taking NSAIDs with certain blood pressure medications such as beta-blockers, angiotensin receptor blockers (ARBs), and angiotensin-converting enzyme (ACE) inhibitors can make the antihypertensives less effective.
Taking NSAIDs and anticoagulants such as aspirin or warfarin (blood thinners) puts you at increased risk of bleeding.
Taking antidepressants such as SSRI or SNRI with NSAIDs also increases the risk of bleeding.
Taking drugs like digoxin, lithium, and methotrexate with NSAIDs can put you at risk of serious side effects.

This is not a complete list of drug interactions between NSAIDs and other drugs. Always talk to a doctor or pharmacist before taking an NSAID if you take other medications.

Warnings

NSAIDs can increase the risk of gastrointestinal adverse effects like stomach ulcers, intestinal ulcers, and bleeding.
Taking NSAIDs can increase the risk of heart attack and stroke, especially in people who have a history of cardiovascular disease.
NSAIDs can worsen heart failure.
NSAIDs can decrease the effectiveness of antihypertensive medications.
People with kidney or liver problems should avoid taking diclofenac and ibuprofen due to toxicity risk and the likelihood of worsening their specific disease.
NSAIDs can cause issues during pregnancy during late gestation.

Diclofenac vs. ibuprofen: Which is better?

Diclofenac is a more potent NSAID than ibuprofen. Taking diclofenac 2-3 times daily can effectively treat arthritis pain. To treat joint pain with ibuprofen, a higher dose such as a “prescription-strength dose” is usually needed.

Is diclofenac or ibuprofen more effective?

A meta-analysis of 176 studies and 146,524 patients published in the Journal of Arthritis Research and Therapy found that diclofenac 150 mg/day is more effective than ibuprofen 2,400 mg/day for arthritis pain relief.

The study also showed that diclofenac is a better choice than other drugs like naproxen 1,000 mg/day and celecoxib 200 mg/day, which are also nonsteroidal anti-inflammatory drugs.

Moreover, the risk of stomach-related side effects was found to be lower with diclofenac when compared to ibuprofen.

Nevertheless, both diclofenac and ibuprofen are effective medications when used at the appropriate doses. Plenty of considerations, such as drug cost, mechanism of action, patient disease profile, etc., go into the decision-making of what medication works best for you, so you should obtain professional medical advice from a healthcare provider to determine which drug is most beneficial for you.

Frequently Asked Questions

Can you take diclofenac and ibuprofen together?

No, you should not take diclofenac and ibuprofen together. These two drugs belong to the same drug class, thus, they work similarly. Raking them together can increase the risk of serious adverse events.

Can you drink alcohol while taking diclofenac or ibuprofen?

You should avoid drinking alcohol if you’re taking diclofenac or ibuprofen, as this combination can increase the risk of bleeding and worsen other side effects like headache and dizziness.

Which is better for back pain - diclofenac or ibuprofen?

Both diclofenac and ibuprofen are used for pain management and inflammation. Despite diclofenac being a more potent NSAID and having FDA approval as a treatment for ankylosing spondylitis (arthritis of the spine), your doctor will consider the origin of back pain and disease process other existing illnesses in the patient and overall benefit before coming to a decision.