Questions about Rheumatoid Arthritis? Get answers from our expert.

Generic Name: esomeprazole and naproxen (ee soe MEP ra zole and na PROX en)
Brand Name: Vimovo

What is esomeprazole and naproxen?

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID). It works by reducing substances in the body that cause inflammation, pain, and fever.

Esomeprazole is a proton pump inhibitor. It decreases the amount of acid produced in the stomach.

Esomeprazole and naproxen is a combination medicine used to treat symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. The esomeprazole in this medication helps reduce the risk of stomach ulcers in people who may be at risk for them while receiving treatment with an NSAID.

Esomeprazole and naproxen may also be used for purposes not listed in this medication guide.

What is the most important information I should know about esomeprazole and naproxen?

Naproxen may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Video: Treatment Options for Rheumatoid Arthritis

Doctor Ariel D. Teitel discusses several treatments that can help control the progression of the disease and help to alleviate the swelling and pain.

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

Naproxen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking esomeprazole and naproxen.

Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

What should I discuss with my healthcare provider before taking esomeprazole and naproxen?

You should not use this medication if you are allergic to esomeprazole or similar medicines (lansoprazole, omeprazole, pantoprazole, Nexium, Prevacid, Prilosec, Protonix, and others), or if you have ever had a severe allergic reaction to naproxen (Aleve, Anaprox, Naprosyn), aspirin, or other NSAIDs.

Naproxen may increase your risk of heart attack or stroke, especially if you use it long term or have heart disease. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Naproxen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are taking esomeprazole and naproxen, especially in older adults.

To make sure esomeprazole and naproxen is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • heart disease, high blood pressure, fluid retention, or a history of stroke, heart attack, or congestive heart failure;

  • low levels of magnesium in your blood;

  • a bleeding or blood clotting disorder, such as hemophilia;

  • a history of stomach ulcer, stomach bleeding, or intestinal disorder (Crohn's disease, ulcerative colitis);

  • asthma, or a history of allergic reaction to aspirin, especially aspirin triad syndrome;

  • if you are on a low econazole topical diet;

  • if you are vomiting or having diarrhea; or

  • if you smoke.

Taking esomeprazole may increase your risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly in people who have taken the medication long term or at high doses, and in those who are age 50 and older. It is not clear whether esomeprazole is the actual cause of an increased risk of fracture. Tell your doctor if you have osteoporosis or osteopenia (low bone mineral density).

FDA pregnancy category D. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking naproxen during the last 3 months of pregnancy may result in birth defects. Do not take esomeprazole and naproxen during pregnancy unless your doctor has told you to.

Naproxen can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking esomeprazole and naproxen.

How should I take esomeprazole and naproxen?

Esomeprazole and naproxen is usually taken 2 times each day, at least 30 minutes before a meal. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Do not crush, chew, or break a delayed-release tablet. Swallow it whole.

While using esomeprazole and naproxen, you may need frequent blood tests. Your blood pressure and kidney or liver function may also need to be tested. You may also need eye exams if you have any changes in your vision.

This medicine can cause unusual results with certain medical tests, and you may need to stop using the medicine for a short time before a test. Tell any doctor who treats you that you are using esomeprazole and naproxen.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include feeling weak or tired, nausea, vomiting, stomach pain or discomfort, severe dizziness or drowsiness, bleeding, uncontrolled muscle movements, weak or shallow breathing, or loss of coordination.

What should I avoid while taking esomeprazole and naproxen?

Ask a doctor or pharmacist before using any other pain or arthritis medicine. Many medicines available over the counter contain naproxen or similar medicines (such as aspirin, ibuprofen, or ketoprofen). Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains naproxen or another NSAID.

This medication can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking esomeprazole and naproxen and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Ask your doctor before using esomeprazole and naproxen if you take an antidepressant such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Taking any of these medicines with an NSAID may cause you to bruise or bleed easily.

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Esomeprazole and naproxen side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

Stop using esomeprazole and naproxen and call your doctor at once if you have:

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • shortness of breath (even with mild exertion), swelling, rapid weight gain;

  • little or no urinating;

  • diarrhea that is watery or bloody;

  • pale skin, feeling light-headed, rapid heart rate, trouble concentrating;

  • wheezing, chest tightness, trouble breathing;

  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • constipation, mild diarrhea;

  • nausea, vomiting, heartburn, gas;

  • dizziness; or

  • mild stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect esomeprazole and naproxen?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with esomeprazole and naproxen, especially:

  • atazanavir:

  • cholestyramine;

  • clopidogrel;

  • cyclosporine;

  • digoxin;

  • erlotinib;

  • iron supplements;

  • ketoconazole;

  • lithium;

  • methotrexate;

  • rifampin;

  • St. John's wort;

  • a blood thinner (warfarin, Coumadin, Jantoven);

  • a diuretic or "water pill";

  • heart or blood pressure medication;

  • NSAIDs--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or

  • steroid medicine--prednisone and others.

This list is not complete and other drugs may interact with esomeprazole and naproxen. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about esomeprazole and naproxen.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 10.02. Revision Date: 2014-04-16, 10:27:17 AM.

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