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  • esomeprazole and naproxen
 

esomeprazole and naproxen

Pronunciation: ee soe MEP ra zole and na PROX en

Brand: Vimovo

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

The naproxen in this medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

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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 serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking esomeprazole and naproxen, especially in older adults.

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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.

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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).

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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.

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.

The combination of esomeprazole and naproxen is 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 should I discuss with my healthcare provider before taking esomeprazole and naproxen?

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You should not use this medication if you are allergic to esomeprazole (Nexium) or naproxen (Aleve, Anaprox, Naprosyn, and others), or if you have ever had a severe allergic reaction to aspirin or other NSAIDs. Do not use esomeprazole and naproxen just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

The naproxen in this medicine may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

Naproxen may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking esomeprazole and naproxen, especially in older adults.

To make sure you can safely take esomeprazole and naproxen, tell your doctor if you have any of these other conditions:

  • 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; or
  • if you smoke.
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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).

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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.

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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?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Esomeprazole and naproxen is usually taken 2 times each day, at least 30 minutes before a meal. Follow your doctor's instructions.

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Do not crush, chew, or break an enteric coated pill. Swallow it whole. The enteric coated pill has a special coating to protect your stomach. Breaking the pill will damage this coating.

To be sure this medication is not causing harmful effects, your blood may need to be tested often. 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. Visit your doctor regularly.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using esomeprazole and naproxen.

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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?

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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?

Multum donot

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 an antidepressant such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft). Taking any of these drugs with an NSAID may increase your risk of stomach bleeding.

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

What are the possible side effects of esomeprazole and naproxen?

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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.

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Stop using esomeprazole and naproxen and call your doctor at once if you have a serious side effect such as:

  • pale skin, easy bruising, unusual bleeding, or any bleeding that will not stop;
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • sudden numbness or weakness, especially on one side of the body;
  • sudden headache, confusion, problems with vision, speech, or balance;
  • pain, swelling, warmth, or redness in one or both legs;
  • low magnesium (dizziness, confusion, fast or uneven heart rate, jerking muscle movements, jittery feeling, muscle cramps, muscle weakness or limp feeling, cough or choking feeling, seizure);
  • urinating less than usual or not at all;
  • swelling, rapid weight gain, feeling short of breath (even with mild exertion);
  • diarrhea that is watery or bloody;
  • black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee grounds;
  • nausea, upper stomach pain, itching, 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.

Less serious side effects may include:

  • constipation, mild diarrhea; 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.

What other drugs will affect esomeprazole and naproxen?

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Esomeprazole should not be taken together with atazanavir (Reyataz) or nelfinavir (Viracept). Tell your doctor if you are taking either of these medications to treat HIV or AIDS.

Tell your doctor about all other medicines you use, especially:

  • clopidogrel (Plavix) or cilostazol (Pletal);
  • cholestyramine (Prevalite, Questran);
  • digoxin (digitalis, Lanoxin);
  • lithium (Eskalith, Lithobid, others);
  • methotrexate (Rheumatrex, Trexall);
  • probenecid (Benemid);
  • rifampin (Rifadin, Rifater, Rifamate);
  • St. John's wort;
  • tacrolimus (Prograf);
  • an iron supplement;
  • a blood thinner such as warfarin (Coumadin, Jantoven);
  • steroids (prednisone and others);
  • a diuretic (water pill) such as furosemide (Lasix);
  • antifungal medication such as ketoconazole (Nizoral) or voriconazole (Vfend);
  • aspirin or other NSAIDs such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others; or
  • heart or blood pressure medication such as atenolol (Tenormin, Tenoretic), benazepril (Lotensin), carvedilol (Coreg), fosinopril (Monopril), lisinopril (Prinivil, Zestril), metoprolol (Dutoprol, Lopressor, Toprol), propranolol (Inderal, InnoPran), ramipril (Altace), 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.

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.

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