Esomeprazole Naproxen Combination: Uses, Dosage & Side Effects

Summary or Key Points

Esomeprazole/naproxen is a combination medication used to manage conditions such as arthritis while also helping to prevent stomach ulcers. It combines esomeprazole, a proton pump inhibitor (PPI), with naproxen, a nonsteroidal anti-inflammatory drug (NSAID). This combination works by reducing inflammation and pain while protecting the stomach lining from potential damage. Always consult your healthcare provider before starting or adjusting your dose. If you need personalized care, consider scheduling a telemedicine visit with one of our providers.

Names of Medication

US Brand Name: Vimovo (Esomeprazole/Naproxen)

The generic name refers to the active ingredients in a medication. In this case, the generic name is listed in parentheses after the brand name.

Pharmacologic Category

Proton Pump Inhibitors (PPIs)

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Esomeprazole Naproxen Dosage

Esomeprazole/naproxen is prescribed to treat various conditions in adults. The dosage will depend on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for further guidance.

Gastroesophageal Reflux Disease (GERD)

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: Typically long-term, depending on the severity of symptoms and response to treatment.

Osteoarthritis

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: As directed by your healthcare provider, often long-term for chronic pain management.

Rheumatoid Arthritis

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: Long-term treatment may be necessary to manage symptoms effectively.

Peptic Ulcer Disease (Prevention)

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: As directed by your healthcare provider, typically long-term to prevent ulcers.

Ankylosing Spondylitis

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: Long-term treatment may be required to manage symptoms.

Tendonitis

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: Short-term, typically 1-2 weeks, or as directed by your healthcare provider.

Bursitis

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: Short-term, typically 1-2 weeks, or as directed by your healthcare provider.

Gout

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: Short-term, typically 1-2 weeks, or as directed by your healthcare provider.

Dyspepsia (Indigestion)

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: As directed by your healthcare provider, typically short-term.

Inflammatory Bowel Disease (IBD)

Dosage: 20 mg of esomeprazole/500 mg of naproxen twice daily.

Duration: As directed by your healthcare provider, typically long-term to manage inflammation.

Dosage Forms and Strengths

Esomeprazole 20 mg/Naproxen 500 mg tablets

Esomeprazole 20 mg/Naproxen 375 mg tablets

Administration Instructions for Esomeprazole Naproxen

Take esomeprazole/naproxen at least 30 minutes before meals. Swallow the tablet whole with water; do not crush, chew, or split it. If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time. Always follow your healthcare provider’s instructions carefully.

Adverse Reactions and Side Effects

Like all medications, esomeprazole/naproxen may cause side effects. Some are more common, while others are rare but potentially serious. If you experience any side effects, contact your healthcare provider or schedule a telemedicine visit with one of our providers.

Common Esomeprazole Naproxen Side Effects

Headache: Mild to moderate headaches may occur.

Nausea: Some patients may feel nauseous after taking the medication.

Diarrhea: Loose stools can occur, especially when starting the medication.

Indigestion: Some patients may experience discomfort or bloating after meals.

Serious Side Effects (Rare)

Stomach bleeding: Severe stomach pain, black or bloody stools, or vomiting blood may indicate bleeding in the stomach.

Kidney problems: Symptoms such as changes in urination, swelling in the legs, or fatigue may signal kidney issues.

Allergic reactions: Rash, itching, swelling, or difficulty breathing may indicate an allergic reaction.

Contraindications for Esomeprazole Naproxen

A contraindication is a specific condition or situation where a particular medication should not be used because it may be harmful. If you have any of the following conditions, you should not take esomeprazole/naproxen. Always consult your healthcare provider before starting any new medication. If you’re unsure, you can schedule a telemedicine appointment with one of our providers.

Allergy to Esomeprazole, Naproxen, or NSAIDs: If you have had an allergic reaction to esomeprazole, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs), taking this medication can cause severe allergic reactions, including rash, swelling, or difficulty breathing.

Active or History of Peptic Ulcer Disease: Naproxen can irritate the stomach lining and increase the risk of ulcers, especially in patients with a history of peptic ulcer disease.

Severe Kidney Disease: Naproxen is processed by the kidneys, and in patients with severe kidney disease, it can worsen kidney function or lead to kidney failure.

Severe Liver Disease: Esomeprazole/naproxen may not be safe for patients with severe liver disease, as it can affect how the liver processes medications and may increase the risk of liver damage.

Heart Failure or Recent Heart Attack: NSAIDs like naproxen can increase the risk of heart attack or stroke, especially in patients with a history of heart disease or heart failure.

Third Trimester of Pregnancy: Naproxen can cause complications in the third trimester of pregnancy, including premature closure of the ductus arteriosus in the fetus, which can lead to serious heart issues for the baby.

Drug to Drug Interactions

The combination of Esomeprazole/naproxen can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. It is essential to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with the Esomeprazole/naproxen combination:

1. Warfarin (Coumadin): Naproxen can increase the risk of bleeding when taken with warfarin.
2. Clopidogrel (Plavix): Esomeprazole may reduce the effectiveness of clopidogrel, a medication used to prevent blood clots.
3. Diuretics (e.g., Furosemide, Lasix): Naproxen may decrease the effectiveness of diuretics, which are used to treat high blood pressure or heart failure.
4. SSRIs (e.g., Fluoxetine, Prozac): Combining naproxen with selective serotonin reuptake inhibitors (SSRIs) may increase the risk of gastrointestinal bleeding.
5. ACE Inhibitors (e.g., Lisinopril, Zestril): Naproxen may reduce the effectiveness of ACE inhibitors, which are commonly prescribed for high blood pressure and heart failure.

Esomeprazole/Naproxen in Pregnancy

Is it Safe to Take Esomeprazole/Naproxen During Pregnancy?

The Esomeprazole/naproxen combination is generally not recommended during pregnancy, particularly in the third trimester. Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), can lead to complications such as the premature closure of a vital blood vessel in the fetus’s heart (ductus arteriosus), which may result in serious heart problems. If you are pregnant or planning to become pregnant, it is important to consult your healthcare provider before taking this medication. Our telemedicine providers are available to discuss safer alternatives for managing your symptoms during pregnancy.

Esomeprazole/Naproxen While Breastfeeding

Is it Safe to Take Esomeprazole/Naproxen While Breastfeeding?

The Esomeprazole/naproxen combination is generally not recommended while breastfeeding. Naproxen can pass into breast milk and may affect the infant, potentially causing gastrointestinal issues or bleeding. If you are breastfeeding and need treatment for pain or inflammation, speak with your healthcare provider about safer alternatives. You can also schedule a telemedicine consultation with one of our providers to discuss your options.

Estimated Cost of Esomeprazole/Naproxen

The estimated cost of a 30-day supply of Esomeprazole/naproxen without insurance, using a GoodRx coupon, ranges from $50 to $100, depending on the dosage and pharmacy. Prices may vary, so it is advisable to check with your local pharmacy or use a GoodRx coupon to find the best deal.

Possible Alternatives to Esomeprazole/Naproxen

If the Esomeprazole/naproxen combination is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss these options with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives.

1. Gastroesophageal Reflux Disease (GERD): Alternatives include other proton pump inhibitors (PPIs) like omeprazole (Prilosec) or H2 blockers such as ranitidine (Zantac). Lifestyle changes, such as avoiding trigger foods, eating smaller meals, and elevating the head of your bed, may also help.
2. Osteoarthritis: Acetaminophen (Tylenol) or topical NSAIDs may be safer alternatives. Physical therapy, weight management, and exercise can also help relieve symptoms.
3. Rheumatoid Arthritis: Disease-modifying antirheumatic drugs (DMARDs) like methotrexate or biologics such as adalimumab (Humira) may be more effective for long-term management.
4. Peptic Ulcer Disease: Proton pump inhibitors (PPIs) like omeprazole or H2 blockers may be safer alternatives. Avoiding NSAIDs and making dietary changes can also help prevent ulcer formation.
5. Ankylosing Spondylitis: Biologic medications such as infliximab (Remicade) or physical therapy may be more effective for managing symptoms.
6. Tendonitis: Rest, ice, and physical therapy are often recommended. Acetaminophen or topical NSAIDs may be safer alternatives to oral NSAIDs.
7. Bursitis: Rest, ice, and physical therapy can help manage symptoms. Corticosteroid injections may also be an option for severe cases.
8. Gout: Medications like allopurinol (Zyloprim) or colchicine can help prevent gout attacks. Dietary changes, such as reducing purine-rich foods, can also help manage symptoms.
9. Dyspepsia: Antacids or H2 blockers like famotidine (Pepcid) may be safer alternatives. Avoiding trigger foods and eating smaller, more frequent meals can also help.
10. Inflammatory Bowel Disease (IBD): Medications like mesalamine (Asacol) or biologics may be more effective for managing IBD. Dietary changes and stress management can also play a role in symptom control.

Recent Updates on Esomeprazole/Naproxen Research

Recent studies have focused on the long-term safety of combining proton pump inhibitors (PPIs) like Esomeprazole with NSAIDs such as naproxen, particularly in patients at high risk for gastrointestinal complications. Some research suggests that while the combination can reduce the risk of ulcers, long-term use of PPIs may be associated with an increased risk of kidney disease and bone fractures. Ongoing studies are also exploring whether alternative therapies, such as COX-2 inhibitors, may offer similar pain relief with fewer gastrointestinal risks. If you have concerns about long-term use, consult with one of our telemedicine providers to discuss your treatment options.

James Kingsley

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