Talk:Naproxen/esomeprazole

This is the talk page for Vimovo.Oceanflynn (talk) 13:21, 20 June 2017 (UTC)

Content from VIMOVO® (naproxen and esomeprazole magnesium) Tablets

"VIMOVO contains two medicines

naproxen, a nonsteroidal anti-inflammatory drug (NSAID) and esomeprazole magnesium, a proton pump inhibitor (PPI). VIMOVO is used to relieve signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis and to decrease the risk of developing stomach (gastric) ulcers in people who are at risk of developing gastric ulcers with NSAIDs. You should not take a naproxen tablet and an esomeprazole magnesium tablet together instead of taking VIMOVO, because they will not work the same way."

Side effects

"The most common side effects of VIMOVO are inflammation of the lining of the stomach and diarrhea...VIMOVO can cause serious side effects. Stop taking VIMOVO and call your doctor or go to your emergency department right away if you get: "Difficulty breathing, swelling of the face or throat. These could be signs of a serious allergic reaction.

Chest pain, shortness of breath, weakness in one part or side of your body, or slurring of speech. These could be signs of a serious blood clotting event. Upper stomach pain, upset stomach, black, tarry stools, or vomiting of blood. These could be signs of an esophagus, stomach, or intestinal ulcer, bleed, or tear. Note: if you are also taking low-dose aspirin, you are at increased risk for esophagus, stomach, or intestinal bleeding. Nausea, more tired or weaker than usual, itching, yellowing of the skin or eyes, right upper abdomen tenderness, and “flu-like” symptoms. These could be signs of a liver problem. Shortness of breath, unexplained weight gain, or swelling of the arms, legs, hands, or feet. These could be signs of a serious heart problem. Diarrhea that does not improve. This could be a sign of an infection called Clostridium difficile infection. Any type of rash. This could be a sign of a serious skin reaction. New or worsening joint pain or a rash on your cheeks or arms that gets worse in the sun. These could be signs of certain types of lupus erythematosus. Decreased volume of urine or blood in urine. These could be signs of a kidney problem. These are not all of the possible side effects of VIMOVO. Please talk to your doctor if you experience any symptoms that bother you or that do not go away...NSAIDs, a component of VIMOVO, cause an increased risk of serious blood clotting events, including heart attack and stroke, which can kill you. This risk may occur early in treatment and may increase with longer use. To minimize the potential for increased risk of serious heart events while being treated with an NSAID, use the lowest effective dose for the shortest duration possible. NSAIDs, a component of VIMOVO, cause an increased risk of serious esophagus, stomach, and intestine events including bleeding, ulcers, and tears, which can kill you. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a history of ulcer disease or stomach or intestine bleeding are at greater risk for serious esophagus, stomach, and intestine events....The risk information provided here is not comprehensive."

"DO NOT USE VIMOVO if you are in the hospital for a certain heart surgery called coronary artery bypass graft surgery. know you are allergic to naproxen, esomeprazole magnesium, substituted benzimidazoles, or to any ingredient of the drug product, including omeprazole. have experienced asthma, hives, or allergic-type reactions after taking aspirin or other NSAIDs. Serious allergic reactions to NSAIDs, including death, have been reported in such patients".

Interactions with VIMOVO

"Avoid using VIMOVO while taking other naproxen-containing products or other non-aspirin NSAIDs, clopidogrel, St. John’s Wort, rifampin, or methotrexate. NSAIDs may be present in over-the-counter medications for treatment of colds, fever, or insomnia; refer to the label of over-the-counter medications you are taking or ask your pharmacist. Do not use VIMOVO and low-dose aspirin until you talk to your health care provider. Tell your doctor about all of the medicines you take as some medicines can react with NSAIDs and cause serious side effects."

Caution; "Before starting VIMOVO, tell your health care provider if you have a history of ulcer disease or esophagus, stomach, or intestine bleeding, liver or kidney problems, high blood pressure, asthma, low magnesium levels, ulcerative colitis or Crohn’s disease, or are pregnant, trying to become pregnant, or breast feeding. Talk to your doctor about the risk of bone fractures or developing low magnesium or vitamin B-12 levels if you take VIMOVO for a long period of time. Also tell your doctor about all of the medicines you take, including prescription or over-the-counter medicines, vitamins, or herbal supplements. Do not start taking new medicines without talking to your health care provider first."

Website Corporate directory AstraZeneca Vimovo Content from Norwegian site translated with Google translate

Vimovo: AstraZeneca, Antiflogistics + oxygen pump inhibitors. ATC No .: M01A E52

 Not on WADA's doping list

Environmental risk in Norway: TABLETS WITH MODIFIED FREEZING 500 mg / 20 mg: Each tablet contains: Naproxen 500 mg, esomeprazole 20 mg (as magnesium trihydrate), methyl and propyl parahydroxybenzoate (E 218 and E 216), excipients. Dye: Black iron oxide (E 172).

indications

Symptomatic treatment in adults with osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, in patients at risk of developing gastric ulcer and / or duodenal ulcer associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) and treatment with lower doses of naproxen or other NSAIDs Is not believed to be sufficient.

Dosage

If the total daily dose of 1000 mg naproxen (500 mg twice daily) is not considered sufficient, alternative treatment with lower naproxenic strength or other NSAIDs as single components should be used. The need for continued gastroprotection should also be considered again. Side effects of naproxen can be minimized by using the lowest effective dose in the shortest possible time. In patients who have not previously been treated with NSAIDs, a lower daily dose of naproxen or other NSAIDs should be considered.

Adults: 1 tablet (500 mg / 20 mg) twice a day. Vimovo should not be used for rapid onset pain relief from acute pain conditions (such as toothache), as a result of delayed release of naproxen. However, attacks of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis can be treated with Vimovo.

Special patient groups

Hepatic impairment: should be used with caution in mild to moderate hepatic impairment, and liver function must be carefully monitored. Reduction in total daily naproxenedose must be considered. Contraindicated in severe hepatic impairment. Renal impairment: should be used with caution in mild to moderate renal impairment, and renal function must be carefully monitored. Reduction in total daily naproxenedose must be considered. Contraindicated in severe renal impairment (ClCR <30 ml / min) because accumulation of naproxen metabolites has been observed in patients with severe renal failure and patients in dialysis. Children (<18 years): Not recommended due to Missing data. Older people (> 65 years): Older people have an increased risk of serious side effects. Administration: Should be taken at least 30 minutes before food. Swallow whole with water. Do not divide, chew or crush.

Contraindications

Hypersensitivity to the substances or substituted benzimidazole. History of asthma, hives or allergic reactions induced by acetylsalicylic acid or other NSAIDs. 3th trimester of swindlership. Severe hepatic impairment (eg Child-Pugh C). Severe heart failure. Severe renal impairment. Active gastric ulcer. Gastrointestinal bleeding, cerebrovascular bleeding or other bleeding disorders. Do not use with atazanavir and nelfinavir.

Cautions

Patients on long-term treatment (especially> 1 year) should be monitored regularly. Treatment should be interrupted by deterioration or if no usefulness is seen. Naproxen should only be used after careful consideration of the benefits / risks of infertile porphyria, systemic lupus erythematosus and mixed connective tissue disease. In order to prevent over treatment, prescribing physicians should evaluate at clinically relevant intervals whether adequate pain relief is possible with lower NSAID dose available as single component, based on individual risk and depending on the characteristic and severity of underlying disease. Gastrointestinal effects: Risk factors for developing NSAID-related gastrointestinal complications include high age, concomitant use of anticoagulants, corticosteroids, other NSAIDs, including lavdose ASA, debilitating cardiovascular disease, Helicobacter pylori infection and history of gastric ulcer and / or duodenal ulcer and bleeding In the upper gastrointestinal tract. Gastrointestinal bleeding, ulcer or perforation, which may be fatal, has been reported for NSAIDs, at any time during treatment, with or without warning symptoms or prior history with severe gastrointestinal events. The risk of gastrointestinal bleeding, ulceration or perforation increases with increasing NSAID doses in patients with history of history, especially if complicated with hemorrhage or perforation and in the elderly. Combination therapy with protective agents should be considered for such patients and also for patients who require concomitant treatment with lavdose ASA or other medicinal products that increase the risk of gastrointestinal complications. Patients with previous gastrointestinal toxicity, especially older, should report if possible. Unusual stomach symptoms (especially gastrointestinal haemorrhage), especially at the beginning of treatment. Caution should be exercised."

References

Convenience drug - what are the potential medical benefits

This is a convenience drug that combines two readily available drugs ( Naproxen/Aleve (OTC) and Esomeprazole/Nexium (OTC); where Esomeprazole can be potentially substituted by even less expensive Omeprazole/Prilosec (OTC)) for about 50x increase in price. Any medical benefits that could justify that ~50x cost difference? 76.21.80.22 (talk) 19:31, 5 July 2017 (UTC)