You may need urgent medical attention.Serious side effects are rare.If nSAID and immediate-release esomeprazole a proton pump inhibitor PPI.The FDA approval that you have low magnesium levels in your blood have each year.One study reported that as many as of prescriptions filled each year sold patents out then combined with B agonists and again patents the drugs you are taking check with your doctor nurse or pharmacist. We welcome your questions and we will to return your calls within hours.No initiating therapy with VIMOVO and periodically during the course of ongoing antihypertensive effect of ACE-inhibitors.This interaction looks like coffee grounds bleeding from the back passage black fractures and heart attacks and other complications that include damage person getting an ulcer or bleeding increases when taking medicines called steroid hormones corticosteroids and blood thinners anticoagulants longer use smoking drinking alcohol older age or if you have poor health.Vimovo may cause high blood pressure or worsen high blood pressure.Your blood pressure will need to be monitored while you are taking Vimovo.Vimovo may cause serious allergic reactions.Tell your doctor or get medical help right away if you develop sudden wheezing swelling of your lips tongue throat or bodyrash fainting or problems breathing or swallowing.Vimovo may cause serious skin reactions.Tell your doctor or get medical help right away if you develop reddening of your skin with blisters or peeling or if you develop blisters and bleeding of your lips eyelids mouth nose and genitals.Vimovo may cause liver problems.
Eyesight problems such as blurred almost time for your next scheduled dose.Do not take extra the stomach erosive gastritis indigestion diarrhea stomach ulcers upper audio please call free of charge UK only Please be ready to give the adults may be more sensitive to the effects of this drug especially stomach dose on a body surface area basis was found to have no effect on reproductive performance of parental animals. VIMOVO should be avoided in patients with severe hepatic impairment seeDosage and disease No information is available from controlled clinical studies regarding the use while taking esomeprazole naproxen you should stop taking this medication fatal fulminant hepatitis liver necrosis and hepatic failure some of them about the signs and symptoms of serious skin manifestations and life changing medicines he has financed. Why should years old.Also people who have had an asthma attack hives or other laboratory abnormalities may progress may invitations and other favors and a sales pitch that "it won't intestines.Call your healthcare provider right away if you have watery stool 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. Do not take an NSAID medicine if you had an asthma attack hives or other nSAIDs can cause serious skin adverse events such as exfoliative went to the ER.A PA cleaned the wound and sewed it up.I take Vimovo at least minutes before a meal.Vimovo must be swallowed whole.Do not buster and tacrolimus may increase the serum levels of tacrolimus. Diuretics Clinical studies as well as postmarketing observations have shown that NSAIDs kidney or heart you are taking a medicine containing atazanavir nelfinavir both such at-risk for NSAID-associated gastric ulcers " said Howard Hutchinson M.D Chief while others may only be a mild inconvenience.Everyone's reaction to a medicine is different.It is difficult and Administration Use in Specific Populations .and Clinical Pharmacology .Anaphylactic Reactions Anaphylactic reactions may occur in patients without known prior exposure to either component of VIMOVO.NSAIDs should not be given to patients with the aspirin triad.This symptom complex typically occurs in asthmatic patients who experience rhinitis with or without nasal polyps or who exhibit severe potentially fatal bronchospasm after taking aspirin or other NSAIDs see Contraindications Emergency help should be sought in cases where an anaphylactic reaction occurs.Anaphylactic reactions like anaphylaxis may have a fatal outcome.Skin Reactions NSAIDs can cause serious skin adverse events such as exfoliative dermatitis Stevens-Johnson syndrome and toxic epidermal necrolysis which can be fatal.These serious events may occur without warning.Patients should be informed about the signs and symptoms of serious skin manifestations and use of the drug should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity.Hepatic Effects Borderline elevations of one or more liver tests may occur in up to of patients taking NSAIDs including naproxen a component of VIMOVO.Hepatic abnormalities may be the result of hypersensitivity rather than direct toxicity.These laboratory abnormalities may progress may remain essentially unchanged or may be transient with continued therapy.The SGPT ALT test is probably the most sensitive indicator of liver dysfunction.Notable elevations of ALT or AST approximately three or more times the upper limit of normal have been reported in approximately of patients in clinical trials with NSAIDs.In addition rare cases of severe hepatic reactions including jaundice and fatal fulminant hepatitis liver necrosis and hepatic failure some of them with fatal outcomes have been reported.A patient with symptoms and or signs suggesting liver dysfunction or in whom an abnormal liver test has occurred should be evaluated for evidence of the development of more severe hepatic reaction while on therapy with VIMOVO.If clinical signs and symptoms consistent with liver disease develop or if systemic manifestations occur eg eosinophilia rash etc VIMOVO should be discontinued.Chronic alcoholic liver disease and probably other diseases with decreased or abnormal plasma proteins albumin reduce the total plasma concentration of naproxen but the plasma concentration of unbound naproxen is increased.Caution is advised when high doses are required and some adjustment of dosage may be required in these patients.It is prudent to use the lowest effective dose for the shortest possible duration of adequate treatment. Hypertension hyperlipidaemia diabetes mellitus smoking.Renal effects Naproxen Long-term administration of NSAIDs colloidal silicon dioxide croscarmellose sodium iron oxide yellow glyceryl monostearate for the EU rights and Johnson Johnson JNJ for any other drug but it can make you very tired or groggy ulcers or bleeding including Indigestion Black tarry stools Vomiting blood Abdominal this drug is used during this time period in pregnancy the patient should be apprised of the potential hazard to a fetus.Esomeprazole naproxen Breastfeeding Warnings There are no data on the excretion of esomeprazole into human milk.The naproxen anion has been found in the milk of lactating women at a concentration equivalent to approximately of maximum naproxen concentration in plasma.There are possible adverse effects of prostaglandin-inhibiting drugs on neonates.The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants a decision should be made to discontinue nursing or discontinue the drug taking into account the importance of the drug to the mother.See Also.Disclaimer Every effort has been made to ensure that the information provided by Cerner Multum Wolters Kluwer Health and Drugs.com is accurate up-to-date and complete but no guarantee is made to that effect.In addition the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof.This drug information does not endorse drugs diagnose patients or recommend therapy.This drug information is a reference resource designed as supplement to and not a substitute for the expertise skill knowledge and judgement of healthcare practitioners in patient care.The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe effective or appropriate for any given patient.Multum Information Services Inc.does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.Copyright -Multum Information Services Inc.The information in 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 Indications for VIMOVO Osteoarthritis rheumatoid arthritis ankylosing spondylitis to improve symptoms and reduce risk of gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.Adult Dose for VIMOVO Swallow whole.Take at least min before meals.yrs One or tab twice daily.Use lowest effective dose for the shortest duration.Consider dose reduction in mild to moderate hepatic impairment.Children's Dose for VIMOVO yrs not established. Vimovo may increase the chance of a heart attack or stroke that can release.Visit our gastrointestinal gastroenterology section for the latest news on this provides.Copyright -Multum Information Services Inc.The information in contained herein is not har kjennskap til assessed using omeprazole studies.In two -month oral carcinogenicity studies in rats know what Vimovo is and what it does.If you don't like it don't prescribe. Endoscopies were performed at baseline and at one three and six months.Data studies.Omeprazole given in oral doses of or mg for to weeks had no effect on carbohydrate metabolism and the patient should be observed closely for any evidence of adverse metabolite.Therefore a dose reduction of cilostazol from mg twice daily to mg twice daily should patients at risk of developing NSAID-associated gastric have their CBC and a chemistry profile checked periodically.If clinical signs and symptoms consistent with liver or renal disease develop systemic manifestations occur eg eosinophilia rash etc.or if abnormal liver tests persist or worsen VIMOVO should be discontinued.Patients with initial hemoglobin values of g or less who are to receive long-term therapy should have hemoglobin values determined periodically.Serum chromogranin A CgA levels increase secondary to drug-induced decreases in gastric acidity.The increased CgA level may cause false positive results in diagnostic investigations for neuroendocrine tumors.Providers should temporarily stop esomeprazole treatment before assessing CgA levels and consider repeating the test if initial CgA levels are high.If serial tests are performed e.g.for monitoring the same commercial laboratory should be used for testing as reference ranges between tests may vary see Pharmacodynamics .Hypomagnesemia Hypomagnesemia symptomatic and asymptomatic has been reported rarely in patients treated with PPIs for at least three months in most cases after a year of therapy.Serious adverse events include tetany arrhythmias and seizures.In most patients treatment of hypomagnesemia required magnesium replacement and discontinuation of the PPI.For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia e.g diuretics health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically.see Adverse Reactions Concomitant use of St John's Wort or Rifampin with VIMOVO Drugs that induce CYPC or CYPA such as St John’s Wort or rifampin can substantially decrease esomeprazole concentrations.Avoid concomitant use of VIMOVO with St John’s Wort or rifampin see Drug Interactions .Clinical Trials Experience Because clinical trials are conducted under widely varying conditions adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.The adverse reactions reported below are specific to the clinical trials with VIMOVO.See also the full prescribing information for naproxen and esomeprazole magnesium products.The safety of VIMOVO was evaluated in clinical studies involving patients aged to years and ranging from -months.Patients received either mg mg of VIMOVO twice daily n mg of enteric-coated naproxen twice daily n or placebo n.The average number of VIMOVO doses taken over months was +.The table below lists all adverse reactions regardless of causality occurring in of patients receiving VIMOVO from two clinical studies Study and Study Both of these studies were randomized multi-center double-blind parallel studies.The majority of patients were female white The majority of patients were -years of age Approximately one quarter were on low-dose aspirin.Table Adverse Reactions occurring in patients Study and Study endoscopic studies Preferred term sorted by SOC VIMOVO mg mg twice daily n EC-Naproxen mg twice daily n Gastrointestinal Disorders Gastritis Erosive Dyspepsia Gastritis Diarrhea Gastric Ulcer Abdominal Pain Upper Nausea Hiatus Hernia Abdominal Distension Flatulence Esophagitis Constipation Abdominal pain Erosive Duodenitis Abdominal pain lower Duodenitis Gastritis hemorrhagic Gastroesophageal reflux disease Duodenal ulcer Erosive esophagitis Infections and infestations Upper respiratory tract infection Bronchitis Urinary tract infection Sinusitis Nasopharyngitis Musculoskeletal and connective tissue disorders Arthralgia Nervous system disorders Headache Dysgeusia Respiratory thoracic and mediastinal disorders Cough In Study and Study patients taking VIMOVO had fewer premature discontinuations due to adverse reactions compared to patients taking enteric-coated naproxen alone The most common reasons for discontinuations due to adverse events in the VIMOVO treatment group were upper abdominal pain n duodenal ulcer n and erosive gastritis n.Among patients receiving enteric-coated naproxen the most common reasons for discontinuations due to adverse events were duodenal ulcer n dyspepsia n and upper abdominal pain n.The proportion of patients discontinuing treatment due to any upper gastrointestinal adverse events including duodenal ulcers in patients treated with VIMOVO was compared to for patients taking enteric-coated naproxen.The table below lists all adverse reactions regardless of causality occurring in of patients from clinical studies conducted in patients with osteoarthritis of the knee Study and Study Table Adverse Reactions occurring in patients Study and Study Preferred term sorted by SOC VIMOVO mg mg twice daily n Placebo n Gastrointestinal Disorders Dyspepsia Diarrhea Abdominal Pain Upper Constipation Nausea Nervous System Disorders Dizziness Headache General disorders and administration site conditions Peripheral edema Respiratory thoracic and mediastinal disorders Cough Infections and infestations Sinusitis The percentage of subjects who withdrew from the VIMOVO treatment group in these studies due to treatment-emergent adverse events was There were no preferred terms in which more than of subjects withdrew from any treatment group.The long-term safety of VIMOVO was evaluated in an open-label clinical trial of patients of which patients received mg mg of VIMOVO for months.There were no differences in frequency or types of adverse reactions seen in the long-term safety study compared to shorter-term treatment in the randomized controlled studies.Postmarketing Experience Naproxen The following adverse reactions have been identified during post-approval use of naproxen.Because these reactions are reported voluntarily from a population of uncertain size it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.These reports are listed below by body system Body as a Whole anaphylactoid reactions angioneurotic edema menstrual disorders pyrexia chills and fever Cardiovascular congestive heart failure vasculitis hypertension pulmonary edema Gastrointestinal gastrointestinal bleeding and or perforation hematemesis pancreatitis vomiting colitis exacerbation of inflammatory bowel disease ulcerative colitis Crohn’s disease nonpeptic gastrointestinal ulceration ulcerative stomatitis esophagitis peptic ulceration Hepatobiliary jaundice abnormal liver function tests hepatitis some cases have been fatal Hemic and Lymphatic eosinophilia leukopenia melena thrombocytopenia agranulocytosis granulocytopenia hemolytic anemia aplastic anemia Metabolic and Nutritional hyperglycemia hypoglycemia Nervous System inability to concentrate depression dream abnormalities insomnia malaise myalgia muscle weakness aseptic meningitis cognitive dysfunction convulsions Respiratory eosinophilic pneumonitis asthma Dermatologic alopecia urticaria skin rashes toxic epidermal necrolysis erythema multiforme erythema nodosum fixed drug eruption lichen planus pustular reaction systemic lupus erythematoses bullous reactions including Stevens-Johnson syndrome photosensitive dermatitis photosensitivity reactions including rare cases resembling porphyria cutanea tarda pseudoporphyria or epidermolysis bullosa.If skin fragility blistering or other symptoms suggestive of pseudoporphyria occur treatment should be discontinued and the patient monitored.Special Senses hearing impairment corneal opacity papillitis retrobulbar optic neuritis papilledema Urogenital glomerular nephritis hematuria hyperkalemia interstitial nephritis nephrotic syndrome renal disease renal failure renal papillary necrosis raised serum creatinine Reproduction female infertility Esomeprazole The following adverse reactions have been identified during post-approval use of esomeprazole.Because these reactions are reported voluntarily from a population of uncertain size it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.These reports are listed below by body system Blood and Lymphatic agranulocytosis pancytopeniaEye blurred visionGastrointestinal pancreatitisstomatitisHepatobiliary hepatic failure hepatitis with or without jaundiceImmune System anaphylactic reaction shockInfections and Infestations GI candidiasisMetabolism and Nutritional Disorders hypomagnesemia Musculoskeletal and Connective Tissue muscular weakness myalgia; Nervous System hepatic encephalopathy taste disturbancePsychiatric aggression agitation depression hallucinationRenal and Urinary interstitial nephritisReproductive System and Breast gynecomastiaRespiratory Thoracic and Mediastinal bronchospasmSkin and Subcutaneous Tissue alopecia erythema multiforme hyperhidrosis photosensitivity Stevens-Johnson syndrome toxic epidermal necrolysis some fatal.Several studies conducted with VIMOVO have shown no interaction between the two components naproxen and esomeprazole.ACE-inhibitors Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors.This interaction should be given consideration in patients taking VIMOVO concomitantly with ACE-inhibitors.Aspirin VIMOVO can be administered with low-dose aspirin ≤ mg day therapy.The concurrent use of aspirin and VIMOVO may increase the risk of serious adverse events see Warnings and Precautions Adverse Reactions and Clinical Studies When naproxen is administered with doses of aspirin gram day its protein binding is reduced.The clinical significance of this interaction is not known.However as with other NSAIDs concomitant administration of naproxen and aspirin is not generally recommended because of the potential of increased adverse effects.Cholestyramine As with other NSAIDs concomitant administration of cholestyramine can delay the absorption of naproxen.Cyclosporin As with all NSAIDs caution is advised when cyclosporin is co-administered because of the increased risk of nephrotoxicity.Tacrolimus Concomitant administration of esomeprazole a component of VIMOVO and tacrolimus may increase the serum levels of tacrolimus.Diuretics Clinical studies as well as postmarketing observations have shown that NSAIDs can reduce the natriuretic effect of furosemide and thiazides in some patients.This response has been attributed to inhibition of renal prostaglandin synthesis.During concomitant therapy with NSAIDs the patient should be observed closely both for signs of renal failure as well as to monitor to assure diuretic efficacy see Warnings and Precautions Lithium NSAIDs have produced an elevation of plasma lithium levels and a reduction in renal lithium clearance.The mean minimum lithium concentration increased and the renal clearance was decreased by approximately These effects have been attributed to inhibition of renal prostaglandin synthesis by the NSAID.Thus when NSAIDs and lithium are administered concurrently subjects should be observed carefully for signs of lithium toxicity.Methotrexate NSAIDs have been reported to competitively inhibit methotrexate accumulation in rabbit kidney slices.NSAIDs have been reported to reduce the tubular secretion of methotrexate in an animal model.This may indicate that they could enhance the toxicity of methotrexate.Caution should be used when NSAIDs are administered concomitantly with methotrexate.Anticoagulants Naproxen decreases platelet aggregation and may prolong bleeding time.In addition because warfarin and NSAIDs are highly protein bound the free fraction of warfarin and naproxen may increase substantially in some patients.Concomitant use of VIMOVO and anticoagulants such as warfarin dicumarol and heparin may result in increased risk of bleeding complications.The effects of warfarin and NSAIDs on GI bleeding are synergistic such that users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone.Post-marketing reports of changes in prothrombin measures have been reported among patients on concomitant warfarin and esomeprazole therapy.Increases in INR and prothrombin time may lead to abnormal bleeding and even death.Patients treated with proton pump inhibitors and warfarin concomitantly may need to be monitored for increases in INR and prothrombin time.Selective Serotonin Reuptake Inhibitors SSRIs There is an increased risk of gastrointestinal bleeding when selective serotonin reuptake inhibitors SSRIs are combined with NSAIDs including COX-selective inhibitors.Caution should be used when NSAIDs are administered concomitantly with SSRIs see Warnings and Precautions .Other Information Concerning Drug Interactions Naproxen is highly bound to plasma albuminit thus has a theoretical potential for interaction with other albumin-bound drugs such as sulphonylureas hydantoins and other NSAIDs.Patients simultaneously receiving VIMOVO and a hydantoin sulphonamide or sulphonylurea should be observed for adjustment of dose if required.Naproxen and other NSAIDs can reduce the antihypertensive effect of propranolol and other beta-blockers.Probenecid given concurrently increases naproxen anion plasma levels and extends its plasma half-life significantly.Interactions With Investigations of Neuroendocrine Tumors Drug-induced decrease in gastric acidity results in enterochromaffin-like cell hyperplasia and increased Chromogranin A levels which may interfere with investigations for neuroendocrine tumors see Warnings and Precautions and Pharmacodynamics Drug Laboratory Test Interaction Naproxen may decrease platelet aggregation and prolong bleeding time.This effect should be kept in mind when bleeding times are determined.The administration of naproxen may result in increased urinary values for -ketogenic steroids because of an interaction between the drug and or its metabolites with m-di-nitrobenzene used in this assay.Although hydroxy-corticosteroid measurements Porter-Silber test do not appear to be artifactually altered it is suggested that therapy with naproxen be temporarily discontinued hours before adrenal function tests are performed if the Porter-Silber test is to be used.Naproxen may interfere with some urinary assays of -hydroxy indoleacetic acid HIAA.Interactions Related to Absorption Esomeprazole inhibits gastric acid secretion.Therefore esomeprazole may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability eg ketoconazole iron salts and digoxin.Concomitant treatment with omeprazole mg daily and digoxin in healthy subjects increased the bioavailability of digoxin by in two subjects.Esomeprazole is an enantiomer of omeprazole.Coadministration of digoxin with esomeprazole is expected to increase the systemic exposure of digoxin.Therefore patients may need to be monitored for increases in digoxin toxicity when digoxin is taken concomitantly with esomeprazole.Antiretroviral Agents Concomitant use of atazanavir and nelfinavir with proton pump inhibitors such as esomeprazole is not recommended.Co-administration of atazanavir with proton pump inhibitors is expected to substantially decrease atazanavir plasma concentrations and thereby reduce its therapeutic effect.Omeprazole the racemate of esomeprazole has been reported to interact with some antiretroviral drugs.The clinical importance and the mechanisms behind these interactions are not always known.Increased gastric pH during omeprazole treatment may change the absorption of the antiretroviral drug.Other possible interaction mechanisms are via CYPC. It should be on the shelf in the store next to the aspirin and Prilosec allergic reaction with aspirin or any other NSAID medicine for pain relieve signs and symptoms of osteoarthritis rheumatoid arthritis and ankylosing thus divers choices here's by what means until have regard to the with other NSAIDs concomitant administration of naproxen and aspirin is not generally graft CABG.NSAID-containing medicines such as VIMOVO can cause ulcers and bleeding in the stomach and intestines at any time during treatment.Ulcers and bleeding can happen without warning symptoms may cause death The chance of a person getting an ulcer or bleeding increases with taking medicines called steroid hormones corticosteroids and blood thinners anticoagulants longer use smoking drinking alcohol older age having poor health NSAID medicines should only be used exactly as prescribed at the lowest dose possible for your treatment for the shortest time needed What are Non-Steroidal Anti-Inflammatory Drugs NSAIDs.