Uses

What is naproxen/esomeprazole used for?

Naproxen/esomeprazole is a combination medicine. Naproxen is commonly used to treat pain, swelling, and discomfort caused by osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis. Esomeprazole reduces the risk of ulcers in your stomach while on naproxen.

Naproxen/esomeprazole may also be used for other conditions as determined by your healthcare provider.

How does naproxen/esomeprazole work (mechanism of action)?

Naproxen works by blocking certain substances in the body that cause pain, inflammation, and fever. Esomeprazole reduces acid secretion and protects the stomach from acid-related problems.

How is naproxen/esomeprazole supplied (dosage forms)?

Naproxen/esomeprazole is available as Vimovo and generic naproxen/esomeprazole in the following dosage forms that are taken by mouth.

  • 375 mg/20 mg oral tablets
  • 500 mg/20 mg oral tablets

How should I store naproxen/esomeprazole?

Naproxen/esomeprazole should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place in a tightly closed container.

Side Effects

What are the most common side effects of naproxen/esomeprazole?

The most common side effects of naproxen/esomeprazole are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Inflammation of the stomach lining
  • Diarrhea

There may be other side effects of naproxen/esomeprazole that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of naproxen/esomeprazole?

While less common, the most serious side effects of naproxen/esomeprazole are described below, along with what to do if they happen.

Heart Attack and Stroke. Naproxen/esomeprazole may increase your risk for a heart attack or stroke that can lead to death. This risk is higher in people with existing heart disease and with longer use of naproxen and higher doses. Do not take naproxen if you have had a recent heart attack without talking to your healthcare provider. This could increase your risk of having another heart attack. Stop taking naproxen and get help right away if you have any of the following symptoms of a heart attack or stroke.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Bleeding. Naproxen/esomeprazole may increase your risk for bleeding, especially if you have a bleeding disorder or take other medicines that increase your risk for bleeding. Tell your healthcare provider right away if you notice signs of bleeding, including easy bruising or bleeding.

Stomach Bleeding. Naproxen/esomeprazole may increase your risk for bleeding, ulcers, and tears (perforation) in your gut. The risk is higher if you have a history of stomach ulcers, or bleeding problems, take higher doses of naproxen/esomeprazole or take it for longer than directed, have poor health, are of 60 years or older, have liver disease, smoke, drink alcohol, or take certain other medicines. Stop taking naproxen and get emergency help right away if you have any of the following symptoms.

  • Vomit blood
  • Black or tarry poop
  • Stomach pain that does not go away
  • Upset stomach
  • Feel faint

Anemia. Naproxen/esomeprazole may cause anemia, which is a condition that causes low levels of red blood cells. Tell your healthcare provider if you have any of the following symptoms of anemia.

  • Unusual weakness or tiredness
  • Cold hands and feet
  • Fast or abnormal heartbeat
  • Pale or yellowish skin
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Shortness of breath

Liver Damage. Liver damage, also called hepatotoxicity, may happen when taking naproxen/esomeprazole. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Blood Pressure (Hypertension). Naproxen/esomeprazole may increase your blood pressure or worsen it if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable but look out for any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble in breathing
  • Nausea/vomiting
  • Blurry or other changes to the vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heart beats

Heart Failure. Naproxen/esomeprazole may increase your risk for heart failure. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble in breathing, especially while lying down
  • Swelling in your feet, ankles, or legs (edema)
  • Unusually fast weight gain
  • Unusual tiredness

Kidney Damage. Kidney damage may happen when taking naproxen/esomeprazole. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs (edema)
  • Weakness or unusual tiredness
  • Difficulty in catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Increased Blood Potassium Levels (Hyperkalemia). Naproxen/esomeprazole may increase the potassium levels in your blood (hyperkalemia), especially if your kidneys are not working as well as they should. Mild increases in potassium may not cause any symptoms. Stop taking the medicine and get help right away if you have any of the following symptoms of sudden high potassium levels.

  • Chest pain or fast or abnormal heartbeat
  • Shortness of breath
  • Nausea or vomiting
  • Unable to move your muscles

Severe Allergic Reactions. Naproxen/esomeprazole may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Naproxen/esomeprazole may cause severe skin reactions called exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) that can lead to death if not treated. Stop naproxen and call your healthcare provider immediately If you develop the following symptoms of a severe skin reaction.

  • Painful red or purple skin that looks burnt and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Fever or general ill feeling
  • Areas of thickened skin
  • Sores that are crusted over

Clostridium difficile-Associated Diarrhea. Naproxen/esomeprazole may cause an overgrowth of germs called Clostridium difficile, or “C. diff,” in your gut. Call your healthcare provider right away if you have any of the following symptoms of this condition.

  • Watery diarrhea
  • Diarrhea that does not go away
  • Blood in your poop
  • Severe stomach cramps
  • Fever that starts after you start or finish the medicine

Vitamin B12 Deficiency. Naproxen/esomeprazole may cause vitamin B12 deficiency. If you take acid-suppressing medicines every day for a long time (more than 3 years), it becomes difficult for your body to absorb vitamin B12. Tell your healthcare provider if you have the following symptoms of vitamin B12 deficiency.

  • Shortness of breath
  • Lightheadedness
  • Irregular heartbeat
  • Muscle weakness
  • Pale skin
  • Feeling tired
  • Mood changes
  • Tingling or numbness in the arms or legs

Bone Fracture. Naproxen/esomeprazole may increase your chances of bone fractures of the hip, wrist, or spine. Tell your healthcare provider right away if you have pain in the hip, wrist, or spine.

Low Magnesium Levels. Naproxen/esomeprazole may decrease the magnesium levels in your body. Tell your healthcare provider if you have the following symptoms. 

  • Seizures
  • Dizziness
  • Irregular heartbeat
  • Jitteriness
  • Muscle aches or weakness
  • Spasms in the hands, feet, or voice

Stomach Growths. Naproxen/esomeprazole may cause growths in the stomach known as fundic gland polyps especially if taken for more than 1 year.

Warnings & Precautions

Who should not use naproxen/esomeprazole?

Allergies to Ingredients. People who are allergic to any of the following should not take naproxen/esomeprazole.

  • Naproxen
  • Esomeprazole
  • Omeprazole
  • Vimovo
  • Aspirin or any other medicine known as a nonsteroidal anti-inflammatory drug (NSAID)
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific naproxen/esomeprazole products they stock.

Drug Interactions. Naproxen/esomeprazole should not be taken while you are using certain other medicines. Before taking naproxen/esomeprazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.

Heart Surgery. Do not take naproxen/esomeprazole right before or after a heart surgery called coronary artery bypass graft (CABG). Taking naproxen during this time may increase your risk for a heart attack or stroke.

What should I know about naproxen/esomeprazole before using it?

Do not take naproxen/esomeprazole unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share naproxen/esomeprazole with other people, even if they have the same condition as you. It may harm them.

Keep naproxen/esomeprazole out of the reach of children.

Take naproxen/esomeprazole at least 30 minutes before a meal.

Swallow naproxen/esomeprazole whole with liquid. Do not split, chew, crush, or dissolve. 

You may use antacids while taking naproxen/esomeprazole. 

People aged 65 years and older may be at a greater risk for some side effects of naproxen/esomeprazole. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using naproxen/esomeprazole?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if naproxen/esomeprazole is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Stomach ulcers, bleeding, or other stomach problems like heartburn
  • Asthma
  • Stroke
  • Heart problems such as heart failure  or recent heart attack
  • Fluid retention (edema)
  • A history of bone fractures 
  • Kidney or liver disease
  • Bleeding problems
  • Diarrhea
  • Lupus erythematosus
  • Low magnesium, calcium, and potassium levels
  • High blood pressure
  • Ulcerative colitis or Crohn’s disease (inflammatory bowel disease or IBD

Pregnancy. Do not take naproxen/esomeprazole at 20 weeks or later during pregnancy without talking to your healthcare provider. Taking naproxen/esomeprazole during this time may cause harm to an unborn baby and complications during delivery. Tell your healthcare provider if you are or plan to become pregnant. 

Breastfeeding. Naproxen/esomeprazole passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take naproxen/esomeprazole while breastfeeding. 

Interactions

Does naproxen/esomeprazole interact with foods or drinks?

There are no known interactions between naproxen/esomeprazole and foods or drinks.

Drinking alcohol while taking naproxen/esomeprazole increases your risk for stomach ulcers and bleeding. It is best to limit the amount of alcohol you drink. 

Does naproxen/esomeprazole interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking naproxen/esomeprazole.

  • A corticosteroid, which is a medicine for certain inflammatory conditions
  • Aspirin, which is a medicine that relieves pain, reduces inflammation, and lowers fever
  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • An angiotensin-converting enzyme (ACE) inhibitor, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and other heart conditions
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • A beta blocker, which is a medicine usually used to reduce blood pressure and for certain other heart conditions
  • A medicine for HIV or AIDS
  • Cilostazol, which is the medicine to treat people with leg pain when they walk
  • Lithium, which is a medicine for certain mental health conditions
  • Digoxin, which is a medicine used to treat heart failure or certain abnormal heart rhythms
  • Diazepam, which is a medicine to treat conditions like anxiety, muscle spasms, and seizures
  • Pemetrexed, which is used in cancer treatment, specifically for certain types of lung cancer and mesothelioma (a type of cancer affecting the lining of the lungs or abdomen)
  • Any nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and others, which are present in many prescription and OTC products for pain, swelling, and fever
  • Tacrolimus, which is a medicine to suppress your immune system
  • Cyclosporine, which is a medicine to suppress your immune system
  • Methotrexate, a medicine used to treat various conditions, including certain types of cancer, autoimmune diseases like rheumatoid arthritis, and psoriasis
  • Rifampin, a medicine to treat bacterial infections, particularly tuberculosis
  • St. John’s wort, which is a supplement that may be used to treat depression

Some other medicines may alter the blood levels of naproxen/esomeprazole. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with naproxen/esomeprazole. Always check with your healthcare provider.

Does Naproxen/Esomeprazole (Vimovo) interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much naproxen/esomeprazole?

If you or someone else has taken too much naproxen/esomeprazole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of naproxen/esomeprazole?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

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