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Vimovo
Vimovo is a combination medication that contains naproxen, a nonsteroidal anti-inflammatory drug (NSAID), and esomeprazole, a proton pump inhibitor (PPI). It is used to relieve symptoms of arthritis, such as pain, swelling, and stiffness, while also reducing the risk of developing stomach ulcers associated with long-term NSAID use. Naproxen reduces inflammation and pain, while esomeprazole helps protect the stomach lining by reducing acid production.
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Frequently Asked Questions
How long does it take for Vimovo to start working?
Vimovo begins to relieve pain and inflammation within 1 to 2 hours of taking the medication, but the full protective effects of the esomeprazole component may take several days to develop.
Can I take Vimovo with other pain relievers?
It is important to avoid taking other NSAIDs (such as ibuprofen or aspirin) while using Vimovo, as this can increase the risk of gastrointestinal bleeding. Acetaminophen (Tylenol) may be used for additional pain relief, but consult your healthcare provider before combining medications.
Can I stop taking Vimovo if I feel better?
No, you should not stop taking Vimovo without consulting your healthcare provider, especially if it has been prescribed for chronic conditions like arthritis. Stopping the medication suddenly may cause your symptoms to return or worsen.
Can I drink alcohol while taking Vimovo?
It is best to avoid alcohol while taking Vimovo, as it can increase the risk of stomach bleeding and ulcers.
Is Vimovo safe for long-term use?
Vimovo can be used long-term in some patients, but the risks of gastrointestinal bleeding, kidney problems, and cardiovascular issues increase with prolonged use. Your healthcare provider will monitor you closely if long-term therapy is necessary.
Comprehensive Drug Guide
How Does Vimovo Work?
- Naproxen: An NSAID that reduces inflammation and pain by inhibiting the production of prostaglandins, chemicals in the body that cause inflammation.
- Esomeprazole: A PPI that reduces the amount of acid produced in the stomach, protecting the stomach lining from the potential ulcer-causing effects of naproxen, especially during long-term use.
Common Dosages
- 375 mg naproxen / 20 mg esomeprazole delayed-release tablets
- 500 mg naproxen / 20 mg esomeprazole delayed-release tablets
Typical Dosing
- The usual dose is one tablet twice daily (morning and evening), taken at least 30 minutes before meals.
- The strength of the tablet (either 375 mg or 500 mg of naproxen) will be determined by your healthcare provider based on your specific condition and response to treatment.
Typical Dosing
FDA Approved Indications
- Treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis in patients who need an NSAID and are at risk of developing NSAID-induced gastric ulcers.
Who Shouldn't Take Vimovo?
- Active gastrointestinal bleeding or peptic ulcer disease
- Severe liver or kidney impairment
- Known hypersensitivity to naproxen, esomeprazole, or other PPIs
- A history of aspirin-sensitive asthma or NSAID allergy
- Pregnancy, especially in the third trimester, due to the risk of fetal harm
Advice From The Pharmacist
- Take Vimovo at least 30 minutes before meals to ensure proper absorption of the esomeprazole component.
- Swallow the tablets whole; do not crush, chew, or break them, as this may affect the release of the medication.
- Vimovo can increase the risk of gastrointestinal bleeding, especially in older adults or those with a history of ulcers. Report any signs of stomach pain, black or bloody stools, or vomiting blood to your healthcare provider immediately.
- Avoid alcohol while taking Vimovo, as it can increase the risk of stomach bleeding.
- If you miss a dose, take it as soon as you remember. If it is close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses.
Side Effects of Vimovo
Common Side Effects
- Stomach pain or upset
- Diarrhea
- Nausea or vomiting
- Headache
- Dizziness
Uncommon/Severe Side Effects
- Gastrointestinal bleeding or ulcers (black or tarry stools, vomiting blood)
- Kidney problems (changes in urine output, swelling in the legs)
- Liver toxicity (yellowing of the skin or eyes, dark urine)
- Severe allergic reactions (rash, swelling, difficulty breathing)
- Heart attack or stroke with long-term NSAID use
Risks and Warnings of Vimovo
- Cardiovascular risk: Long-term use of naproxen, like other NSAIDs, may increase the risk of heart attack or stroke, especially in patients with pre-existing cardiovascular conditions. Use should be limited to the lowest effective dose for the shortest duration.
- Gastrointestinal risk: Vimovo can increase the risk of gastrointestinal bleeding, ulcers, and perforation of the stomach or intestines, particularly in older adults or those with a history of ulcers. Taking the medication as prescribed and avoiding additional NSAIDs can help minimize this risk.
- Kidney and liver toxicity: Prolonged use of NSAIDs, including naproxen, can affect kidney and liver function. Regular monitoring may be required in patients with pre-existing liver or kidney conditions.
- Bone fractures: Long-term use of esomeprazole (a PPI) can increase the risk of bone fractures, particularly in the hip, wrist, or spine.
Interactions with Vimovo
Common Drug Interactions
- Other NSAIDs: Taking Vimovo with other NSAIDs, such as ibuprofen or aspirin, increases the risk of gastrointestinal side effects and should be avoided.
- Blood thinners (warfarin): Vimovo may increase the risk of bleeding when taken with anticoagulants or antiplatelet drugs like warfarin or clopidogrel.
- Methotrexate: Naproxen may increase methotrexate levels in the blood, raising the risk of toxicity.
- Diuretics and ACE inhibitors: Combining Vimovo with certain blood pressure medications like diuretics or ACE inhibitors may reduce kidney function and increase the risk of kidney problems.
- Proton pump inhibitors (PPIs): Esomeprazole, as a PPI, can reduce the absorption of certain medications, such as ketoconazole or iron supplements.
Alternatives to Vimovo
- Naproxen alone: If the risk of stomach ulcers is low, patients may be prescribed naproxen without esomeprazole.
- Celecoxib (Celebrex): Another NSAID that may have a lower risk of gastrointestinal complications in some patients.
- Omeprazole or pantoprazole: These PPIs may be used alongside NSAIDs to protect the stomach lining from irritation.
- Acetaminophen (Tylenol): An alternative pain reliever that does not carry the same gastrointestinal risks as NSAIDs but may be less effective for inflammation.
