Esomeprazole + Naproxen

Naproxen is an NSAID that reduces prostaglandin synthesis by inhibiting COX enzymes, providing analgesic and anti-inflammatory effects. Esomeprazole is a PPI that irreversibly blocks the H+/K+-ATPase enzyme in gastric parietal cells, reducing gastric acid secretion. This combination maintains naproxen's analgesic and anti-inflammatory effects while esomeprazole reduces the risk of naproxen-induced gastric ulcers.

Pain relief: Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, muscle pain, back pain, toothache, ear and throat pain.

Analgesic & Anti-inflammatory

NSAID + Proton Pump Inhibitor

Naproxen inhibits COX-1 and COX-2 enzymes, reducing prostaglandin synthesis and decreasing pain, inflammation and fever. Esomeprazole inhibits gastric acid secretion by blocking the H+/K+-ATPase enzyme (proton pump) in gastric parietal cells, preventing naproxen-induced gastric damage.

Naproxen inhibits cyclooxygenase enzymes to reduce prostaglandin synthesis, decreasing pain and inflammation. Esomeprazole inhibits the proton pump to reduce gastric acid production, protecting the stomach lining from naproxen-induced damage.

Adults: 1 tablet (Naproxen 375mg or 500mg + Esomeprazole 20mg) twice daily, or as prescribed. Take at least 30 minutes before meals on an empty stomach. Use caution with high doses in elderly patients.

Take at least 30 minutes before meals on an empty stomach. Swallow tablet whole; do not chew, crush or split. Take with a glass of water. Antacids may be used.

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 continue with your regular schedule. Do not double the dose.

Common side effects: Dyspepsia, gastritis, diarrhea, gastric ulcer, abdominal pain, nausea, flatulence, headache. Serious side effects: Cardiovascular thrombotic events (heart attack, stroke), hypertension, heart failure, gastrointestinal bleeding, renal impairment, elevated liver enzymes, severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), allergic reactions.

Avoid use during pregnancy (especially third trimester). Caution during lactation. Caution in elderly, patients with heart disease, hypertension, kidney or liver disease. Caution while driving as it may cause dizziness, drowsiness or vision problems. Avoid alcohol. Long-term use may increase fracture risk and vitamin B12 deficiency.

Hypersensitivity to naproxen, esomeprazole or any other NSAID/PPI. Aspirin-sensitive asthma. Recent heart bypass surgery. Severe renal or hepatic impairment. History of GI bleeding or ulcer.

Warfarin, clopidogrel, other NSAIDs, aspirin, corticosteroids, diuretics, ACE inhibitors, angiotensin II receptor blockers, lithium, methotrexate, cyclosporine, tacrolimus, digoxin, SSRIs. Avoid use with nelfinavir, atazanavir, rilpivirine.

Caution advised when consuming alcohol as it increases the risk of stomach bleeding and ulcer.

Avoid use during pregnancy, especially in the third trimester. Limit use between 20-30 weeks of pregnancy. Animal studies have shown harmful effects on the fetus.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Use with caution during breastfeeding. Limited data suggests it does not pass into breast milk in significant amounts, but caution is required.

Safety and efficacy not established in children. Avoid use in children under 12 years.

Elderly patients (over 65 years) have higher risk of GI bleeding; use lower doses and caution.

Caution in renal impairment; not recommended in moderate to severe renal impairment (CrCl <30 mL/min). Caution in hepatic impairment; avoid in severe hepatic disease.

Symptoms of overdose: Drowsiness, irregular heartbeat, stomach discomfort, nausea, vomiting, headache. Seek medical attention immediately if overdose is suspected.

Store below 30°C in a cool and dry place, protected from light. Keep out of reach of children.

Naproxen + Esomeprazole