Esomeprazole + Naproxen

Indications

Esomeprazole + Naproxen is used for: Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis, Joint stiffness

Adult Dose

Rheumatoid Arthritis, Osteoarthritis, Alkylosing Spondylitis, and dysmenorrhoea: 375/20 or 500/20 mg, one tablet twice daily.

Child Dose

Renal Dose

Administration

The tablets are to be swallowed whole with liquid. Do not split, chew, crush or dissolve the tablet.The tablet is to be taken at least 30 minutes before meals.

Contra Indications

• Known hypersensitivity to any component or substituted benzimidazoles • History of asthma, urticaria or other allergic-type reactions after taking aspirin or other NSAIDs • Use during the peri-operative period in the setting of coronary artery bypass graft (CABG) surgery • Late pregnancy

Precautions

Patients with known CV disease/risk factors may be at greater risk. Progesic should be used with caution in patients with fluid retention or heart failure. Lactation: Should not be used in nursing mother.

Pregnancy-Lactation

Pregnancy Category C in 1st trimester, D in 3rd trimester or near delivery.

Interactions

Increased risk of digoxin-induced cardiotoxic effects. Increased risk of hypomagnesaemia w/ diuretics. May increase INR and prothrombin time w/ warfarin. May increase serum concentration of tacrolimus, saquinavir, methotrexate. May interfere the elimination of drugs metabolised by CYP2C19 (e.g. diazepam). May decrease the bioavailability of ketoconazole, erlotinib and Fe salts. Potentially Fatal: May decrease serum concentration and pharmacological effects of rilpivirine, atazanavir and nelfinavir. May decrease the antiplatelet effects of clopidogrel.

Adverse Effects

Side effects of Esomeprazole + Naproxen : In general,The most common adverse reactions in clinical trials (>5%): erosive gastritis, dyspepsia, gastritis, diarrhea, gastric ulcer, upper abdominal pain, nausea etc.

Mechanism of Action

Naproxen, a propionic acid derivative, is a prototypical NSAID. It reversibly inhibits the cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, thus resulting in reduced synthesis of prostaglandin precursors. It can inhibit platelet aggregation, has anti-inflammatory, analgesic and antipyretic actions. Esomeprazole is a PPI that suppresses gastric acid secretion by inhibiting H+/K+ ATPase in the gastric parietal cell. It is the S-isomer of omeprazole.