Esomeprazole Magnesium (es-oh-MEP-ra-zole mag-NEE-zee-um), Naproxen (na-PROX-en)
Treats pain caused by arthritis or ankylosing spondylitis. This medicine is a combination of a nonsteroidal anti-inflammatory drug (NSAID) and a proton pump inhibitor (PPI) that helps protect against ulcers in your stomach or intestines.
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
Do not use this medicine if you have had an allergic reaction to naproxen or esomeprazole, or to any similar medicines. Do not use this medicine if you have had an asthma attack, hives, or other allergic reaction to aspirin or other NSAIDs. Do not use this medicine right before or right after you have heart bypass surgery.
How to Use This Medicine
Delayed Release Tablet
- Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
- Take this medicine at least 30 minutes before a meal.
- Swallow the tablet whole with water. Do not break, crush, chew, or dissolve it.
- Your doctor may tell you to take vitamin D and calcium supplements while you are using this medicine.
- This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you also use clopidogrel (Plavix®), rifampin (Rifadin®, Rimactane®), St John's wort, a blood thinner (such as dicumarol, heparin, warfarin, Coumadin®, Jantoven), a steroid medicine (such as hydrocortisone, methylprednisolone, prednisolone, prednisone), or a diuretic (water pill, such as furosemide, hydrochlorothiazide, torsemide, Lasix®).
- Do not use any other NSAID medicine unless your doctor tells you to. Some examples of other NSAIDs are aspirin, diclofenac, ibuprofen, Advil®, Aleve®, Celebrex®, Voltaren®.
- Make sure your doctor knows if you also use cholestyramine (Questran®), cilostazol (Pletal®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), diazepam (Valium®), digoxin (Lanoxin®), erlotinib (Tarceva®), ketoconazole (Nizoral®), lithium (Eskalith®, Lithobid®), methotrexate (Rheumatrex®), probenecid (Benemid®), tacrolimus (Prograf®), or voriconazole (Vfend®).
- Tell your doctor if you use iron supplements, blood pressure medicine (such as atenolol, benazepril, enalapril, lisinopril, metoprolol, propranolol, Bystolic®, Lotrel®, Tenormin®, Vasotec®, Zestoretic®, Zestril®), medicine to treat depression (such as citalopram, fluoxetine, sertraline, Cymbalta®, Effexor®, Lexapro®, Pristiq®), diabetes medicine that you take by mouth (such as glimepiride, glipizide, glyburide, Amaryl®), medicine for seizures (such as phenytoin, Dilantin®), or medicine to treat HIV infection (such as atazanavir, nelfinavir, saquinavir, Reyataz®).
Warnings While Using This Medicine
- Make sure your doctor knows if you are pregnant or breastfeeding. Do not use this medicine during the later part (third trimester) of pregnancy unless your doctor tells you to.
- Make sure your doctor knows if you have kidney disease, liver disease, anemia, asthma, bleeding problems, osteoporosis, congestive heart failure, fluid retention or swelling, high blood pressure, or any other heart or circulation problems. Tell your doctor if you have seizures, a history of low magnesium levels in your blood, Crohn disease, or ulcers or other stomach problems.
- Naproxen may increase your risk of a heart attack or stroke. This is more likely in people who already have heart disease or who use this medicine for a long time. Get emergency help right away if you have any symptoms of a heart attack or stroke. Some possible symptoms are chest pain or discomfort, uneven heartbeat, pain that spreads to your arm or jaw, unusual sweating, feeling faint, trouble breathing, slurred speech, or weakness on one side of your body.
- Naproxen may cause bleeding in your stomach or intestines. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, are older than 60 years of age, are in poor health, or use certain medicines (such as steroids or a blood thinner).
- Tell your doctor right away if you have seizures, dizziness, a fast or pounding heartbeat, or muscle spasms. These may be symptoms of hypomagnesemia (low magnesium in the blood). This is more likely to occur if you take this medicine longer than 1 year or if you take it with digoxin or certain diuretics (water pills).
- Tell your doctor right away if you have diarrhea that does not go away, stomach pain, and fever. These may be symptoms of Clostridium difficile colitis (also called C diff). C diff is an inflammation of your large intestine that causes diarrhea. If you have severe diarrhea, ask your doctor before taking any medicine to stop the diarrhea.
- Serious allergic reactions can occur. Check with your doctor right away if you have any of the following symptoms: blistering, peeling, or loose skin, chills, fever, itching, joint or muscle pain, red skin rash, or sores, ulcers, or white spots in the mouth or on the lips.
- Check with your doctor right away if you have any symptoms of liver problems, such as dark urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, or yellow skin or eyes.
- This medicine may increase your risk of broken bones in the hip, wrist, and spine. This is more likely if you are older than 50 years of age, if you receive high doses of this medicine, or if you use it for longer than 1 year.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
- This medicine may make you dizzy or drowsy. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.
- Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.You may need blood or other lab tests to check for side effects.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
- Blistering, peeling, red skin rash, sometimes with a fever
- Bloody, black, or tarry stools
- Change in how much or how often you urinate, bloody or cloudy urine
- Chest pain, trouble breathing, or coughing up blood
- Dark urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellow skin or eyes
- Fast, slow, pounding, or uneven heartbeat
- Numbness or weakness in your arm or leg, or on one side of your body
- Seizures, tremors, muscle spasms or cramps
- Severe diarrhea that does not go away, stomach pain, and fever
- Sudden or severe headache, problems with vision, speech, or walking
- Unexplained weight gain, swelling in your hands, ankles, or feet
- Unusual bleeding, bruising, or weakness
- Vomiting of blood or something that looks like coffee grounds
If you notice these less serious side effects, talk with your doctor:
- Diarrhea, heartburn, indigestion, gas, stomach pain or upset
- Mild skin rash or itching