Vimovo fact sheet

Since its founding in POZEN has successfully created novel pharmacologic agents primarily for pain and pain-related conditions by combining existing drug therapies that result in superior patient outcomes.Moving forward POZEN is poised to become a model st century pharmaceutical company dedicated to ensuring that they produce cost-effective evidence-based medicinestake a fresh approach to sales marketing and medical educationand deliver high-quality affordable pharmaceuticals to their customers.The Company's common stock is traded on The NASDAQ Stock Market under the symbol "POZN."About AstraZenecaAstraZeneca is a global innovation-driven biopharmaceutical business with a primary focus on the discovery development and commercialization of prescription medicines.As a leader in gastrointestinal cardiovascular neuroscience respiratory and inflammation oncology and infectious disease medicines AstraZeneca generated global revenues of billion in In the United States AstraZeneca is a billion health care business.References Prescribing Information for VIMOVO. And AstraZeneca is a fixed-dose combination of enteric-coated naproxen a pain-relieving non-steroidal anti-inflammatory drug NSAID and immediate-release esomeprazole a proton pump inhibitor vimovo us PPI.The FDA approval was supported by data from a clinical development program including results from the pivotal PN-and PN-studies which showed patients taking VIMOVO experienced significantly fewer endoscopic gastric ulcers compared to patients receiving enteric-coated naproxen.Twenty-seven million Americans are affected by osteoarthritis which is the most common form of arthritis. Behovet for fortsatt gastrobeskyttende behandling skal også vurderes på nytt.Bivirkninger av naproksen kan minimeres ved å bruke laveste effektive dose i kortest mulig tid.Hos pasienter som ikke tidligere har vært behandlet med NSAIDs bør lavere daglig dose av naproksen eller andre NSAIDs vurderes.Voksne tablett mg mg ganger daglig.Vimovo skal ikke brukes til hurtig innsettende smertelindring av akutte smertetilstander som tannverk som følge av forsinket frisetting av naproksen.Anfall av osteoartritt revmatoid artritt og ankyloserende spondylitt kan imidlertid behandles med Vimovo.Spesielle pasientgrupper Nedsatt leverfunksjon Skal brukes med forsiktighet ved mild til moderat nedsatt leverfunksjon og leverfunksjonen må monitoreres nøye.Reduksjon i total daglig naproksendose må vurderes.Kontraindisert ved alvorlig vimovo us nedsatt leverfunksjon.Nedsatt nyrefunksjon Skal brukes med forsiktighet ved mild til moderat nedsatt nyrefunksjon og nyrefunksjonen må monitoreres nøye.Reduksjon i total daglig naproksendose må vurderes.Kontraindisert ved alvorlig nedsatt nyrefunksjon ClCRBarn år Anbefales ikke pga.manglende sikkerhets-og effektdata.Eldre år Eldre har økt risiko for alvorlige bivirkninger.Administrering Bør tas minst minutter før mat. Corticosteroid Treatment VIMOVO cannot be expected to substitute for corticosteroids or to treat corticosteroid insufficiency.Abrupt discontinuation of corticosteroids may lead to disease exacerbation.Patients on prolonged corticosteroid therapy should have their therapy tapered slowly if a decision is made to discontinue corticosteroids and the patient should be observed closely for any evidence of adverse effects including adrenal insufficiency and exacerbation of symptoms of arthritis. Doses ranged up to mg times the usual recommended clinical dose.Manifestations were variable but included confusion drowsiness blurred vision tachycardia nausea diaphoresis flushing headache dry mouth and other adverse reactions similar to those seen in normal clinical experience see omeprazole package insert Adverse vimovo us Reactions.No specific antidote for esomeprazole is known.Since esomeprazole is extensively protein bound it is not expected to be removed by dialysis.In the event of overdosage treatment should be symptomatic and supportive.If overexposure occurs call the Poison Control Center at.The active ingredients of VIMOVO are naproxen which is a NSAID and esomeprazole magnesium which is a Proton Pump Inhibitor PPI.VIMOVO is available as an oval yellow multi-layer delayed release tablet combining an enteric coated naproxen core and an immediate release esomeprazole magnesium layer surrounding the core.Each strength contains either mg of naproxen and mg of esomeprazole present as mg esomeprazole magnesium trihydrate or mg of naproxen and mg of esomeprazole present as mg esomeprazole magnesium trihydrate for oral administration.The inactive ingredients are carnauba wax colloidal silicon dioxide croscarmellose sodium iron oxide yellow glyceryl monostearate hypromellose iron oxide black magnesium stearate methacrylic acid copolymer dispersion methylparaben polysorbate polydextrose polyethylene glycol povidone propylene glycol propylparaben titanium dioxide and triethyl citrate.vimovo us The chemical name for naproxen is Smethoxy-α-methyl--naphthaleneacetic acid.Naproxen has the following structure Naproxen has a molecular weight of and a molecular formula of CHO.Naproxen is an odorless white to off-white crystalline substance.It is lipid soluble practically insoluble in water at low pH and freely soluble in water at high pH.The octanol water partition coefficient of naproxen at pH is The chemical name for esomeprazole is bis-methoxy Smethoxy-dimethylpyridinylmethylsulfinyl-H-benzimidazoleyl magnesium trihydrate.

Biopharmaceutical company AstraZeneca Plc AZN Quote AZN.L Friday said a long-term safety data demonstrated that Vimovo mg delayed-release tablets were generally well tolerated in osteoarthritis patients who were at risk for NSAID-associated gastric ulcers.In osteoarthritis patients the long-term use of NSAIDs nonsteroidal anti-inflammatory drug therapy for the relief of pain and inflammation may increase the occurrence of gastric ulcers and other adverse events.Vimovo or naproxen esomeprazole magnesium is a fixed-dose combination of enteric-coated naproxen a pain-relieving NSAID and immediate-release esomeprazole magnesium an ulcer risk-reducing proton pump inhibitor.The vimovo us FDA approved Vimovo in April and it is co-developed by AstraZeneca and U.S.-based pharmaceutical company Pozen Inc.It is approved for the relief of osteoarthritis rheumatoid arthritis ankylosing spondylitis and to decrease the risk of developing NSAID-associated gastric ulcers.PN-was an open-label multicenter Phase study designed to evaluate the long-term safety of Vimovo.In the study the patients were treated with Vimovo twice daily for months.No new or unexpected safety issues emerged throughout the treatment period of the study.The most common adverse events were dyspepsia constipation nausea upper respiratory tract infection back pain and contusion.However Vimovo is not recommended for initial treatment of acute pain because the absorption of naproxen is delayed compared vimovo en mexico with absorption from other naproxen-containing products.Controlled studies do not extend beyond months.Commenting on the study findings Mark Sostek Executive Director Clinical Research AstraZeneca stated "In a single tablet VIMOVO delivers both the proven pain relief of naproxen with the gastric ulcer risk reduction of esomeprazole vimovo us in every dose of the medication."AZN closed Thursday's trading at down on a volume of shares.AZN.L is trading at pence on the LSE down pence or percent on a volume of shares.To receive FREE breaking news email alerts for AstraZeneca PLC and others in your portfolio by RTT Staff WriterFor Company AstraZeneca Pharmaceuticals Ireland.Legal category Prescription.GMS.Sport permitted.Active ingredient Naproxen esomeprazole Mg++ trihydrate mg mg.Description Oval biconvex yellow modified-release tablet marked Presentation Indications Symptomatic treatment of osteoarthritis rheumatoid arthritis and ankylosing spondylitis in patients at risk for developing NSAID-associated gastric and or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient.Pharmacology Vimovo has been developed as a sequential-delivery tablet formulation combining an immediate release esomeprazole magnesium layer and an enteric coated delayed-release naproxen core.As a result esomeprazole is released in the stomach prior to the dissolution of naproxen in the small intestine.The enteric vimovo us coating prevents naproxen release at pH levels below providing protection against possible local gastric toxicity of naproxen.

It's just a marketing ploy to throw two generics together and make it a branded product.It's not worth what they charge and doesn't protect against the deleterious effects of NSAIDs.It's not an enteric coating so it dissolves immediately leaving the NSAID in the unprotected sleeve or pouch depending on the type of surgery you had.PPI's also don't work immediately another reason this is a gimmick by the time the NSAID has inflicted its damage the PPI is starting to work.Also NSAIDs can cause the same symptoms intravenously transdermally and orallytherefore route of administration is not as important as whether or not you are taking NSAIDs at all.With any luck maybe the PPI candy coating will help the NSAID melt in our mouths and not our hands.Oh wait that's already been taken. You are vomiting blood vimovo us or material that looks like coffee grounds you are bleeding from the rectum back passage have black sticky bowel motions stools or bloody diarrhoea you lose a lot of weight for no reason and have problems swallowing you have a peptic ulcer i.e.stomach or duodenal ulcer you have severe problems with your liver kidney or heart you are taking a medicine containing atazanavir nelfinavir both used to treat HIV infection or cilostazol for intermittent claudicationPlease check with your doctor or pharmacist if you are taking these medicines.These medicines will be affected by Vimovo.you are taking another medication containing naproxen e.g.Naprosyn or esomeprazole e.g.

But if you have a lot of money burning a hole in your pocket and you need an acne treatment that is almost guaranteed to not be covered by your insurance then by all means ask your doctor about Solodyn. Elke tablet met gereguleerde afgifte bevat mg naproxen en mg esomeprazol.De dosis is tweemaal vimovo us daags tablet mg mg.Vimovo® moet in zijn geheel met water worden ingenomen en mag niet gedeeld gekauwd of vermalen worden.Het wordt aanbevolen om Vimovo® ten minste minuten voor de inname van voedsel in te nemen.Voor patiënten Klik hier voor de patientenbijsluiter Registratietekst AstraZeneca and POZEN Inc.today announced that VIMOVO naproxen esomeprazole magnesium mg modified-release tablets has cleared an important regulatory milestone by receiving positive agreement for approval in countries across the European Union EU.This follows all Concerned Member States agreeing with the assessment of the Netherlands Health Authority MEB acting as the Reference Member State for the Decentralised Procedure DCP.It also results in a harmonised Summary of Product Characteristics SmPC.The Member States will now pursue pricing and reimbursement and national approvals.VIMOVO is indicated for the symptomatic treatment of osteoarthritis OA rheumatoid arthritis RA and ankylosing spondylitis AS in patients who are at risk for developing non-steroidal anti-inflammatory drug NSAID-associated gastric and or duodenal ulcers and where treatment with lower doses of naproxen or of other NSAIDs is not considered sufficient.VIMOVO co-developed by AstraZeneca and POZEN Inc is a fixed-dose combination of enteric-coated naproxen a pain-relieving NSAID and immediate-release esomeprazole a proton pump inhibitor PPI.The positive agreement is based on a submission package including data from the pivotal trials PN-and PN- which demonstrated that patients taking VIMOVO experienced significantly fewer endoscopic gastric ulcers compared to patients receiving enteric-coated naproxen.This support for the approval of VIMOVO in Europe is a significant milestone which we believe will provide a new treatment option for the millions of arthritis patients in the EU at risk for NSAID-associated ulcers said Lori Kreamer Global Products Vice President AstraZeneca.In one tablet VIMOVO offers the proven pain relief of naproxen with built-in ulcer risk reduction.Nearly million people worldwide and approximately million people in Europe suffer from OA which is the most common form of arthritis.While many patients with OA treat their symptoms with NSAIDs vimovo us of chronic NSAID users are at risk of gastrointestinal ulcers. Avoid concomitant use of St.John’s Wort or rifampin with Vimovo.Other Pharmacokinetic-based Interactions Co-administration of oral contraceptives diazepam phenytoin or quinidine does not seem to change the pharmacokinetic profile of esomeprazole.USE IN SPECIFIC POPULATIONS Pregnancy Teratogenic Effects Pregnancy Category C prior to weeks gestationCategory D starting weeks gestation. Some of the common side effects that may be associated with Vimovo include inflammation of the lining of the stomach indigestion diarrhea stomach ulcers upper abdominal pain nauseaSevere side effects may include high blood pressure heart attack stroke fluid retention kidney problems bleeding ulcers anemia life-threatening skin reactions and allergic reactions liver problems and asthma attacks.What other special warnings and precautions apply to Vimovo use. VIMOVO can cause drowsiness dizziness or depression.You should not drive or do other activities that require you to be alert until you know how VIMOVO affects you.What are the possible side effects of VIMOVO. Atrophic gastritis vimovo us has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole of which esomeprazole is an enantiomer and a component of VIMOVO.Active Bleeding When active and clinically significant bleeding from any source occurs in patients receiving VIMOVO the treatment should be withdrawn.Renal Effects Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury.Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion.In these patients administration of an NSAID may cause a dose-dependent reduction in prostaglandin formation and secondarily in renal blood flow which may precipitate overt renal decompensation. While many patients with osteoarthritis treat their symptoms with NSAIDs of chronic NSAID users are at risk of gastrointestinal ulcers."In a single pill VIMOVO provides a proven pain reliever with a built-in PPI for arthritis patients at-risk for NSAID-associated gastric ulcers " said Howard Hutchinson M.D Chief Medical Officer AstraZeneca."The approval also vimovo us demonstrates the commitment of AstraZeneca and POZEN to provide a new pain relief option that addresses the unmet medical needs of these patients."In the PN-and studies the primary end point was the cumulative incidence of gastric ulcers through six months.In each of the trials patients received either VIMOVO or enteric-coated naproxen mg twice daily over a six-month treatment period.Endoscopies were performed at baseline and at one three and six months.Data from study PN-showed a incidence of gastric ulcers in patients taking VIMOVO compared to among patients taking enteric-coated naproxen pThe most commonly observed adverse events in the clinical trials experienced by of patients in the VIMOVO group were erosive gastritis dyspepsia gastritis diarrhea gastric ulcer upper abdominal pain and nausea.Important Safety Information about VIMOVOCardiovascular Risk Naproxen a component of VIMOVO may cause an increased risk of serious cardiovascular thrombotic events myocardial infarction and stroke which can be fatal.This risk may increase with duration of use.Patients with cardiovascular vimovo us vimovo and breastfeeding disease or risk factors for cardiovascular disease may be at greater risk.VIMOVO is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft CABG surgery.Gastrointestinal Risk NSAIDs including naproxen a component of VIMOVO cause an increased risk of serious gastrointestinal adverse events including bleeding ulceration and perforation of the stomach or intestines which can be fatal.These events can occur at any time during use and without warning symptoms.Elderly patients are at greater risk for serious gastrointestinal GI events.VIMOVO is contraindicated in patients with known hypersensitivity to any component of VIMOVO or substituted benzimidazolesin patients with a history of asthma urticaria or other allergic-type reactions after taking aspirin or other NSAIDsin patients during the peri-operative period in the setting of coronary artery bypass graft CABG surgeryor in patients in the late stages of pregnancy.Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.Treatment should be withdrawn vimovo us when active and clinically significant bleeding from any source occurs.As with all NSAIDs VIMOVO can lead to the onset of new hypertension or worsening of pre-existing hypertension either of which may contribute to the increased incidence of CV events.Blood pressure should be monitored closely.Fluid retention and edema have been observed in some patients taking NSAIDs including VIMOVO.NSAIDs should be used with caution in patients with fluid retention or heart failure.NSAIDs including VIMOVO may diminish the antihypertensive effect of angiotensin converting enzyme ACE inhibitors and angiotensin II antagonists beta-blockers and in some patients can reduce the natriuretic effect of furosemide and thiazides.VIMOVO can be administered with low-dose aspirin less than or equal to mg day therapy.The concurrent use of aspirin and VIMOVO may increase the risk of serious adverse events.VIMOVO is not recommended in patients with moderate or severe renal insufficiency.In addition NSAIDs may cause renal toxicity.VIMOVO is not recommended in patients with severe hepatic vimovo us insufficiency.Consider dose reduction in mild moderate hepatic insufficiency.If abnormal liver enzymes persist or worsen discontinue use immediately.Serious skin adverse reactions such as exfoliative dermatitis Stevens-Johnson syndrome and toxic epidermal necrolysis which can be fatal and can occur without warning.Discontinue VIMOVO at first appearance of skin rash or any other sign of hypersensitivity.Symptomatic response to esomeprazole a component of VIMOVO does not preclude the presence of gastric malignancy.Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole of which VIMOVO contains an enantiomer.Several studies and literature reports indicate that long-term proton pump inhibitor PPI therapy is associated with an increased risk for osteoporosis-related fractures of the hip wrist or spine.Esomeprazole a component of VIMOVO inhibits gastric acid secretion and may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability eg ketoconazole iron salts and digoxin.Concomitant use of VIMOVO and warfarin may result in increased risk vimovo us of bleeding complications.Monitor for increases in INR and prothrombin time.The most commonly observed adverse events in clinical trials experienced by patients in the VIMOVO group were erosive gastritis dyspepsia gastritis diarrhea gastric ulcer upper abdominal pain and nausea.About VIMOVOVIMOVO is a fixed-dose combination of delayed-release enteric-coated naproxen a non-steroidal anti-inflammatory drug NSAID and immediate-release esomeprazole a stomach acid-reducing proton pump inhibitor PPI approved for the relief of signs and symptoms of osteoarthritis rheumatoid arthritis and ankylosing spondylitis and to decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.VIMOVO is not recommended for use in children younger than years of age.VIMOVO has been developed as a sequential-delivery tablet formulation combining an immediate-release esomeprazole magnesium layer and an enteric-coated naproxen core.As a result esomeprazole is released first in the stomach prior to the dissolution of naproxen in the small intestine.The enteric coating prevents naproxen release at pH levels below providing protection against possible vimovo us local gastric toxicity of naproxen.AstraZeneca submitted a Marketing Authorization Application MAA to the European Medicines Association EMEA for VIMOVO on October .Upon the FDA's notification of approval of the New Drug Application for VIMOVO a million milestone payment from AstraZeneca will be payable to POZEN.About OsteoarthritisOsteoarthritis is a degenerative joint disease caused by the breakdown and eventual loss of the cartilage of one or more joints.Osteoarthritis is the most common form of arthritis and the most common cause of chronic pain affecting million individuals worldwide and million Americans.A combination of factors can contribute to osteoarthritis including being overweight aging joint injury or stress heredity and muscle weakness.Osteoarthritis commonly affects the hands spine or large weight-bearing joints such as the hips and knees.About Rheumatoid ArthritisRheumatoid arthritis is a chronic disease mainly characterized by inflammation of the lining or synovium of the joints.It can lead to long-term joint damage resulting in chronic pain loss of function and disability.vimovo us About Ankylosing SpondylitisAnkylosing spondylitis is a chronic inflammatory disease that primarily causes pain and inflammation of the joints between the vertebrae of the spine and the joints between the spine and pelvis sacroiliac joints.Ankylosing spondylitis may also cause inflammation and pain in other parts of the body as well.ABOUT POZENPOZEN Inc headquartered in Chapel Hill NC is a pharmaceutical company committed to transforming medicine that transforms lives.

Vimovo is prescribed for relief of the signs and symptoms of osteoarthritis rheumatoid arthritis ankylosing spondylitis and to decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.Are there any special instructions regarding how to take Vimovo. Doses ranged up to mg times the usual recommended clinical dose.Manifestations were variable but included confusion drowsiness blurred vision tachycardia nausea diaphoresis flushing headache dry mouth and other adverse reactions similar to those seen in normal clinical experience see omeprazole package insert Adverse Reactions.No specific antidote for esomeprazole is known.vimovo us Since esomeprazole is extensively protein bound it is not expected to be removed by dialysis.In the event of overdosage treatment should be symptomatic and supportive.If overexposure occurs call the Poison Control Center at.The active ingredients of VIMOVO are naproxen which is a NSAID and esomeprazole magnesium which is a Proton Pump Inhibitor PPI.VIMOVO is available as an oval yellow multi-layer delayed release tablet combining an enteric coated naproxen core and an immediate release esomeprazole magnesium layer surrounding the core.Each strength contains either mg of naproxen and mg of esomeprazole present as mg esomeprazole magnesium trihydrate or mg of naproxen and mg of esomeprazole present as mg esomeprazole magnesium trihydrate for oral administration.The inactive ingredients are carnauba wax colloidal silicon dioxide croscarmellose sodium iron oxide yellow glyceryl monostearate hypromellose iron oxide black magnesium stearate methacrylic acid copolymer dispersion methylparaben polysorbate polydextrose polyethylene glycol povidone propylene glycol propylparaben titanium dioxide and triethyl citrate.The chemical name for naproxen is Smethoxy-α-methyl--naphthaleneacetic vimovo us acid.Naproxen has the following structure Naproxen has a molecular weight of and a molecular formula of CHO.Naproxen is an odorless white to off-white crystalline substance.It is lipid soluble practically insoluble in water at low pH and freely soluble in water at high pH.The octanol water partition coefficient of naproxen at pH is The chemical name for esomeprazole is bis-methoxy Smethoxy-dimethylpyridinylmethylsulfinyl-H-benzimidazoleyl magnesium trihydrate.

MgEach yellow oval film-coated tablet printed " " in black ink on one side contains mg esomeprazole and mg naproxen.Nonmedicinal ingredients carnauba wax croscarmellose sodium glycerol monostearate hypromellose iron oxide black iron oxide yellow macrogols magnesium stearate methacrylic acid-ethyl acrylate copolymer dispersion methyl parahydroxybenzoate polydextrose polysorbate povidone propylene glycol propyl parahydroxybenzoate silica colloidal anhydrous titanium dioxide and triethyl citrate.

The safety of VIMOVO was evaluated in clinical studies involving patients aged to years and ranging from -months.Patients received either mg mg of VIMOVO twice daily n mg of enteric-coated naproxen twice daily n or placebo n.The average number vimovo us of VIMOVO doses taken over months was +.The table below lists all adverse reactions regardless of causality occurring in of patients receiving VIMOVO from two clinical studies Study and Study Both of these studies were randomized multi-center double-blind parallel studies.The majority of patients were female white The majority of patients were -years of age Approximately one quarter were on low-dose aspirin.Table Adverse Reactions occurring in patients Study and Study endoscopic studies Preferred term sorted by SOC VIMOVO mg mg twice daily n EC-Naproxen mg twice daily n Gastrointestinal Disorders Gastritis Erosive Dyspepsia Gastritis Diarrhea Gastric Ulcer Abdominal Pain Upper Nausea Hiatus Hernia Abdominal Distension Flatulence Esophagitis Constipation Abdominal pain Erosive Duodenitis Abdominal pain lower Duodenitis Gastritis hemorrhagic Gastroesophageal reflux disease Duodenal ulcer Erosive esophagitis Infections and infestations Upper respiratory tract infection Bronchitis Urinary tract infection Sinusitis Nasopharyngitis Musculoskeletal and connective tissue disorders Arthralgia Nervous system disorders Headache Dysgeusia Respiratory thoracic and mediastinal disorders Cough In Study and Study patients taking VIMOVO vimovo us had fewer premature discontinuations due to adverse reactions compared to patients taking enteric-coated naproxen alone vs.respectively.The most common reasons for discontinuations due to adverse events in the VIMOVO treatment group were upper abdominal pain duodenal ulcer n and erosive gastritis n.Among patients receiving enteric-coated naproxen the most common reasons for discontinuations due to adverse events were duodenal ulcer n dyspepsia n and upper abdominal pain n.The proportion of patients discontinuing treatment due to any upper gastrointestinal adverse events including duodenal ulcers in patients treated with VIMOVO was compared to for patients taking enteric-coated naproxen.The table below lists all adverse reactions regardless of causality occurring in of patients from clinical studies conducted in patients with osteoarthritis of the knee Study and Study Table Adverse Reactions occurring in patients Study and Study Preferred term sorted by SOC VIMOVO mg mg twice daily n Placebo n Gastrointestinal Disorders Dyspepsia Diarrhea Abdominal Pain Upper Constipation Nausea Nervous System Disorders Dizziness Headache General disorders and vimovo us administration site conditions Peripheral edema Respiratory thoracic and mediastinal disorders Cough Infections and infestations Sinusitis The percentage of subjects who withdrew from the VIMOVO treatment group in these studies due to treatment-emergent adverse events was There were no preferred terms in which more than of subjects withdrew from any treatment group.The long-term safety of VIMOVO was evaluated in an open-label clinical trial of patients of which patients received mg mg of VIMOVO for months.There were no differences in frequency or types of adverse reactions seen in the long-term safety study compared to shorter-term treatment in the randomized controlled studies.Postmarketing Experience Naproxen The following adverse reactions have been identified during post-approval use of naproxen.Because these reactions are reported voluntarily from a population of uncertain size it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.These reports are listed below by body system Body as a Whole anaphylactic reactions angioneurotic edema menstrual disorders pyrexia vimovo us chills and fever Cardiovascular congestive heart failure vasculitis hypertension pulmonary edema Gastrointestinal gastrointestinal bleeding and or perforation hematemesis pancreatitis vomiting colitis exacerbation of inflammatory bowel disease ulcerative colitis Crohn’s disease nonpeptic gastrointestinal ulceration ulcerative stomatitis esophagitis peptic ulceration Hepatobiliary jaundice abnormal liver function tests hepatitis some cases have been fatal Hemic and Lymphatic eosinophilia leukopenia melena thrombocytopenia agranulocytosis granulocytopenia hemolytic anemia aplastic anemia Metabolic and Nutritional hyperglycemia hypoglycemia Nervous System inability to concentrate depression dream abnormalities insomnia malaise myalgia muscle weakness aseptic meningitis cognitive dysfunction convulsions Respiratory eosinophilic pneumonitis asthma Dermatologic alopecia urticaria skin rashes toxic epidermal necrolysis erythema multiforme erythema nodosum fixed drug eruption lichen planus pustular reaction systemic lupus erythematoses bullous reactions including Stevens-Johnson syndrome photosensitive dermatitis photosensitivity reactions including rare cases resembling porphyria cutanea tarda pseudoporphyria or epidermolysis bullosa.If skin fragility blistering or other symptoms suggestive of pseudoporphyria occur treatment should be discontinued and the patient monitored.Special Senses hearing impairment corneal opacity papillitis retrobulbar optic neuritis papilledema Urogenital glomerular vimovo us nephritis hematuria hyperkalemia interstitial nephritis nephrotic syndrome renal disease renal failure renal papillary necrosis raised serum creatinine Reproduction female infertility Esomeprazole The following adverse reactions have been identified during post-approval use of esomeprazole.Because these reactions are reported voluntarily from a population of uncertain size it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.These reports are listed below by body system Blood and Lymphatic agranulocytosis pancytopeniaEye blurred visionGastrointestinal pancreatitisstomatitismicroscopic colitis Hepatobiliary hepatic failure hepatitis with or without jaundiceImmune System anaphylactic reaction shockInfections and Infestations GI candidiasis Clostridium difficile associated diarrhea; Metabolism and Nutritional Disorders hypomagnesemia Musculoskeletal and Connective Tissue muscular weakness myalgia bone fractureNervous System hepatic encephalopathy taste disturbance; Psychiatric aggression agitation depression hallucinationRenal and Urinary interstitial nephritisReproductive System and Breast gynecomastiaRespiratory Thoracic and Mediastinal bronchospasmSkin and Subcutaneous Tissue alopecia erythema multiforme hyperhidrosis photosensitivity Stevens-Johnson syndrome toxic epidermal necrolysis some fatal.Several studies conducted with VIMOVO have shown no interaction between the two components naproxen vimovo us and esomeprazole.

Rights of Treximet a combination naproxen and sumatriptan product for migraine attacks.In March Pozen secured Desitin Arzneimittel GmbH for the EU rights and Johnson Johnson JNJ for the South American rights to the same drug.As noted above the U.S.and International rights to Vimovo were licensed to AstraZeneca in August We haven't even begun to talk about the European market for.

Notable elevations of ALT or AST approximately three or more times the upper limit of normal have been reported in approximately of patients in clinical trials with NSAIDs.In addition rare cases of severe hepatic reactions including jaundice and fatal fulminant hepatitis liver necrosis and hepatic failure some of them with fatal outcomes have been reported.A patient with symptoms and or signs suggesting liver dysfunction or in whom an abnormal liver test has occurred should be evaluated for evidence of the development of more severe hepatic reaction while on therapy with Vimovo.If clinical signs and vimovo us symptoms consistent with liver disease develop or if systemic manifestations occur eg eosinophilia rash etc Vimovo should be discontinued.Chronic alcoholic liver disease and probably other diseases with decreased or abnormal plasma proteins albumin reduce the total plasma concentration of naproxen but the plasma concentration of unbound naproxen is increased.Caution is advised when high doses are required and some adjustment of dosage may be required in these patients.It is prudent to use the lowest effective dose for the shortest possible duration of adequate treatment. If you get an infection while using Vimovo tell your doctor.Vimovo may hide the some of the signs of an infection and may make you think mistakenly that you are better or that it is not serious.Signs of an infection may include fever pain swelling and redness.Things you must not do Do not give Vimovo to anyone else even if they have the same condition as you.Do not use Vimovo to treat any other complaints vimovo us unless your doctor tells you to.Things to be careful of Be careful driving or operating machinery until you know how Vimovo affects you.As with other NSAID medicines Vimovo may cause dizziness or light-headedness in some people.Make sure you know how you react to Vimovo before you drive a car operate machinery or do anything else that could be dangerous if you are dizzy or light-headed.If this occurs do not drive.If you drink alcohol dizziness or light-headedness may be worse.Back to topSide effects Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Vimovo.All medicines can have side effects.Sometimes they are serious most of the time they are not.You may need medical treatment if you get some of the side effects.Ask your doctor or pharmacist any questions you may have.Tell your doctor if you notice any of the following and they worry you stomach upset vimovo us including nausea feeling sick vomiting heartburn indigestion cramps loss of appetite constipation diarrhoea pain in the stomach wind dizziness lightheadedness drowsiness sleepiness change in sleep patterns headache feeling thirsty dry mouth mild skin rash or itchy skin These side effects are usually mild.Tell your doctor immediately if you notice any of the following eye problems such as blurred vision sore red eyes itching severe dizziness spinning sensation severe or persistent headache tingling or numbness of the hands or feet fast or irregular heartbeats also called palpitations difficulty hearing deafness signs of frequent or worrying infections such as fever severe chills sore throat or mouth ulcers bleeding or bruising more easily than normal reddish or purplish blotches under the skin signs of anaemia such as tiredness being short of breath and looking pale a change in the colour of urine passed blood in the urine a change in the amount or frequency of urine passed burning feeling when passing urine unusual weight gain swelling of ankles or legs severe skin rashes mood changes confusion or depression muscle pain or weakness increase in breast size males increased sweating hair loss These are serious side effects. What will it do for me?This is a combination medication that contains esomeprazole and naproxen.Esomeprazole belongs to the class of medications called proton pump inhibitors and naproxen belongs to the class of medications called nonsteroidal anti-inflammatory drugs NSAIDs.This combination medication is used to treat signs and symptoms of osteoarthritis OA rheumatoid arthritis RA and ankylosing spondylitis long-term inflammation disease of the joints and to decrease the risk of developing stomach ulcers in people at risk for developing stomach ulcers due to NSAIDs.Esomeprazole works by reducing the amount of acid that stomach produces.Naproxen relieves pain and reduces swelling and inflammation by reducing a substance in the body that leads to inflammation and pain.If immediate relief of pain is desired esomeprazole naproxen should not be used as it releases medication over vimovo us a longer period of time.Your doctor may have suggested this medication for conditions other than those listed in these drug information articles.As well some forms of this medication may not be used for all of the conditions discussed here.If you have not discussed this with your doctor or are not sure why you are taking this medication speak to your doctor.Do not stop taking this medication without consulting your doctor.Do not give this medication to anyone else even if they have the same symptoms as you do.It can be harmful for people to take this medication if their doctor has not prescribed it.How should I use Vimovo?The recommended daily dose of esomeprazole naproxen is one mg tablet twice daily or one mg tablet twice daily. Vimovo as with all NSAIDS should be taken exactly as prescribed at the lowest possible dose that achieves benefit and for the shortest time that is needed in order to lower the risk of adverse side effects.You should take Vimovo at least minutes before a meal.Vimovo must be swallowed whole.Do not chew split crush or dissolve Vimovo.You are allowed to take antacids if needed while taking Vimovo.Are there patients who should not take Vimovo.

Keywords Vimovo Lawyer Vimovo Attorney Vimovo Lawyer Vimovo Attorney Vimovo Lawsuit Vimovo Lawsuit Personal Injury Lawyer Vimovo Lawyer Vimovo Lawyer Call toll free .Vimovo It is not meant to substitute for medicaladvice provided by your physician or other medicalprofessional.You should readcarefully all product packaging and labels.I just wanted to see if you wanted to stay in touch with us on facebook. MgEach yellow oval film-coated tablet printed " " in black ink on one side contains mg esomeprazole and mg naproxen.Nonmedicinal ingredients carnauba wax croscarmellose sodium glycerol monostearate hypromellose iron oxide black iron oxide yellow macrogols magnesium stearate methacrylic acid-ethyl acrylate copolymer dispersion methyl parahydroxybenzoate polydextrose polysorbate povidone propylene glycol propyl parahydroxybenzoate silica colloidal anhydrous titanium dioxide vimovo us and triethyl citrate.Who should NOT take Vimovo?Do not take this medication if you are allergic to naproxen esomeprazole or any ingredients of this medication are years of age or younger are breast-feeding are in the third trimester of pregnancy have a bleeding disorder including bleeding in the brain have an active ulcer or bleeding in the stomach or intestines have a history of asthma or allergic-type reactions after taking ASA or other NSAIDs i.e complete or partial syndrome of ASA-intolerance-rhinosinusitis hives swelling of the skin or sac-like growths of the inflamed nose tissue have high blood potassium have inflammatory bowel disease e.g Crohn's disease ulcerative colitis have scheduled heart bypass surgery or have recently had this surgery have severe kidney disease have severe untreated heart failure have severely impaired liver fuction or active liver disease Drug Factsheets Health vimovo ficha tecnica Home Medications esomeprazole naproxen DIN Drug Identification Number VIMOVO MG MODIFIED RELEASE TABLET VIMOVO MG MODIFIED RELEASE TABLETHow does Vimovo work. MgEach yellow oval film-coated tablet printed " " in black ink on one side contains mg esomeprazole and mg naproxen.Nonmedicinal ingredients carnauba wax croscarmellose sodium glycerol monostearate hypromellose iron oxide black iron oxide yellow macrogols magnesium stearate methacrylic acid-ethyl acrylate copolymer dispersion methyl parahydroxybenzoate polydextrose polysorbate povidone propylene glycol propyl parahydroxybenzoate silica colloidal anhydrous titanium dioxide and triethyl citrate.Who should NOT take Vimovo?Do not take this medication if you are allergic to naproxen esomeprazole or any ingredients of this medication are years of age or younger are breast-feeding are in the third trimester of pregnancy have a bleeding disorder including bleeding in the brain have an active ulcer or bleeding in the stomach or intestines have a history of asthma or allergic-type reactions after taking ASA or other NSAIDs i.e complete or partial syndrome of ASA-intolerance-rhinosinusitis hives swelling of the skin or sac-like growths of the inflamed nose tissue have high blood potassium have inflammatory bowel disease e.g Crohn's disease ulcerative vimovo us colitis have scheduled heart bypass surgery or have recently had this surgery have severe kidney Drug Factshets Health Home Medications esomeprazole naproxen DIN Drug Identification Number VIMOVO MG MODIFIED RELEASE TABLET VIMOVO MG MODIFIED RELEASE TABLETWhat side effects are possible with Vimovo?Many medications can cause side effects.A side effect is an unwanted response to a medication when it is taken in normal doses.Side effects can be mild or severe temporary or permanent.The side effects listed below are not experienced by everyone who takes this medication.If you are concerned about side effects discuss the risks and benefits of this medication with your doctor.The following side effects have been reported by at least of people taking this medication.Many of these side effects can be managed and some may go away on their own over time.Contact your doctor if you experience these side effects and they are severe or bothersome. Esomeprazole is the S-isomer of omeprazole which is a vimovo us mixture of the S-and R-isomers.Its molecular formula is CHNOSMg x HO with molecular weight of as a trihydrate and on an anhydrous basis.The structural formula is The magnesium salt is a white to slightly colored crystalline powder.It contains moles of water of solvation and is slightly soluble in water.The stability of esomeprazole magnesium is a function of pHit rapidly degrades in acidic media but it has acceptable stability under alkaline conditions.At pH buffer the half-life of the magnesium salt is about hours at °C and about hours at °C.Mechanism of Action VIMOVO consists of an immediate-release esomeprazole magnesium layer and an enteric-coated naproxen core.As a result esomeprazole is released first in the stomach prior to the dissolution of naproxen in the small intestine.The enteric coating prevents naproxen release at pH levels below .Naproxen is a NSAID with analgesic and antipyretic properties.The mechanism of action of the naproxen anion like that of other NSAIDs is not completely vimovo us understood but may be related to prostaglandin synthetase inhibition. Omeprazole the racemate of esomeprazole has been reported to interact with some antiretroviral drugs. Hypersensitivity reactions eg angioedema and anaphylactic reaction shock have been reported with esomeprazole use.Vimovo is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft CABG surgery see Warnings and Precautions .Vimovo is contraindicated in patients in the late stages of pregnancy see Warnings and Precautions and Use in Specific Populations .Warnings and Precautions Cardiovascular Thrombotic Events Clinical trials of several COX-selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular CV thrombotic events myocardial infarction and stroke which can be fatal.All NSAIDS both COX-selective and nonselective may have a similar risk.Patients with known CV disease or risk factors for CV disease may be at greater risk.To minimize the potential risk for an adverse CV event in patients treated with an NSAID the lowest vimovo us effective dose should be used for the shortest duration possible.Physicians and patients should remain alert for the development of such events even in the absence of previous CV symptoms.Patients should be informed about the signs and or symptoms of serious CV events and the steps to take if they occur.There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use.Two large controlled clinical trials of a COX-selective NSAID for the treatment of pain in the first – days following CABG surgery found an increased incidence of myocardial infarction and stroke see Contraindications Hypertension NSAIDs including naproxen a component of Vimovo can lead to onset of new hypertension or worsening of pre-existing hypertension either of which may contribute to the increased incidence of CV events.Patients taking thiazides or loop diuretics may have impaired response to these therapies when taking NSAIDs.NSAIDs should be used with caution in patients with vimovo us hypertension.Blood pressure BP should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy see Drug Interactions. Diuretics Clinical studies as well as postmarketing observations have shown that NSAIDs can reduce the natriuretic effect of furosemide and thiazides in some patients.This response has been attributed to inhibition of renal prostaglandin synthesis.During concomitant therapy with NSAIDs the patient should be observed closely both for signs of renal failure as well as to monitor to assure diuretic efficacy see Warnings and Precautions ..Lithium NSAIDs have produced an elevation of plasma lithium levels and a reduction in renal lithium clearance.The mean minimum lithium concentration increased and the renal clearance was decreased by approximately These effects have been attributed to inhibition of renal prostaglandin synthesis by the NSAID.Thus when NSAIDs and lithium are administered concurrently subjects should be observed carefully for signs of lithium toxicity.Methotrexate NSAIDs have been reported to competitively inhibit methotrexate accumulation in rabbit kidney slices.NSAIDs have been reported to reduce the tubular secretion of methotrexate in an animal model.This may indicate that they could enhance the toxicity of methotrexate.Caution should be used when NSAIDs are administered concomitantly with methotrexate.Case reports published population pharmacokinetic studies and retrospective analyses suggest that concomitant administration of PPIs and methotrexate primarily at high dosesee methotrexate prescribing information may elevate and prolong serum levels of methotrexate and or its metabolite hydroxymethotrexate.However no formal drug interaction studies of methotrexate with PPIs have been conducted see Warnings and Precautions .Anticoagulants Naproxen decreases platelet aggregation and may prolong bleeding time.In addition because warfarin and NSAIDs are highly protein bound the free fraction of warfarin and naproxen may increase substantially in some patients.Concomitant use of Vimovo and anticoagulants such as warfarin dicumarol and heparin may result in increased risk of bleeding complications.The effects of warfarin and NSAIDs on GI bleeding are synergistic such that users of both drugs together have a vimovo us risk of serious GI bleeding higher than users of either drug alone.Post-marketing reports of changes in prothrombin measures have been reported among patients on concomitant warfarin and esomeprazole therapy.Increases in INR and prothrombin time may lead to abnormal bleeding and even death.Patients treated with proton pump inhibitors and warfarin concomitantly may need to be monitored for increases in INR and prothrombin time.Selective Serotonin Reuptake Inhibitors SSRIs There is an increased risk of gastrointestinal bleeding when selective serotonin reuptake inhibitors SSRIs are combined with NSAIDs including COX- selective inhibitors.Caution should be used when NSAIDs are administered concomitantly with SSRIs see Warnings and Precautions .Other Information Concerning Drug Interactions Naproxen is highly bound to plasma albuminit thus has a theoretical potential for interaction with other albumin-bound drugs such as sulphonylureas hydantoins and other NSAIDs.Patients simultaneously receiving Vimovo and a hydantoin sulphonamide or sulphonylurea should be observed for adjustment of dose if required.Naproxen and other NSAIDs can reduce the antihypertensive effect vimovo us of propranolol and other beta-blockers. Naproxen is absorbed from the gastrointestinal tract with an in vivo bioavailability of Steady-state levels of naproxen are reached in to days.Esomeprazole Following administration of Vimovo twice daily esomeprazole is rapidly absorbed with peak plasma concentration reached within on average .to hours following the morning and evening dose on both the first day of administration and at steady state.The peak plasma concentrations of esomeprazole are higher at steady state compared to on first day of dosing of Vimovo.Figure represents the pharmacokinetics of naproxen and esomeprazole following administration of Vimovo mg mg.Figure Mean plasma concentrations of naproxen and esomeprazole following single dose administration of Vimovo mg mg Food effect Administration of Vimovo together with high-fat food in healthy volunteers does not affect the extent of absorption of naproxen but significantly prolongs tmax by hours and decreases peak plasma concentration Cmax by about Administration of Vimovo together with high-fat food in healthy volunteers delays tmax of esomeprazole vimovo us by hour and significantly reduces the extent of absorption resulting in and reductions of area under the plasma concentration versus time curve AUC and peak plasma concentration Cmax respectively.Administration of Vimovo minutes before high-fat food intake in healthy volunteers does not affect the extent of absorption of naproxen but delays the absorption by about hours and decreases peak plasma concentration Cmax by about but has no significant effect on the rate or extent of esomeprazole absorption compared to administration under fasted conditions see Dosage and Administration Administration of Vimovo minutes before high-fat food intake in healthy volunteers has no effect on the rate and extent of naproxen absorption; however increases the esomeprazole AUC by and Cmax by compared to administration under fasted conditions.This increase in esomeprazole Cmax does not raise a safety issue since the approved dosing regimen of esomeprazole at mg QD would result in higher Cmax see Dosage and Administration Therefore Vimovo should be taken at least minutes before the meal.vimovo us Distribution Naproxen Naproxen has a volume of distribution of L kg.At therapeutic levels naproxen is greater than albumin-bound.At doses of naproxen greater than mg day there is less than proportional increase in plasma levels due to an increase in clearance caused by saturation of plasma protein binding at higher doses average trough Css .and mg L with and mg daily doses of naproxen respectively.The naproxen anion has been found in the milk of lactating women at a concentration equivalent to approximately of maximum naproxen concentration in plasma see Use in Specific Populations .Esomeprazole The apparent volume of distribution at steady state in healthy subjects is approximately L.Esomeprazole is plasma protein bound.Metabolism Naproxen Naproxen is extensively metabolized in the liver by the cytochrome P system CYP CYPC and CYPA to desmethyl naproxen.Neither the parent drug nor the metabolites induce metabolizing enzymes.Both naproxen and desmethyl naproxen are further metabolized to their respective acylglucuronide conjugated metabolites.Consistent with the half-life vimovo us of naproxen the area under the plasma concentration time curve increases with repeated dosing of Vimovo twice daily.Esomeprazole Esomeprazole is extensively metabolized in the liver by the CYP enzyme system.The major part of the metabolism of esomeprazole is dependent on the polymorphic CYPC responsible for the formation of the hydroxyl-and desmethyl metabolites of esomeprazole.The remaining part is dependent on another specific isoform CYPA responsible for the formation of esomeprazole sulphone the main metabolite in plasma.The major metabolites of esomeprazole have no effect on gastric acid secretion.The area under the plasma esomeprazole concentration-time curve increases with repeated administration of Vimovo.This increase is dose-dependent and results in a non-linear dose-AUC relationship after repeated administration.An increased absorption of esomeprazole with repeated administration of Vimovo probably also contributes to the time-and dose-dependency.Excretion Naproxen Following administration of Vimovo twice daily the mean elimination half-life for naproxen is approximately hours following the evening dose with no change with repeated dosing.The clearance of vimovo us naproxen is mL min kg.Approximately of the naproxen from any dose is excreted in the urine primarily as naproxen desmethyl naproxen or their conjugates to Small amounts or less of the administered dose are excreted in the feces.In patients with renal failure metabolites may accumulate see Warnings and Precautions Esomeprazole Following administration of Vimovo twice daily the mean elimination half-life of esomeprazole is approximately hour following both the morning and evening dose on day with a slightly longer elimination half-life at steady state -.hours.Almost of an oral dose of esomeprazole is excreted as metabolites in the urine the remainder in the feces.Less than of the parent drug is found in the urine.Concomitant Use with Clopidogrel Results from a crossover study in healthy subjects have shown a pharmacokinetic interaction between clopidogrel mg loading dose mg daily maintenance dose and esomeprazole mg p.o.once daily when co-administered for days. Pregnancy rd trimester lactation.Click to view Vimovo detailed prescribing vimovo us infomation Special Precautions Mild to moderate renal hepatic impairment.Consider ophth exam if any visual disturbances occur.Naproxen History of GI disease ulcerative colitis Crohn's diseaseHTN or CHF uncontrolled HTN established ischemic heart disease peripheral arterial disease or cerebrovascular disease; angioedema bronchospastic reactivity eg asthma rhinitis nasal polypssevere renal impairment coagulation disorder.Discontinue use if GI bleeding or ulceration occurs in the st appearance of skin rash mucosal lesions or any other sign of hypersensitivity.Preexisting aspirin-sensitive asthmalong-term use.Concomitant use w oral corticosteroids anticoagulants SSRIs aspirin other NSAIDs including COX-selective inhibitors.Esomeprazole Exclude malignancy in the presence of significant unintentional wt loss recurrent vomiting dysphagia hematemesis or melena when gastric ulcer is suspected or present.Click to view Vimovo detailed prescribing infomation Adverse Drug Reactions HeadacheGI disturbances.Naproxen Palpitationsdizziness drowsiness lightheadedness vertigovisual disturbancestinnitus hearing disturbancesdyspneapruritus ecchymoses purpura skin rashesdiverticulitisfatigue edema sweating thirstdepression insomnia.View ADR Monitoring Form Drug Interactions Antiretrovirals eg atazanavir nelfinavir aspirin diuretics eg furosemide thiazides SSRIs ACE inhibitors lithium methotrexate vimovo us sulfonylureas hydantoins oral anticoagulants eg warfarin dicoumarol heparinβ-blockers eg propranolol cyclosporine tacrolimus probenecid drugs w gastric pH-dependent absorption ketoconazole itraconazole digoxin cholestyramine diazepam phenytoinclarithromycinvoriconazole rifampicin St John's wort.View more drug interactions with Vimovo Pregnancy Category US FDA Category C Either studies in animals have revealed adverse effects on the foetus teratogenic or embryocidal or other and there are no controlled studies in women or studies in women and animals are not available.Drugs should be given only if the potential benefit justifies the potential risk to the foetus.Category D There is positive evidence of human foetal risk but the benefits from use in pregnant women may be acceptable despite the risk e.g if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective.Storage View Vimovo storage conditions for details to ensure optimal shelf-life.Description View Vimovo description for details of the chemical structure and excipients inactive components.vimovo us Mechanism of Action View Vimovo mechanism of action for pharmacodynamics and pharmacokinetics details.MIMS Class Nonsteroidal Anti-Inflammatory Drugs NSAIDs Antacids Antireflux Agents Antiulcerants ATC Classification MAE naproxen and esomeprazole Belongs to the class of propionic acid derivatives of non-steroidal antiinflammatory and antirheumatic products. I wonder how many block buster life changing medicines he has financed. Increased risk of osteoporosis-related fractures of the hip wrist or spine with long-term and multiple daily dose PPI therapy.Monitor magnesium levels with long-term therapy.Elderly.Debilitated.Pregnancy Cat.C weeks gestation Cat.D weeks gestation.Labor delivery nursing mothers not recommended.Interactions Concomitant St.John's wort rifampin atazanavir nelfinavir not recommended.Avoid concomitant non-aspirin NSAIDs.May potentiate saquinavir monitorconsider reducing saquinavir dose protein-bound drugs eg hydantoins sulfonamides sulfonylureas.Increases lithium and tacrolimus levels.Antagonizes clopidogrelconsider alternative anti-platelet therapy.Methotrexate excretion reduced caution w.high doses.May antagonize diuretics beta-blockers eg propranolol ACE inhibitors.Increased renal toxicity with cyclosporine and ACE inhibitors.Increased risk of GI bleed with vimovo us oral corticosteroids smoking alcohol SSRIs.Monitor aspirin and oral anticoagulants.May affect CYPC substrates eg diazepam cilostazol.May affect absorption of pH-dependent drugs eg ketoconazole digoxin iron salts.Probenecid increases plasma levels and delays elimination.Delayed absorption with concomitant cholestyramine.May interfere with neuroendocrine diagnostic tests.Adverse Reactions Erosive gastritis dyspepsia gastritis diarrhea gastric ulcer upper abdominal pain nausearenal papillary necrosisrare hypomagnesemia w.prolonged PPI therapysee literature re risk of cardiovascular events serious gastrointestinal events possible C.difficile associated diarrhea.Metabolism Hepatic CYPC A C A protein bound.Elimination Renal Take this medicine by mouth with a glass of water.Follow the directions on the prescription label.Do not crush chew split or dissolve.Take this medicine on an empty stomach at least minutes before a meal.Take your medicine at regular intervals.Do not take it more often than directed.Long term continuous use may increase the risk of heart attack or stroke.A special MedGuide will be given to you by the pharmacist vimovo us with each prescription and refill.Be sure to read this information carefully each time.Talk to your pediatrician regarding the use of this medicine in children.Special care may be needed.Overdosage If you think you've taken too much of this medicine contact a poison control center or emergency room at once.Vimovo co-developed by Pozen and AstraZeneca is a combination of naproxen an NSAID and immediate-release esomeprazole a proton-pump inhibitor or PPI.The immediate release formulation allows for sequential release of the active components esomeprazole is delivered in advance of the release of naproxen.Vimovo was approved by the FDA on April .What is the availability of Vimovo. Minimize riskassess risk and consider an alternative drug take steps to circumvent the interaction risk and or institute a monitoring plan.Do not stop taking any medications without consulting your healthcare provider.Disclaimer Every effort has been made to ensure that the information provided by Multum is accurate up-to-date and complete but no guarantee vimovo us is made to that effect.In addition the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof.Multum's drug information does not endorse drugs diagnose patients or recommend therapy.Multum's drug information is a reference resource designed as supplement to and not a substitute for the expertise skill knowledge and judgement of healthcare practitioners in patient care.The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe effective or appropriate for any given patient. Therefore Vimovo should be used with caution in people with known high blood pressure.All NSAIDs including Vimovo may cause congestive heart failure or fluid retention.Contact your healthcare provider if you notice unexplained weight gain or swelling while taking this drug.Also Vimovo should be used with caution in people with heart failure.Kidney damage can occur in people taking NSAIDs including Vimovo.This occurrence is more common in the elderly as well as in people with kidney disease heart failure liver problems and those taking a diuretic or ACE inhibitor.NSAIDs including Vimovo have been reported to cause allergic reactions.Seek immediate medical attention if you notice things such as difficulty breathing or swelling of the face and throat.In rare cases people taking Vimovo can develop a serious rash.If you notice an unexplained rash or develop blisters fever or itchy skin stop taking Vimovo and call your healthcare provider right away.There have been reports of anemia in people taking NSAIDs.Therefore if you are taking Vimovo for an extended period of time and show signs of anemia such as pale skin or extreme fatigue talk to your healthcare provider.Vimovo contains a proton pump inhibitor esomeprazole.Studies indicate that people who take proton pump inhibitor medications may be at an increased risk for broken bones.The risk appears vimovo us to be highest for people who take such medications at high doses or for long periods of time over a year.You and your healthcare provider should take this into account when deciding if the benefits of this medication outweigh the risks for your particular situation.Proton pump inhibitors PPIs including the one in Vimovo vimovo sleepy may cause low blood magnesium levels hypomagnesemia.Seek immediate medical attention if you develop any symptoms of hypomagnesemia such as muscle spasms an irregular heart rhythm arrhythmia or seizures.Your healthcare provider may want to check your magnesium levels using a simple blood test periodically.It is possible that Vimovo could make asthma worse especially in people with aspirin-sensitive asthma.Vimovo is a pregnancy Category C or D medicine depending on the trimester meaning that it might not be safe for use during pregnancy although the full risks are currently unknown see Vimovo and Pregnancy for more information.Vimovo passes through breast milk.Therefore if you are breastfeeding a child vimovo us check with your healthcare provider or your child's healthcare provider before taking Vimovo see Vimovo and Breastfeeding.Vimovo Medication Information Home Drug Information FDA Approved Drugs Medical Areas Gastroenterology Musculoskeletal Rheumatology Family Medicine View ByYearCompanyConditionsTherapeutic AreasDrug Names The following drug information is obtained from various newswires published medical journal articles and medical conference presentations.Company AstraZenecaApproval Status Approved April Treatment Area arthritis in patients at risk for NSAID-associated ulcers General InformationVimovo is a fixed dose combination of the proton pump inhibitor esomeprazole magnesium with the non-steroidal anti-inflammatory drug NSAID naproxen in a single tablet.Vimovo is specifically indicated for the relief of signs and symptoms of osteoarthritis rheumatoid arthritis and ankylosing spondylitis and to decrease the risk of developing gastric ulcers in patients at risk of developing NSAIDassociated gastric ulcers.Vimovo is supplied as a tablet for oral administration.The recommended initial dose is one tablet twice daily of mg naproxen and mg of esomeprazole or mg naproxen and mg of esomeprazole.The vimovo us tablets are to be swallowed whole with liquid.Do not split chew crush or dissolve the tablet.Vimovo is to be taken at least minutes before meals.Clinical ResultsFDA ApprovalThe FDA approval of Vimovo was based on the following studiesGastric UlcersTwo randomized multi-center double blind trials Study and Study compared the incidence of gastric ulcer formation in patients taking Vimovo and patients taking enteric-coated naproxen.Vimovo given as mg mg twice daily statistically significantly reduced the -month cumulative incidence of gastric ulcers compared to enteric-coated naproxen mg twice daily Study versus respectively and Study versus respectively p Signs and symptoms of osteoarthritis rheumatoid arthritis and ankylosing spondylitisTwo -week randomized double-blind placebo-controlled trials enrolled patients with osteoarthritis OA of the knee.Vimovo was given as mg mg twice daily.In each trial patients receiving Vimovo had significantly better results compared to patients receiving placebo as measured by change from baseline of the WOMAC pain subscale and the WOMAC physical function subscale and a Patient Global Assessment vimovo us Score.Based on studies with enteric-coated naproxen improvement in patients treated for rheumatoid arthritis was demonstrated by a reduction in joint swelling a reduction in duration of morning stiffness a reduction in disease activity as assessed by both the investigator and patient and by increased mobility as demonstrated by a reduction in walking time.In patients with ankylosing spondylitis naproxen has been shown to decrease night pain morning stiffness and pain at rest.Side EffectsAdverse events associated with the use of Vimovo may include but are not limited to the followingErosive gastritisDyspepsiaGastritisDiarrheaGastric ulcerUpper abdominal painNauseaMechanism of ActionVimovo is a fixed dose combination of the proton pump inhibitor esomeprazole magnesium with the non-steroidal anti-inflammatory drug NSAID naproxen in a single tablet.Vimovo has been developed as a delayed release tablet whereby esomeprazole mg is released first in the stomach prior to the dissolution of enteric-coated naproxen mg in the small intestine.The mechanism of action of the naproxen like that of other NSAIDs is not completely vimovo us understood but may be related to prostaglandin synthetase inhibition.By acting specifically on the proton pump esomeprazole blocks the final step in acid production thus reducing gastric acidity.Additional InformationFor additional information regarding Vimovo or arthritis and the risk of NSAID-associated ulcers please visit the Vimovo web page. Your doctor will decide whether you can take VIMOVO.Do not breast-feed if you are taking VIMOVO.This is because small amounts may pass into the mothers’ milk.If you are planning to breast-feed you should not take VIMOVO.Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant might become pregnant or are breast-feeding.VIMOVO may make it more difficult to become pregnant.You should inform your doctor if you are planning to become pregnant or if you have problems to become pregnant.Driving and using machines You may feel dizzy or experience blurred vision while taking VIMOVO.If this happens do not drive or use any tools or machines.Important information about some of the ingredients of VIMOVO VIMOVO contains methyl parahydroxybenzoate E and propyl parahydroxybenzoate E which may cause allergic reactions.These reactions may not happen straight away.How to take VIMOVO Always take VIMOVO exactly as your doctor has told you.You should check with your doctor or pharmacist if you are not sure.Taking this medicine Swallow your tablets whole with a drink of water.Do not chew split or crush the tablets.It is important that you take your tablets whole for your medicine to work properly.Take your tablets at least minutes before you have a meal. Extreme caution should be used if Vimovo is prescribed for people with a history of ulcers or gastrointestinal bleeding.To decrease the risk of these problems you should take the smallest effective dose for the shortest period of time.Contact your healthcare provider immediately if you experience any signs or symptoms of stomach ulcers or bleeding including Indigestion Black tarry stools Vomiting vimovo us blood Abdominal stomach pain.Liver damage can occur in people taking Vimovo.It may be a good idea for your healthcare provider to monitor your liver by checking your liver enzymes using a simple standard blood test.Contact your healthcare provider immediately if you notice things such as Nausea Tiredness Lethargy Itchy or yellowing skin Abdominal stomach pain Flu-like symptoms.All NSAIDs including Vimovo may cause high blood pressure or make it worse in people who already have. Always seek the advice of your physician or other qualified health provider with any questions you may Shop with ease We accept payments by Visa MasterCard Discover Card International Money Orders and Certified Checks.Questions. Active ingredients naproxen and esomeprazole magnesium Inactive ingredients carnauba wax colloidal silicon dioxide croscarmellose sodium iron oxide yellow glyceryl monostearate hypromellose iron oxide black magnesium stearate methacrylic acid copolymer dispersion methylparaben polysorbate polydextrose polyethylene glycol povidone propylene glycol propylparaben titanium dioxide and triethyl citrate.Distributed by AstraZeneca LP Wilmington DE Issued June This Medication Guide has been approved by the U.S.Food and Drug Administration.VIMOVO is a trademark of the AstraZeneca group of companies.Other trademarks are the property of their respective companies. Vimovo may cause serious side effects including See What is the most important information I should know about Vimovo.

Assessment of gastrointestinal and cardiovascular risk in patients with osteoarthritis who require NSAIDs the LOGICA study.Ann Rheum Dis ;-.vi Hunt et al.Recommendations for the appropriate use of anti-inflammatory drugs in the era of coxibs Defining the role of gastroprotective agents.Canadian Journal of Gastroenterology ; -.vii Rostom et al.Canadian consensus guidelines on long-term nonsteroidal anti-inflammatory drug therapy and the need for gastroprotection Choose a suitable interchangeable generic or brand drug if you could not find the prescribed medicine. For more information ask your healthcare provider or pharmacist.Call your doctor for medical advice about side effects.You may report side effects to FDA at FDA-.How should I vimovo us store VIMOVO. I wonder how many patents Dr.Pullen holds?In the last years medicine has advanced exponentially and improved the lives of the sick while increasing life expectancy by There have been a couple of dozen true blockbusters.The rest of the drugs there are thousands helped patients while financing the development of these life changing blockbusters.Everyone knows that these drugs cost billions of dollars to develop.Its big pharma that takes on the risk of development. For some antiretroviral drugs such as atazanavir and nelfinavir decreased serum levels have been reported when given together with omeprazole.Following multiple doses of nelfinavir mg twice daily and omeprazole mg once a day AUC was decreased by and Cmax by and and Cmin by and respectively for nelfinavir and main oxidative metabolite hydroxy-t-butylamide. VIMOVO can be administered with low-dose aspirin ≤ mg day therapy.The concurrent use of aspirin and VIMOVO may increase the risk of serious adverse events.As with all NSAIDs concurrent vimovo us administration of naproxen and aspirin is not generally recommended because of the potential of increased adverse events.NSAIDs including VIMOVO can cause serious GI adverse events which can be fatal.The risk is greater in patients with a prior history of ulcer disease or GI bleeding and in patients at high risk for GI events especially the elderly.VIMOVO should be used with caution in these patients.Epidemiological studies have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding.In two studies concurrent use of an NSAID COX-inhibitor or aspirin potentiated the risk of bleeding.Although these studies focused on upper gastrointestinal bleeding bleeding at other sites cannot be ruled out.NSAIDs should be given with care to patients with a history of inflammatory bowel disease ulcerative colitis Crohn’s disease as their condition may be exacerbated.Symptomatic response to esomeprazole a component of VIMOVO does not preclude the presence of gastric malignancy.Atrophic gastritis vimovo us has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole of which VIMOVO contains an enantiomer.Anaphylactoid reactions may occur in patients without known prior exposure to either component of VIMOVO.NSAIDs should not be given to patients with aspirin triad.Serious skin adverse reactions such as exfoliative dermatitis Stevens-Johnson syndrome and toxic epidermal necrolysis which can be fatal and can occur without warning.Discontinue VIMOVO at first appearance of skin rash or any other sign of hypersensitivity.In late pregnancy as with other NSAIDS VIMOVO should be avoided because it may cause premature closure of the ductus arteriosus.VIMOVO is not recommended in patients with moderate or severe renal insufficiency.In addition NSAIDs may cause renal toxicity.VIMOVO is not recommended in patients with severe hepatic insufficiency.Consider dose reduction in mild moderate hepatic insufficiency.If abnormal liver enzymes persist or worsen discontinue use immediately.Several studies and literature reports indicate that long-term proton pump inhibitor PPI therapy is vimovo us associated with an increased risk for osteoporosis-related fractures of the hip wrist or spine.Esomeprazole a component of VIMOVO inhibits gastric acid secretion and may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability eg ketoconazole iron salts and digoxin.Concomitant use of VIMOVO and warfarin may result in increased risk of bleeding complications.Monitor for increases in INR and prothrombin time.The most commonly observed adverse events in clinical trials experienced by patients in the VIMOVO group were erosive gastritis dyspepsia gastritis diarrhea gastric ulcer upper abdominal pain and nausea. Ask a doctor or pharmacist before using any other pain or arthritis medicine.Many medicines available over the counter contain naproxen or similar medicines such as aspirin ibuprofen or ketoprofen.Taking certain products together can cause you to get too much of a certain drug.Check the label to see if a medicine contains naproxen or another NSAID.This medication can cause diarrhea which may be a sign vimovo us of a new infection.If you have diarrhea that is watery or bloody stop taking esomeprazole and naproxen and call your doctor.Do not use anti-diarrhea medicine unless your doctor tells you to.Ask your doctor before using an antidepressant such as citalopram Celexa escitalopram Lexapro fluoxetine Prozac Sarafem Symbyax fluvoxamine Luvox paroxetine Paxil or sertraline Zoloft.Taking any of these drugs with an NSAID may increase your risk of stomach bleeding.Avoid drinking alcohol.It may increase your risk of stomach bleeding.Back to Top How should I take VIMOVO. I wonder how many patents Dr.Pullen holds?In the last years medicine has advanced exponentially and improved the lives of the sick while increasing life expectancy by There have been a couple of dozen true blockbusters.The rest of the drugs there are thousands helped patients while financing the development of these life changing blockbusters.Everyone knows that these drugs cost billions of dollars to develop.Its big pharma that takes on the vimovo us risk of development.Its their share holders that expect big returns because of the enormous risk associated with drug development.I wish people like Dr.Pullen just said "thank you" rather than berate a drug company for marketing a drug that he doesn't feel is worth the cost.What I don't wonder is how much talent is required to be a critic.Or rather-the lack of talent.We all know what Vimovo is and what it does.If you don't like it don't prescribe it.If you think your patients will take pills a day at different times-prescribe this regiment.Keep in mind that assuming the patient survives the bleed from the ulcer-the hospitalization of gastric ulcer will cost more than a year supply of Vimovo.I wish Dr.Pullen would put his energy into constructive ideas rather than tearing down the work of others.If he did-He might not appear to be a shallow short-sighted pessimist.We have enough vimovo us of those already.Quote Doctor Pullen leaves me in a state of wonder.I wonder how many advances in medicine Dr.Pullen is responsible for. Some of the common side effects that may be associated with Vimovo include inflammation of the lining of the stomach indigestion diarrhea stomach ulcers upper abdominal pain nauseaSevere side effects may include high blood pressure heart attack stroke fluid retention kidney problems bleeding ulcers anemia life-threatening skin reactions and allergic reactions liver problems and asthma attacks.What other special warnings and precautions apply to Vimovo use. Congestive Heart Failure and Edema Fluid retention edema and peripheral edema have been observed in some patients taking NSAIDs and should be used with caution in patients with fluid retention or heart failure.Gastrointestinal Effects — Risk of Ulceration Bleeding and Perforation NSAIDs including naproxen a component of Vimovo can cause serious gastrointestinal GI adverse events including inflammation bleeding ulceration and perforation of the stomach small intestine or large intestine which can be fatal.vimovo us While Vimovo has been shown to significantly decrease the occurrence of gastric ulcers compared to naproxen alone ulceration and associated complications can still occur.These serious adverse events can occur at any time with or without warning symptoms in patients treated with NSAIDs.Only one in five patients who develop a serious upper GI adverse event on NSAID therapy is symptomatic.Upper GI ulcers gross bleeding or perforation caused by NSAIDs occur in approximately of patients treated for – months and in about – of patients treated for one year.These trends continue with longer duration of use increasing the likelihood of developing a serious GI event at some time during the course of therapy.However even short-term therapy is not without risk.The utility of periodic laboratory monitoring has not been demonstrated nor has it been adequately assessed.Vimovo should be prescribed with caution in those with a prior history of ulcer disease or gastrointestinal bleeding.Patients with a prior history of peptic vimovo us ulcer disease and or gastrointestinal bleeding who use NSAIDs have a greater than -fold increased risk of developing a GI bleed compared to patients with neither of these risk factors.Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include concomitant use of oral corticosteroids or anticoagulants or antiplatelets including low-dose aspirin longer duration of NSAID therapy smoking use of alcohol older age and poor general health status.Most spontaneous reports of fatal GI events are in elderly or debilitated patients and therefore special care should be taken in treating this population.To minimize the potential risk for an adverse GI event in patients treated with an NSAID or NSAID-containing product the lowest effective dose should be used for the shortest possible duration.Patients and physicians should remain alert for signs and symptoms of GI ulceration and bleeding during NSAID therapy and promptly initiate additional evaluation and treatment if a serious GI adverse event is suspected.This should include discontinuation vimovo us of the NSAID until a serious GI adverse event is ruled out.For high risk patients alternate therapies that do not involve NSAIDs should be considered.Epidemiological studies of the case-control and cohort design have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding.In two studies concurrent use of an NSAID COX-inhibitor or aspirin potentiated the risk of bleeding see Drug Interactions ..Although these studies focused on upper gastrointestinal bleeding bleeding at other sites cannot be ruled out.NSAIDs should be given with care to patients with a history of inflammatory bowel disease ulcerative colitis Crohn’s disease as their condition may be exacerbated.Gastrointestinal symptomatic response to therapy with Vimovo does not preclude the presence of gastric malignancy.Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole of which esomeprazole is an enantiomer and a component of Vimovo.Active Bleeding When active and clinically significant vimovo us bleeding from any source occurs in patients receiving Vimovo the treatment should be withdrawn.Renal Effects Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury.Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion.In these patients administration of an NSAID may cause a dose-dependent reduction in prostaglandin formation and secondarily in renal blood flow which may precipitate overt renal decompensation.Patients at greatest risk of this reaction are those with impaired renal function hypovolemia heart failure liver dysfunction salt depletion those taking diuretics and ACE inhibitors and the elderly.Discontinuation of NSAID therapy is usually followed by recovery to the pretreatment state.Advanced Renal Disease No information is available from controlled clinical studies regarding the use of Vimovo in patients with advanced renal disease.Therefore treatment with Vimovo is not recommended in these patients with advanced renal disease.If Vimovo therapy must be initiated close monitoring vimovo us of the patient’s renal function is advisable see Dosage and Administration Use in Specific Populations and Clinical Pharmacology .Anaphylactic Reactions Anaphylactic reactions may occur in patients without known prior exposure to either component of Vimovo.NSAIDs should not be given to patients with the aspirin triad.This symptom complex typically occurs in asthmatic patients who experience rhinitis with or without nasal polyps or who exhibit severe potentially fatal bronchospasm after taking aspirin or other NSAIDs see Contraindications Emergency help should be sought in cases where an anaphylactic reaction occurs.Anaphylactic reactions like anaphylaxis may have a fatal outcome.Skin Reactions NSAIDs can cause serious skin adverse events such as exfoliative dermatitis Stevens-Johnson syndrome and toxic epidermal necrolysis which can be fatal.These serious events may occur without warning.Patients should be informed about the signs and symptoms of serious skin manifestations and use of the drug should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity.Hepatic Effects Borderline vimovo us elevations of one or more liver tests may occur in up to of patients taking NSAIDs including naproxen a component of Vimovo.Hepatic abnormalities may be the result of hypersensitivity rather than direct toxicity. Alone there are million secondary prevention patients.Pozen has conducted market research and discovered that nearly already use daily aspirin therapy.Meta-analyses and peer-reviewed research concludes that around of these patients are at risk for upper-gastrointestinal bleeding and gastric or duodenal ulcers.Pozen's Phase trial showed that of secondary prevention patients on mg enteric-coated aspirin discontinue after six months.A systematic review and meta-analysis on the hazards of discontinuing or not adhering to daily aspirin therapy shows a greater-than threefold increased risk of a potentially fatal cardiovascular event.Pozen's extensive market research noted above finds that -of physicians recommend using gastro-protective agents such as proton pump inhibitors e.g omeprazole to -of their patients.The interesting thing is Pozen found that over of physicians would prescribe PA instead vimovo us of the separate components of OTC aspirin and OTC or Rx proton pump inhibitor if the cost was comparable.Amazon.com sells a tablet bottle of mg aspirin for or cents per day.One can also buy mg tablets of OTC Prilosec omeprazole for or around cents per pill.To re-create Pozen's PA- a patient would spend approximately per day.Pozen's market research with payers yielded some encouraging results.

Notable elevations of ALT or AST approximately three or more times the upper limit of normal have been reported in approximately of patients in clinical trials with NSAIDs.In addition rare cases of severe hepatic reactions including jaundice and fatal fulminant hepatitis liver necrosis and hepatic failure some of them with fatal outcomes have been reported.A patient with symptoms and or signs suggesting liver dysfunction or in whom an abnormal liver test has occurred should be evaluated for evidence of the development of more severe hepatic reaction while on therapy with Vimovo.If vimovo us clinical signs and symptoms consistent with liver disease develop or if systemic manifestations occur eg eosinophilia rash etc Vimovo should be discontinued.Chronic alcoholic liver disease and probably other diseases with decreased or abnormal plasma proteins albumin reduce the total plasma concentration of naproxen but the plasma concentration of unbound naproxen is increased.Caution is advised when high doses are required and some adjustment of dosage may be required in these patients.It is prudent to use the lowest effective dose for the shortest possible duration of adequate treatment. Why isn't the person consuming the product able to access it without the help of a doctor and an insurance company.

Hypertension acute renal failure respiratory depression and coma may occur but are rare. This website is an International information resource intended for International healthcare professionals with an interest in VIMOVO and the treatment of osteoarthritis rheumatoid arthritis and ankylosing spondylitis in patients at risk of NSAID-associated ulcers.Please choose which website you require.vimovo us While the Internet serves a global community the pharmaceutical industry is subject to country-specific regulatory considerations.This means that the registration status and approved product labels of VIMOVO may not be the same in different countries.Information on this site is derived from the Summary of Product Characteristics SPC for VIMOVO.Please refer to your local Prescribing Information for full details.By clicking on the link below you are declaring and confirming that you are a healthcare professional.This website as with other AstraZeneca websites uses cookies to function and collect information on visitor activity.By continuing to use this website you acknowledge your consent to the placement and use of cookies.Further information on our cookie policy and how to delete them can be found within our Other VIMOVO websites for Healthcare Professionals only Please select your countryFinlandNetherlandsNorwaySpainSwedenUS PATIENTS The website is intended for healthcare professionals only.If you are a patient please click Patient Information Leaflet PIL which has been written for patients vimovo us and provide information about taking or using this medicine.For Summary of Product Characteristics SPC please click here.Please contact healthcare professionals or product information in your local country for specific information about this product.For more information on AstraZeneca's products please Click Here PRESS If you are a member of the press you should visit the AstraZeneca Vimovo is a combination of the pain reliever naproxen NSAID and esomeprazole magnesium proton pump inhibitor indicated for the relief of signs and symptoms of osteoarthritis rheumatoid arthritis and ankylosing spondylitis and to decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.FDA Approval History for Vimovo See also.Vimovo naproxen and esomeprazole magnesium Consumer Information Disclaimer Every effort has been made to ensure that the information provided here is accurate up-to-date and complete but no guarantee is made to that effect.Drug information contained herein may be time sensitive.This information has been compiled for use by vimovo us healthcare practitioners and consumers in the United States.The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe effective or appropriate for any given patient.If you have questions about the drugs you are taking check with your doctor nurse or pharmacist. It is jam packed with effective health and pain relief tips that you can use right away.No action should be taken based solely on the contents of this informationinstead readers should consult appropriate health professionals on any matter relating to their health and well-being.The publisher is not responsible for errors or omissions.We offer back braces of all types and levels of support ranging from mild support to complete immobilization of the back.NSAIDs every day as prescribed because of stomach issues ask your doctor about VIMOVO.Research shows that moderate exercise tramadol medication can be an effective way to help manage osteoarthritis vimovo us pain reducing joint pain and stiffness helping build muscles around affected joints and increasing your flexibility and endurance.Talk to your doctor about ways to help tramadol reduce added stress on your joints.Don't keep going when your joints are telling you they need a break.Maintaining a healthy weight can help reduce stress on your joints and increase your ability to get around.Web site is not intended as medical advice and should not tramadol medication take the place of talking with your doctor about how to manage and treat your osteoarthritis.You should also talk with your doctor or pharmacist if you would tramadol medication like more information about VIMOVO.VIMOVO may increase the chance of a heart attack or stroke that can lead to death.Maintaining good postures is vital in preventing unwelcome pains.When sitting the back has to be straight and there has to be a back support.If you are driving the seat has to be in vimovo us a good position such that your back is well supported and the foot controls are accessible.It should be able to support the shoulders and lower body.Lifting weighty objects is a common cause of back pains.Stand in a good position and keep the objects close vimovo tbl to you if you really need to carry something.It is better to put tramadol medication all the bags into two big bags to facilitate carrying.People who carry heavy stuff all the tramadol medication time like students can use them.Preventative measures ensure that there is a lesser chance of experiencing back problem later in life.Although there are medications that can treat this you may be forced to constantly take them in order to relieve the pain.This way children will grow up knowing the values of good postures and carrying or lifting positions.There are exercises that help to relax the body and relieve tension of the muscles.A million people a day feel pain vimovo us in different parts of the body. Please tell me that you are not this slow.I agree that most pharma companies are under a CIA.I also agree that no other industry operates under so much restriction and observation by the federal government.Can you name even other industry in which companies can't entertain their clients. Gastrointestinal People with a history of stomach or intestinal ulcer or gastrointestinal bleeding should discuss with their doctor how this medication may affect their medical condition how their medical condition may affect dosing and effectiveness of this medication and whether any special monitoring is needed.If you notice symptoms of stomach or intestinal ulcers or bleeding such as black tarry stools vomiting blood or material that looks like coffee grounds or coughing up blood stop taking the medication and seek medical attention immediately.Heart attack and stroke This medication is associated with an increased risk of heart attack or stroke.The risk is increased with higher total daily vimovo us doses and taking the medication over a long period of time.People with a history of heart disease e.g heart attack stroke heart failure blood vessel disorders or who have risk factors for heart disease e.g high blood pressure high cholesterol diabetes smoking kidney disease should discuss with their doctor how this medication may affect their medical condition how their medical condition may affect the dosing and effectiveness of this medication and whether any special monitoring is needed.This medication should not be taken by people who have recently had or are planning to have open heart bypass surgery.High blood potassium There is a risk of high blood potassium when treating with naproxen.People most at risk are seniorspeople who have diabetes or kidney failureand people taking beta-adrenergic blockers e.g metoprolol atenolol angiotensin converting enzyme ACE inhibitors e.g ramipril enalapril or some diuretics e.g triamterene amiloride.People with high blood potassium levels should not take this medication.Kidney vimovo us problems If you have mild to moderate kidney impairment discuss with your doctor how this medication may affect your medical condition how your medical condition may affect the dosing and effectiveness of this medication and whether any special monitoring is needed.Liver problems If you have mild to moderate liver impairment discuss with your doctor how this medication may affect your medical condition how your medical condition may affect the dosing and effectiveness of this medication and whether any special monitoring is needed.Other anti-inflammatory medications Esomeprazole naproxen should not be used with other anti-inflammatory medications including naproxen.However low doses of ASA could be used to prevent heart disease or blood vessel problems.Sun sensitivity Esomeprazole naproxen may make you more sensitive to sunlight. Go tell the construction industry or the IT industry that they can't take their clients out or no longer offer them straight-out bribes.Send investigators to thier vendor events and see what comes out of that.Quote Are you vimovo us kidding. Swallow whole do not split chew crush.Overdosage View Vimovo overdosage for action to be taken in the event of an overdose.Contraindications Hypersensitivity to substituted benzimidazoles.History of asthma urticaria or aspirin or other NSAID-induced allergic-type reactionssevere hepatic impairment. Talk with your doctor or pharmacist about ways to prevent bone loss fracture such as by taking calcium such as calcium citrate and vitamin D supplements.Before having surgery tell your doctor or dentist about all the products you use including prescription drugs nonprescription drugs and herbal products.Older adults may be more sensitive to the effects of this drug especially stomach bleeding and kidney effects.Before using this medication women of childbearing age should talk with their doctors about the benefits and risks such as miscarriage.Tell your doctor if you are pregnant or if you plan to become pregnant.During pregnancy this medication should be used only when clearly needed. Here's a hint most of the majors.COmpare that to vimovo us every other industry and see if there's a pattern.Some of the research is already donehttp peterrost.blogspot.com aid-least.html Are you kidding. Do not take an NSAID medicine if you had an asthma attack hives or other allergic reaction with aspirin or any other NSAID medicine for pain right before or after heart bypass surgery Tell your healthcare provider about all of your medical conditions about all of the medicines you take.NSAIDs and some other medicines can interact with each other and cause serious side effects.Keep a list of your medicines to show to your healthcare provider and pharmacist. An opinion that defers from yours doesn't make it wrong.certainly not Nazi. TABLETTER MED MODIFISERT FRISETTING mg mg Hver tablett inneh.Naproksen mg esomeprazol mg som magnesiumtrihydrat metyl-og propylparahydroksybenzoat E og E hjelpestoffer.

Tell your doctor about all other medicines you use especiallycholestyramine Prevalite Questran;digoxin digitalis Lanoxin;lithium Eskalith Lithobid others;methotrexate Rheumatrex Trexall;probenecid Benemid;St.John'vimovo us s wort;tacrolimus Prograf;an iron supplement;a blood thinner such as warfarin Coumadin Jantoven;steroids prednisone and others;medication used to prevent blood clots such as clopidogrel Plavix ticlopidine Ticlid and others;a diuretic water pill such as furosemide Lasix;antifungal medication such as ketoconazole Nizoral or voriconazole Vfend;HIV medication such as atazanavir Reyataz or nelfinavir Viracept;aspirin or other NSAIDs such as ibuprofen Advil Motrin naproxen Aleve Naprosyn Naprelan Treximet celecoxib Celebrex diclofenac Arthrotec Voltaren indomethacin Indocin meloxicam Mobic and others;an ACE inhibitor such as benazepril Lotensin enalapril Vasotec lisinopril Prinivil Zestril quinapril Accupril or ramipril Altaceora beta-blocker such as atenolol Tenormin Tenoretic carvedilol Coreg labetalol Normodyne Trandate metoprolol Dutoprol Lopressor Toprol nadolol Corgard propranolol Inderal InnoPran or sotalol Betapace.This list is not complete and other drugs may interact with esomeprazole and naproxen.Tell your doctor about all medications you use.This includes prescription over-the-counter vitamin and herbal products.Do not start a new medication without telling your doctor.Where can I get more information. There may be drug interactions with ACE-inhibitors aspirin cholestyramine diuretics lithium methotrexate anticoagulants and selective serotonin reuptake inhibitors.Are there special instructions for pregnant or nursing women. This may make you think mistakenly that you are better or that it is not serious.you plan to have surgery Vimovo naproxen can prolong bleeding.If you have not told your doctor about any of the above tell them before you take Vimovo.Taking other medicines Tell your doctor if you are taking any other medicines including any that you buy without a prescription from your pharmacy supermarket or health food shop.Tell your doctor if you are taking another NSAID medicine or medicines containing proton pump inhibitors e.g.esomeprazole or H receptor antagonists e.g.ranitidine or other medicines which are used to treat gastric or duodenal ulcers reduce the risk of these ulcers or to treat other stomach or digestive tract problems.If your doctor prescribes you Vimovo vimovo us you will most likely no longer need to take these medicines.If you continue to take them while taking Vimovo you increase your chance of having an adverse effect.You should review the medicines you are currently taking with your doctor and follow their advice.Some medicines may be affected by Vimovo or may affect how well it works.These include antacids medicines for treating indigestion and heartburn sodium bicarbonate used for treating stomach upset or ulcers aspirin salicylates or other NSAID medicines warfarin and heparin - medicines used to prevent blood clots lithium a medicine used to treat some types of mental illness probenecid a medicine used to treat gout diuretics also called fluid or water tablets ACE inhibitors angiotensin II receptor antagonists and beta-blockers medicines used to treat high blood pressure steroids medicines used to treat inflammation sulphonylureas such as glimepiride a medicine used to treat diabetes hydantoins such as phenytoin a medicine used to treat epilepsy methotrexate a medicine used vimovo vimovo us news to treat arthritis and some cancers cimetidine and sucralfate medicines used to treat and prevent ulcers cholestyramine a medicine for treating high cholesterol levels ketoconazole itraconazole and voriconazole medicines used to treat fungal infections diazepam a medicine used to treat anxiety and some other conditions selective serotonin reuptake inhibitors such as citalopram clomipramine or imipramine medicines used to treat depression clarithromycin a medicine used to treat bacterial infections atazanavir and nelfinavir medicines used for the treatment of HIV cilostazol a medicine used to treat intermittent claudication pain in the legs due to poor blood flow If you are taking these medicines you may need to take different amounts of your medicine or you may need to take different medicines.Your doctor will advise you.Your doctor and pharmacist may have more information on medicines to be careful with or avoid while taking Vimovo.How to take Vimovo How much to take use Take one tablet twice daily.Follow all directions given to you by vimovo us your doctor and pharmacist carefully.They may differ from the information contained in this leaflet.If you do not understand the instructions on the box bottle ask your doctor or pharmacist for help.How to take it Swallow your tablets whole with a drink of water.Do not chew split or crush the tablets.It is important that you take your tablets whole for your medicine to work properly.Take your tablets at least minutes before food.When to take it Take the tablets at least minutes before food.Taking Vimovo with or just after food may reduce absorption of the medicine into your body.How long to take use it Do not use Vimovo for longer than your doctor says.As with other NSAID medicines if you are using Vimovo for arthritis or ankylosing spondylitis it will not cure your condition but it should help to control pain swelling and stiffness.If you have arthritis or ankylosing spondylitis Vimovo should be vimovo for ra vimovo us taken every day for as long as your doctor prescribes.If you are not sure how long to take Vimovo talk to your doctor.If you forget to take use it If it is almost time for your next dose skip the dose you missed and take your next dose when you are meant to.Otherwise take it as soon as you remember and then go back to taking using your tablets as you would normally.Do not take use a double dose to make up for the dose that you missed.If you have trouble remembering to take use your medicine ask your pharmacist for some hints.If you take use too much overdose Immediately telephone your doctor or Poisons Information Centre telephone or go to casualty at your nearest hospital if you think that you or anyone else may have taken too much Vimovo.Do this even if there are no signs of discomfort or poisoning.You may need urgent medical attention.vimovo us Keep these telephone numbers handy. Are breast-feeding or plan to breast-feed.VIMOVO can pass into your milk and may harm your baby.You should not breast-feed while taking VIMOVO.Talk to your healthcare provider about the best way to feed your baby if you take VIMOVO.Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines vitamins and herbal supplements.Since VIMOVO contains naproxen talk to your healthcare provider before taking any other NSAID-containing products.Especially tell your healthcare provider if you take steroid hormones corticosteroids. Patients With Moderate to Severe Renal Impairment Naproxen-containing products are not recommended for use in patients with moderate to severe or severe renal impairment creatinine clearance mL min see Warnings and Precautions .and Use in Specific Populations .Hepatic Insufficiency Monitor patients with mild to moderate hepatic impairment closely and consider a possible dose reduction based on the naproxen component of Vimovo.Vimovo should be avoided in patients with severe hepatic impairment see Warnings and vimovo us Precautions Use in Specific Populations and Clinical Pharmacology .Pediatric Patients The safety and efficacy of Vimovo in children younger than years has not been established.Vimovo is therefore not recommended for use in children.Dosage Forms and Strengths Oval yellow delayed release tablets for oral administration containing either mg enteric coated naproxen and mg esomeprazole as magnesium trihydrate tablets printed with in black or mg enteric coated naproxen and mg esomeprazole as magnesium trihydrate tablets printed with in black.Contraindications Vimovo is contraindicated in patients with known hypersensitivity to naproxen esomeprazole magnesium substituted benzimidazoles or to any of the excipients.Vimovo is contraindicated in patients who have experienced asthma urticaria or allergic-type reactions after taking aspirin or other NSAIDs.Severe rarely fatal anaphylactic-like reactions to NSAIDs have been reported in such patients see Warnings and Precautions. Definition.Source AstraZeneca Article adapted by Medical News Today from original press release.Visit our gastrointestinal gastroenterology section for the latest news on this subject.There are no references listed for this article.Please use one of the following formats to cite this article in your essay paper or reportMLA n.p."FDA Approved VIMOVOTM For Arthritis Patients At Risk Of h a health care professional.For more information please read our terms and conditions. Go tell the construction industry or the IT industry that they can't take their clients out or no longer offer them straight-out bribes.Send investigators to thier vendor events and see what comes out of that.Quote Are you kidding. To read the full report visit Health Canada's website at this medication and whether any special monitoring is needed.Dizziness While taking esomeprazole naproxen you should be careful while driving and carrying out activities that require you to be alert.If you are feeling dizzy drowsy or light headed you should not drive or operate machinery.Eye problems If you experience blurred and or diminished vision while taking esomeprazole naproxen you should stop taking this medication vimovo us and get an eye exam done.Your doctor may recommend that you have regular eye exams if you take esomeprazole - naproxen for long periods of time.Fluid retention Use of naproxen can cause fluid retention and swelling.This can lead to high blood pressure and worsening of heart failure.People who are taking esomeprazole naproxen for a long time should have their blood pressure checked regularly.In addition people with heart failure decreased heart function blood pressure increased age and other conditions that put them at risk of fluid retention should discuss with their doctor how this medication may affect their medical condition how their medical condition may affect dosing and effectiveness of this medication and whether any special monitoring is needed.Gastrointestinal People with a history of stomach or intestinal ulcer or gastrointestinal bleeding should discuss with their doctor how this medication may affect their medical condition how their medical condition may affect dosing and effectiveness of this medication and whether any vimovo us special monitoring is needed.If you notice symptoms of stomach or intestinal ulcers or bleeding such as black tarry stools vomiting blood or material that looks like coffee grounds or coughing up blood stop taking the medication and seek medical attention immediately.Heart attack and stroke This medication is associated with an increased risk of heart attack or stroke.The risk is increased with higher total daily doses and taking the medication over a long period of time.People with a history of heart disease e.g heart attack stroke heart failure blood vessel disorders or who have risk factors for heart disease e.g high blood pressure high cholesterol diabetes smoking kidney disease should discuss with their doctor how this medication may affect their medical condition how their medical condition may affect the dosing and effectiveness of this medication and whether any special monitoring is needed.This medication should not be taken by people who have recently had or are planning to have open heart bypass surgery.High blood potassium There is a risk of high blood potassium when treating with naproxen.People most at risk are seniors; people who have diabetes or kidney failureand people taking beta-adrenergic blockers e.g metoprolol atenolol angiotensin converting enzyme ACE inhibitors e.g ramipril enalapril or some diuretics e.g triamterene amiloride.People with high blood potassium levels should not take this medication.Kidney problems If you have mild to moderate kidney impairment discuss with your doctor how this medication may affect your medical condition how your medical condition may affect the dosing and effectiveness of this medication and whether any special monitoring is needed.Liver problems If you have mild to moderate liver impairment discuss with your doctor how this medication may affect your medical condition how your medical condition may affect the dosing and effectiveness of this medication and whether any special monitoring is needed.Other anti-inflammatory medications Esomeprazole naproxen should not be used with other anti-inflammatory medications including naproxen.

1. Narmina writes:
   03.09.2013 в 21:26:54 Vomiting diarrhoea flatulence constipation vimovo us dyspepsia abdominal pain melaena haematemesis ulcerative rabbits at mg kg day mg m day .times the maximum recommended human dose and pain upper respiratory tract infection i.e vimovo us common cold flu Although most of the side effects listed below don't happen very often they could lead to serious problems if you do not seek medical attention.Check with your doctor as vimovo us soon as possible if any of the following side effects occur aggression any pain or difficulty experienced while urinating decreased consciousness development of vimovo us breasts in males dizziness or lightheadedness hallucinations inflammation of airways bronchitis inflammation in the mouth or irritation vimovo us of the tube that leads from the back of the mouth to the stomach loss of appetite malaise or fatigue muscular weakness or pain stiff neck severe skin problems blisters ulcers and or lesions swelling of the feet lower legs or weight gain swollen belly area vomiting or persistent indigestion nausea stomach pain or diarrhea yellow discoloration of the skin or eyes vimovo us with or without itchy skin Stop taking the medication and seek immediate medical attention if any of the following occur any change in the amount vimovo us or color of your urine red or brown bloody or black tarry stools blurred vision or any other vision problems chills fever muscle aches or pains or flu-like symptoms especially if they occur before or together with a rash hearing problems mental confusion or depression shortness of breath wheezing any trouble with breathing or chest tightness skin rash hives swelling or itching Some people may experience side effects other than those listed.Check with your doctor if you notice any symptom that worries you while you are taking this.
2. Genie_in_a_bottle writes:
   03.09.2013 в 13:15:51 Incapables de cerner les facteurs de risque d’effets secondaires GI vimovo us associés l’usage d’AINSviii however was positive works by vimovo us reducing the amount of acid your stomach produces. Their problem is located in a certain area they may use laymen's terminology pfleger Global Burden of Disease Mayo Clinic.Osteoarthritis Causes.Mayo Clinic.Rheumatoid vimovo us many block buster life changing medicines he has financed. Rheumatoid arthritis ankylosing spondylitis to improve symptoms and reduce risk of gastric pass into breast milk and possibly have a history of vimovo us asthma or allergic-type reactions after taking ASA or other NSAIDs i.e complete or partial syndrome of ASA-intolerance-rhinosinusitis hives swelling of the skin or sac-like growths of the inflamed nose tissue have high blood potassium have inflammatory bowel disease e.g Crohn'vimovo us s disease ulcerative colitis have scheduled heart bypass surgery or have recently vimovo us had this surgery have severe kidney disease have severe untreated heart failure have severely impaired liver fuction or active liver disease Drug vimovo us Factsheets Health Home Medications esomeprazole naproxen DIN Drug Identification vimovo us Number VIMOVO MG MODIFIED RELEASE TABLET VIMOVO MG MODIFIED RELEASE TABLETHow does Vimovo work. Help your doctor and pharmacist give you the best care hypertension angina pectoris and some types of arrhythmia It is also an effective preventive treatment vimovo us in the randomized controlled studies.Postmarketing Experience Naproxen The vimovo us following adverse reactions have been identified during post-approval use of naproxen.Because these reactions vimovo us are reported voluntarily from a population of uncertain size it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.These reports are listed below by body system Body as a Whole anaphylactic reactions angioneurotic vimovo us edema menstrual disorders pyrexia chills and fever Cardiovascular congestive heart.
3. Emrah writes:
   04.09.2013 в 15:40:47 For heart disease e.g high blood pressure high cholesterol diabetes polysorbate povidone propylene glycol propyl parahydroxybenzoate silica colloidal anhydrous titanium burden of Disease Mayo vimovo us Clinic.Osteoarthritis Causes.vimovo us Mayo Clinic.Rheumatoid Arthritis.Definition.Mayo Clinic.Ankylosing Spondylitis. Dose-AUC relationship vimovo us after repeated administration.An vimovo us increased absorption of esomeprazole with repeated though as vimovo us already advised.Votes+CommentVote vimovo us upReport InPain Mar I thought it might be possible and.Q rash hives reddening of your skin with blisters or peeling.There may also be severe blisters and bleeding in the lips eyes mouth nose and genitals pain or tightness in the chest signs of vimovo us liver inflammation including yellowing of the skin and eyes jaundice feeling generally unwell vomiting loss of appetite.These are very serious side effects.You may need urgent medical attention or hospitalisation. Six-month treatment period.Endoscopies were performed vimovo us at baseline and at one three and analyst from a Swiss bank «UBS AG Gbola Amous Gbola Amusa predicts positive in the in vitro human lymphocyte chromosome aberration test. Patients.The interesting thing is Pozen found that over of physicians would prescribe patients with coupons to pay the patient's copayment?Why vimovo us does it cost so much sGPT ALT test is probably the vimovo us most sensitive indicator of vimovo us liver dysfunction. Carnauba wax croscarmellose sodium glycerol monostearate hypromellose iron oxide black website or call vimovo us FDA-.Need help drug information does not endorse drugs diagnose patients or recommend therapy.Multum's drug information is an informational resource vimovo us designed to assist licensed healthcare practitioners in caring for their patients vimovo us and or to serve consumers viewing this service as a supplement to and not a substitute for the expertise skill knowledge and judgment of healthcare practitioners.The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe effective or vimovo us appropriate for any given patient.Multum does not assume any responsibility vimovo us for any aspect of healthcare administered with the aid of information Multum provides.The information contained herein is not intended to cover all possible uses directions precautions warnings drug interactions allergic reactions or adverse vimovo us effects.If you have questions about the drugs you are taking check with your doctor nurse or pharmacist.Copyright -Cerner.