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Pregnancy rd trimester lactation.Click to view Vimovo detailed prescribing 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 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.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.

Esomeprazole is the S-isomer of omeprazole which is a 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 understood but may be related to prostaglandin synthetase inhibition. Here's an exampleI cut my knee recently and it required stitches now HR you can find out who I am!.It was bleeding badly so I went to the ER.A PA cleaned the wound and sewed it up.I took out the stitches myself.The bill came from the hospital and first it was an estimate .for hour of the PA's time a tetanus shot and some wound cleaning.A gigantic ripoff by anyone's standards. 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 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. Esomeprazole naproxen should be taken at least minutes before meals.You should swallow esomeprazole naproxen tablet whole with water.It should not be split chewed or crushed.Many things can affect the dose of medication that a person needs such as body weight other medical conditions and other medications.If your doctor has recommended a dose different from the ones listed here do not change the way that you are taking the medication without consulting your doctor.It is important to take this medication exactly as prescribed by your doctor.If you miss a dose take it as soon as possible and continue with your regular schedule.If it is almost time for your next dose skip the missed dose and continue with your regular dosing schedule.Do not take a double dose to make up for a missed one.If you are not sure what to do after missing a dose contact your doctor or pharmacist for advice.Store this medication at room temperature protect it from light and moisture and keep it out of the reach of children.Do not dispose of medications in wastewater e.g.down the sink or in the toilet or in household garbage.Ask your pharmacist how to dispose of medications that are no longer needed or have expired.What forms does Vimovo come.

Des répondants ont éprouvé des complications GI après avoir arrêté leur médicament pour les troubles digestifs tout en poursuivant leur traitement par AINSviii À propos d’AstraZeneca Canada AstraZeneca est engagée envers la recherche le développement et la fabrication de médicaments d’ordonnance de grande valeur.Elle possède une imposante gamme de produits dans les six domaines thérapeutiques suivants gastro-entérologie cardiologie infectiologie neurosciences oncologie et pneumologie.Le siège social canadien d’AstraZeneca est situé Mississauga en Ontario et l’entreprise exploite un centre ultramoderne de découverte de médicaments Montréal au Québec.Pour de plus amples renseignements visitez le site Web de la Consulté le février Lanas et al; Assessment of gastrointestinal and cardiovascular risk in patients with osteoarthritis who require NSAIDs the LOGICA study.Ann Rheum Dis ;–.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.; -.Rostom et al.Canadian consensus guidelines on long-term nonsteroidal anti-inflammatory drug therapy and the need for gastroprotection benefits versus risks.Alimentary Pharmacology Therapeutics ; -.Léger Marketing.Sondage MISSISSAUGA ON Wednesday April AstraZeneca Canada Inc.announced today that Health Canada has approved VIMOVO® modified-release tablets for the treatment of the 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 non-steroidal anti-inflammatory drug NSAID-associated gastric ulcersi VIMOVO is the first fixed-dose combination of enteric-coated naproxen an NSAID and immediate-release esomeprazole a proton pump inhibitor PPI.The approval of VIMOVO was supported by data from a clinical development program including results from the PN-and PN-studies which demonstrated that subjects taking VIMOVO experienced significantly fewer gastric ulcers and NSAID-associated upper GI adverse events had significantly less treatment discontinuations and as measured through patient reports of dyspepsia and heartburn had better upper gastrointestinal tolerability compared to subjects receiving enteric-coated naproxen aloneii "While NSAIDs are effective at relieving the pain and inflammation associated with osteoarthritis many patients discontinue use and live in pain due to gastrointestinal side-effects or safety concerns " says Dr.Peter Lin family physician in Toronto."VIMOVO combines an NSAID and PPI together into one pill allowing patients to have pain relief while protecting their stomach." Osteoarthritis which affects three million Canadians iii is the most common form of arthritis and is a degenerative joint disease caused by the breakdown and eventual loss of the cartilage of one or more joints.A common misconception is that arthritis is a disease of the elderly.In fact almost per cent per cent of arthritis patients are under the age of iv While many patients with osteoarthritis treat their symptoms with NSAIDs per cent of chronic NSAID-users are at increased risk of gastrointestinal GI complications.v An estimated Canadians die every year from complications associated with NSAID consumption.vi Risk factors for NSAID-associated upper GI clinical events include age history of GI events concomitant use of oral corticosteroids and anticoagulants high-dose multiple NSAID use and concomitant use of aspirin.vii A new survey of Canadian osteoarthritis patients found per cent of patients at risk of NSAID-associated GI complications were not aware they were at risk and the majority could not identify risk factors for developing GI side effects associated with NSAID use.viii In addition per cent of patients with osteoarthritis discontinued their GI medication because they started to "feel better" per cent and preferred to take less medication per cent.viii Thirty per cent of respondents experienced GI complications as a result of stopping their GI medication continuing on their NSAID therapy.viii CONTACTS REFERENCESi VIMOVO®Canadian Product Monograph.AstraZeneca Canada Inc.January .ii Goldstein et al.PN significantly reduces the incidence of gastric ulcers compared with enteric-coated naproxen in patients requiring chronic NSAID therapy regardless of low-dose aspirin use MISSISSAUGA ON Wednesday April AstraZeneca Canada Inc.announced today that Health Canada has approved VIMOVO® modified-release tablets for the treatment of the 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 non-steroidal anti-inflammatory drug NSAID-associated gastric ulcersi VIMOVO is the first fixed-dose combination of enteric-coated naproxen an NSAID and immediate-release esomeprazole a proton pump inhibitor PPI.The approval of VIMOVO was supported by data from a clinical development program including results from the PN-and PN-studies which demonstrated that subjects taking VIMOVO experienced significantly fewer gastric ulcers and NSAID-associated upper GI adverse events had significantly less treatment discontinuations and as measured through patient reports of dyspepsia and heartburn had better upper gastrointestinal tolerability compared to subjects receiving enteric-coated naproxen aloneii "While NSAIDs are effective at relieving the pain and inflammation associated with osteoarthritis many patients discontinue use and live in pain due to gastrointestinal side-effects or safety concerns " says Dr.Peter Lin family physician in Toronto."VIMOVO combines an NSAID and PPI together into one pill allowing patients to have pain relief while protecting their stomach." Osteoarthritis which affects three million Canadians iii is the most common form of arthritis and is a degenerative joint disease caused by the breakdown and eventual loss of the cartilage of one or more joints.A common misconception is that arthritis is a disease of the elderly.In fact almost per cent per cent of arthritis patients are under the age of iv While many patients with osteoarthritis treat their symptoms with NSAIDs per cent of chronic NSAID-users are at increased risk of gastrointestinal GI complications.v An estimated Canadians die every year from complications associated with NSAID consumption.vi Risk factors for NSAID-associated upper GI clinical events include age history of GI events concomitant use of oral corticosteroids and anticoagulants high-dose multiple NSAID use and concomitant use of aspirin.vii A new survey of Canadian osteoarthritis patients found per cent of patients at risk of NSAID-associated GI complications were not aware they were at risk and the majority could not identify risk factors for developing GI side effects associated with NSAID use.viii In addition per cent of patients with osteoarthritis discontinued their GI medication because they started to "feel better" per cent and preferred to take less medication per cent.viii Thirty per cent of respondents experienced GI complications as a result of stopping their GI medication continuing on their NSAID therapy.viii CONTACTS REFERENCESi VIMOVO®Canadian Product Monograph.AstraZeneca Canada Inc.January .ii Goldstein et al.PN significantly reduces the incidence of gastric ulcers compared with enteric-coated naproxen in patients requiring chronic NSAID therapy regardless of low-dose aspirin use results from two prospective randomized controlled trials.Accessed February .v Lanas. High blood pressure.Heart problems such as congestive heart failure.Tell your healthcare provider about any swelling of your body hands or feet sudden weight gain or trouble breathing.Active bleeding.Tell your healthcare provider if you have signs of active bleeding including passing black sticky bowel movements stools having bloody diarrhea vomiting or coughing up blood or dark particles that look like coffee grounds Serious allergic reactions.Tell your healthcare provider or get medical help right away if you develop sudden wheezing swelling of your lips tongue throat or body rash fainting or problems breathing or swallowing severe allergic reaction.Serious skin reactions.Tell your healthcare provider or get medical help right away if you develop reddening of your skin with blisters or peeling blisters and bleeding of your lips eye lids mouth nose and genitals.Liver problems.Tell your healthcare provider if you develop yellowing of the skin or the whites of your eyes dark urine feel tired nausea right upper stomach area abdomen pain flu-like symptoms Chronic lasting a long time inflammation of the stomach lining Atrophic Gastritis.Using Vimovo for a long period of time may increase the risk of inflammation to your stomach lining.You may or may not have symptoms.Tell your doctor if you have stomach pain nausea vomiting or weight loss.Low magnesium levels in your body.This problem can be serious.Low magnesium can happen in some people who take a proton pump inhibitor medicine for at least months.If low magnesium levels happen it is usually after a year of treatment.You may or may not have symptoms of low magnesium.Tell your doctor right away if you have any of these symptoms seizures dizziness abnormal or fast heart beat jitteriness jerking movements or shaking tremors muscle weakness spasms of the hands and feet cramps or muscle aches spasm of the voice box Your doctor may check the level of magnesium in your body before you start taking Vimovo during treatment or if you will be taking Vimovo for a long period of time.The most common side effects of Vimovo include inflammation of the lining of the stomach with or without loss of the protective layer of the stomach erosive gastritis indigestion diarrhea stomach ulcers upper stomach-area abdominal pain nausea Tell your healthcare provider if you have any side effect that bothers you or that does not go away.These are not all the possible side effects of Vimovo.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 store Vimovo.

Marketing Authorisation Holder and Manufacturer The marketing authorisation for VIMOVO is held by AstraZeneca UK Ltd Capability Green Luton LU LU United Kingdom.VIMOVO is manufactured by AstraZeneca AB SE-Södertälje Sweden.To listen to or request a copy of this leaflet in Braille large print or audio please call free of charge UK only Please be ready to give the following information Product name Reference number VIMOVO mg mg tablets This is a service provided by the Royal National Institute of Blind People.This medicinal product is authorised in the Member States of the EEA under the following names Austria Vimovo Lithuania Vimovo Belgium Vimovo Luxembourg Vimovo Bulgaria Vimovo Malta Vimovo Czech Republic Vimovo Netherlands Vimovo Denmark Vimovo Norway Vimovo Estonia Vimovo Poland Vimovo Finland Vimovo Portugal Vimovo Germany Vimovo Romania Vimovo Greece Vimovo Slovakia Vimovo Hungary Vimovo Slovenia Vimovo Ireland Vimovo Spain Vimovo Italy Vimovo Sweden Vimovo Latvia Vimovo United Kingdom Vimovo This leaflet was last updated in December Source Medicines and Healthcare Products Regulatory AgencyDisclaimer Every effort has been made to C 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 healthcare practitioners and consumers in the United States.

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.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 ..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 .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 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. What is Vimovo?Vimovo contains two medicines naproxen a nonsteroidal anti-inflammatory drug NSAID and esomeprazole magnesium a proton pump inhibitor PPI.Vimovo is used to relieve signs and symptoms of osteoarthritis rheumatoid arthritis and ankylosing spondylitis arthritis of the spine.It is also used to decrease the risk of developing stomach ulcers in people who are at risk of developing stomach ulcers with NSAIDs.What is the most important information I should know about Vimovo.

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 hypertension.Blood pressure BP should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy see Drug Interactions ..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. Hepatorenal syndrome The use of NSAIDs may be associated with acute renal failure in patients with severe hepato-cirrhosis.These patients frequently also have concomitant coagulopathy related to inadequate synthesis of clotting factors.Antiplatelet effects associated with naproxen could further increase risk of severe bleeding in these patients.Haematological effects Naproxen Patients who have coagulation disorders or are receiving drug therapy that interferes with haemostasis should be carefully observed if naproxen-containing products are administered.Patients at high risk of bleeding and those on full anti-coagulation therapy e.g.dicoumarol derivates may be at increased risk of bleeding if given naproxen-containing products concurrently.Naproxen decreases platelet aggregation and prolongs bleeding time.This effect should be kept in mind when bleeding times are determined.When active and clinically significant bleeding from any source occurs in patients receiving VIMOVO the treatment should be withdrawn.Eye effects Naproxen Because of adverse eye findings in animal studies with NSAIDs it is recommended that an ophthalmic examination be carried out if any change or disturbance in vision occurs.Dermatological effects Naproxen Serious skin reactions some of them fatal including exfoliative dermatitis Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported very rarely in association with the use of NSAIDs.Patients appear to be at highest risk of these reactions early in the course of therapy the onset of the reaction occurring within the first month of treatment in the majority of cases.VIMOVO should be discontinued at the first appearance of skin rash mucosal lesions or any other sign of hypersensitivity.Anaphylactic anaphylactoid reactions Naproxen Hypersensitivity reactions may occur in susceptible individuals.Anaphylactic anaphylactoid reactions may occur both in patients with and without a history of hypersensitivity or exposure to aspirin other NSAIDs or naproxen-containing products.They may also occur in individuals with a history of angio-oedema bronchospastic reactivity e.g.asthma rhinitis and nasal polyps.Pre-existing asthma Naproxen The use of aspirin in patients with aspirin-sensitive asthma has been associated with severe bronchospasm which can be fatal.Since cross reactivity including bronchospasm between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients VIMOVO should not be administered to patients with this form of aspirin sensitivity and should be used with caution in patients with pre-existing asthma.Inflammation Naproxen The anti-pyretic and anti-inflammatory activities of naproxen may reduce fever and other signs of inflammation thereby diminishing their utility as diagnostic signs.Female fertility The use of VIMOVO as with any drug known to inhibit cyclooxygenase prostaglandin synthesis may impair female fertility and is not recommended in women attempting to conceive.In women who have difficulties conceiving or who are undergoing investigation of infertility withdrawal of VIMOVO should be considered.Combination with other medicinal products Co-administration of atazanavir with proton pump inhibitors is not recommended.If the combination of atazanavir with a proton pump inhibitor is judged unavoidable close clinical monitoring e.g.virus loading is recommended in combination with an increase in the dose of atazanavir to mg with mg of ritonaviresomeprazole mg should not be exceeded and therefore VIMOVO must not be used concomitantly with atazanavir.Esomeprazole is a CYPC inhibitor.When starting or ending treatment with esomeprazole the potential for interactions with drugs metabolised through CYPC should be considered.An interaction is observed between clopidogrel and omeprazole.The clinical relevance of this interaction is uncertain.As a precaution concomitant use of esomeprazole and clopidogrel should be discouraged.VIMOVO Adverse Reactions VIMOVO Adverse Reactions Summary of safety profile Immediate release esomeprazole has been included in the tablet formulation to decrease the incidence of gastrointestinal side effects from naproxen.VIMOVO has been shown to significantly decrease the occurrence of gastric ulcers and NSAID associated upper gastrointestinal adverse events compared to naproxen alone.No new safety findings were identified during VIMOVO treatment in the overall study population n compared to the well-established safety profiles of the individual active substances naproxen and esomeprazole.Tabulated summary of adverse reactions Adverse reactions are classified according to frequency and System Organ Class.Frequency categories are defined according to the following convention Very common Common to Uncommon to Rare to Very rare Not known cannot be estimated from the available data VIMOVO The following adverse experiences have been reported in patients taking VIMOVO during clinical trials Very Common Common Uncommon Rare Infections and infestations infection diverticulitis Blood and lymphatic system disorders eosinophilia leucopenia Immune system disorders hypersensitivity reactions Metabolism and nutrition disorders appetite disorder fluid retention hyperkalemia hyperuricemia Psychiatric disorders anxiety depression insomnia confusion dream abnormalities Nervous system disorders dizziness headache taste disturbance paraesthesia syncope somnolence tremor Ear and labyrinth disorders tinnitus vertigo Cardiac disorders arrhythmia palpitations myocardial infarction tachycardia Vascular disorders hypertension Respiratory thoracic and mediastinal disorders asthma bronchospasm dyspnea Gastrointestinal disorders dyspepsia abdominal pain constipation diarrhoea esophagitis flatulence gastric duodenal ulcers gastritis nausea vomiting dry mouth eructation gastrointestinal bleeding stomatitis glossitis hematemesis rectal bleeding Skin and subcutaneous tissue disorders skin rashes dermatitis hyperhidrosis pruritis urticaria alopecia ecchymoses Musculoskeletal and connective tissue disorders arthralgia myalgia Renal and urinary disorders proteinuria renal failure Reproductive system and breast disorders menstrual disorder General disorders and administration site disorders oedema asthenia fatigue pyrexia Investigations abnormal liver function tests raised serum creatinine as detected by scheduled routine endoscopy Naproxen The following adverse experiences have been reported in patients taking naproxen during clinical trials and through postmarketing reports.Common Uncommon Rare Infections and infestations diverticulitis aseptic meningitis infection sepsis Blood and lymphatic system disorders agranulocytosis aplastic anemia eosinophilia granulocytopenia hemolytic anemia leucopenia lymphadenopathy pancytopenia thrombocytopenia Immune system disorders anaphylactic reactions anaphylactoid reactions hypersensitivity reactions Metabolism and nutrition disorders appetite disorder fluid retention hyperglycemia hyperkalemia hyperuricemia hypoglycemia weight changes Psychiatric disorders depression insomnia agitation anxiety confusion dream abnormalities hallucinations nervousness Nervous system disorders dizziness drowsiness headache lightheadedness vertigo cognitive dysfunction coma convulsions inability to concentrate optic neuritis paresthesia syncope tremor Eye disorders visual disturbances blurred vision conjunctivitis corneal opacity papilloedema papillitis Ear and labyrinth disorders tinnitus hearing disturbances hearing impairment Cardiac disorders palpitations arrhythmia congestive heart failure myocardial infarction tachycardia Vascular disorders hypertension hypotension vasculitis Respiratory thoracic and mediastinal disorders dyspnea asthma bronchospasm eosinophilic pneumonitis pneumonia pulmonary edema respiratory depression Gastrointestinal disorders dyspepsia abdominal pain nausea vomiting diarrhoea constipation heartburn peptic ulcers stomatitis dry mouth esophagitis gastric ulcers gastritis glossitis eructation flatulence gastric duodenal ulcers gastrointestinal bleeding and or perforation melena hematemesis pancreatitis colitis exacerbation of inflammatory bowel disease ulcerative colitis Crohn's disease nonpeptic gastrointestinal ulceration rectal bleeding ulcerative stomatitis Hepatobiliary disorders cholestasis hepatitis jaundice liver failure Skin and subcutaneous tissue disorders pruritis ecchymoses purpura skin rashes alopecia exanthema urticaria bullous reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis TEN erythema multiforme erythema nodosum fixed drug eruption lichen planus systemic lupus erythematoses photosensitive dermatitis photosensitivity reactions including rare cases resembling porphyria cutanea tarda pseudoporphyria exfoliative dermatitis angioneurotic edema pustular reaction Musculoskeletal and connective tissue disorders muscle weakness myalgia Renal and urinary disorders glomerular nephritis hematuria interstitial nephritis nephrotic syndrome oliguria polyuria proteinuria renal failure renal papillary necrosis tubular necrosis Reproductive system and breast disorders infertility menstrual disorder General disorders and administration site disorders fatigue oedema sweating thirst asthenia malaise pyrexia Investigations abnormal liver function tests increased bleeding time raised serum creatinine Esomeprazole The following adverse drug reactions have been identified or suspected in the clinical trials programme for enteric-coated esomeprazole and or from post-marketing use.None were found to be dose-related.Common Uncommon Rare Very rare Blood and lymphatic system disorders leukopenia thrombocytopenia agranulocytosis pancytopenia Immune system disorders hypersensitivity reactions e.g.fever angioedema and anaphylactic reaction shock Metabolism and nutrition disorders peripheral oedema hyponatraemia hypomagnesaemia Psychiatric disorders insomnia agitation confusion depression aggression hallucinations Nervous system disorders headache dizziness paraesthesia somnolence taste disturbance Eye disorders blurred vision Ear and labyrinth disorders vertigo Respiratory thoracic and mediastinal disorders bronchospasm Gastrointestinal disorders abdominal pain diarrhoea flatulence nausea vomiting constipation dry mouth stomatitis gastrointestinal candidiasis Hepatobiliary disorders increased liver enzymes hepatitis with or without jaundice hepatic failure hepatic encephalopathy in patients with pre-existing liver disease Skin and subcutaneous tissue disorders dermatitis pruritus urticaria rash alopecia photosensitivity erythema multiforme Stevens-Johnson syndrome toxic epidermal necrolysis TEN Musculoskeletal and connective tissue disorders arthralgia myalgia muscular weakness Renal and urinary disorders Interstitial nephritis Reproductive system and breast disorders gynaecomastia General disorders and administration site disorders malaise increased sweating Description of selected adverse reactions Naproxen Clinical trial and epidemiological data suggest that use of coxibs and some NSAIDs particularly at high doses and in long-term treatment may be associated with a small increased risk of arterial thrombotic events for example myocardial infarction or stroke.Although data suggest that the use of naproxen mg daily may be associated with a lower risk some risk cannot be excluded.Oedema hypertension and cardiac failure have been reported in association with NSAID treatment.The most commonly observed adverse events are gastrointestinal in nature.Peptic ulcers perforation or GI bleeding sometimes fatal particularly in the elderly may occur.Nausea vomiting diarrhoea flatulence constipation dyspepsia abdominal pain melaena haematemesis ulcerative stomatitis exacerbation of colitis and Crohn's disease have been reported following administration.Less frequently gastritis has been observed.VIMOVO has been developed with esomeprazole to decrease the incidence of gastrointestinal side effects from naproxen and has been shown to significantly decrease the occurrence of gastric and or duodenal ulcers and NSAID associated upper gastrointestinal adverse events compared to naproxen alone. This problem can be serious.Low magnesium can happen in some people who take a proton pump inhibitor medicine for at least months.If low magnesium levels happen it is usually after a year of treatment. Fact-There is not a single medicine that has been discovered or deveoloped by any government agency. Corticosteroid medicines such as hydrocortisone or prednisolone used as anti-inflammatory medicines. John's wort because they may interact with Vimovo delayed-release tablets.Ask your doctor or pharmacist if you are unsure if any of your medicines might interact with Vimovo delayed-release tablets.This may not be a complete list of all interactions that may occur.Ask your health care provider if Vimovo delayed-release tablets may interact with other medicines that you take.Check with your health care provider before you start stop or change the dose of any medicine.How to use Vimovo delayed-release tablets Use Vimovo delayed-release tablets as directed by your doctor.Check the label on the medicine for exact dosing instructions.Vimovo delayed-release tablets comes with an extra patient information sheet called a Medication Guide.Read it carefully.Read it again each time you get Vimovo delayed-release tablets refilled.Take Vimovo delayed-release tablets by mouth at least minutes before a meal unless your doctor tells you otherwise.Talk with your doctor or pharmacist if you have persistent stomach upset.Take Vimovo delayed-release tablets with a full glass of water oz mL.Swallow Vimovo delayed-release tablets whole.Do not break crush chew or dissolve before swallowing.Tell your doctor if you cannot swallow tablets whole.You may need a different medicine.If you also take antacids or cholestyramine ask your doctor or pharmacist how to take them with Vimovo delayed-release tablets.Continue to take Vimovo delayed-release tablets even if you feel well.Do not miss any doses.If you miss a dose of Vimovo delayed-release tablets take it as soon as possible.If it is almost time for your next dose skip the missed dose and go back to your regular dosing schedule.Do not take doses at once.Ask your health care provider any questions you may have about how to use Vimovo delayed-release tablets.Important safety information Vimovo delayed-release tablets may cause drowsiness or dizziness.These effects may be worse if you take it with alcohol or certain medicines.

Multum Information Services Inc.does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.Copyright -Multum Information Services Inc.The information in contained herein is not intended to cover all possible uses directions precautions warnings drug interactions allergic reactions or adverse effects.If you have questions about the drugs you are taking check with your doctor nurse or pharmacist. 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.

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. 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 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. 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 understood but may be related to prostaglandin synthetase inhibition.Esomeprazole is the S-enantiomer of omeprazole and reduces gastric acid secretion through a specific targeted mechanism of action.Dosage Adult One tablet twice daily swallowed whole with water at least minutes prior to food intake.Use lowest effective dose.Elderly As per adults. Get emergency medical help if you have any of these signs of an allergic reaction hivesdifficulty breathingswelling of your face lips tongue or throat.Stop using esomeprazole and naproxen and call your doctor at once if you have a serious side effect such as pale skin easy bruising unusual bleeding or any bleeding that will not stop chest pain or heavy feeling pain spreading to the arm or shoulder nausea sweating general ill feeling sudden numbness or weakness especially on one side of the body sudden headache confusion problems with vision speech or balance pain swelling warmth or redness in one or both legs low magnesium dizziness confusion fast or uneven heart rate jerking muscle movements jittery feeling muscle cramps muscle weakness or limp feeling cough or choking feeling seizure urinating less than usual or not at all swelling rapid weight gain feeling short of breath even with mild exertion diarrhea that is watery or bloody black bloody or tarry stools coughing up blood or vomit that looks like coffee grounds nausea upper stomach pain itching loss of appetite dark urine clay-colored stools jaundice yellowing of the skin or eyesor severe skin reaction fever sore throat swelling in your face or tongue burning in your eyes skin pain followed by a red or purple skin rash that spreads especially in the face or upper body and causes blistering and peeling Less serious side effects may include constipation mild diarrheaor mild stomach pain This is not a complete list of side effects and others may occur.Call your doctor for medical advice about side effects.You may report side effects to FDA at FDA-.Back to Top What other drugs affect VIMOVO. Anaphylactoid 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. The combination into one pill will greatly improve patient compliance and ease of use.We believe there is significant unmet prescription need caused by the removal of the Cox-II drugs.We believe Vimovo represents a safer option for patients than Cox-II drugs or enteric-coated naproxen.In fact we would not be surprised to see AstraZeneca AZN and Pozen develop a lower-dose version of PN seeking a potential move to over-the-counter OTC once the prescription candidate loses patent protection.Our only concern is a potential direct competitor to Vimovo from Horizon Therapeutics.HZT-is an ibuprofen famotidine Advil Pecid product currently in phase III trials.At today's price Pozen is trading with a market value of only million.The company has no debt and million in cash.Pozen should burn very little cash in Management's guidance is that the company Product Stofnaam IndicatiegebiedVimovo® naproxen esomeprazol Artrose reumatoïde artritis en ankyloserende spondylitis Toepassingsgebied Vimovo wordt gebruikt voor symptomatische behandeling van osteoartrose reumatoïde artritis en ankyloserende spondylitis bij patiënten die een risico lopen op het ontwikkelen van niet steroïde anti-inflammatoire geneesmiddel NSAID-geassocieerde gastrische en of duodenale ulcera en waar behandeling met lagere doseringen van naproxen of van andere NSAID’s niet voldoende wordt geacht.Toedieningsvorm Vimovo® wordt geleverd in tabletten met gereguleerde afgifte. Clostridium difficile associated diarrhea Published observational studies suggest that PPI therapy like VIMOVO may be associated with an increased risk of Clostridium difficile associated diarrhea especially in hospitalized patients.This diagnosis should be considered for diarrhea that does not improve see Adverse Reactions .Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated see Dosage and Administration Interaction with Clopidogrel Avoid concomitant use of esomeprazole with clopidogrel.Clopidogrel is a prodrug. Call your doctor for medical advice about side effects.To report side effects to the appropriate agency please read the Guide to Reporting Problems to FDA.If OVERDOSE is suspected Contact the American Association of Poison Control Centers your local poison control center or emergency room immediately.Symptoms may include black tarry stoolsconfusiondecreased coordinationdecreased urinationfast heartbeatflushingheartburnloss of consciousnessseizures; severe heartburn nausea or stomach painsevere or persistent dizziness drowsiness or headacheslow or difficult breathingsluggishnessuncontrolled movementsunusual bleeding or bruisingunusual sweatingunusual tiredness or weaknessvision changesvomiting that may or may not look like coffee grounds.Proper storage of Vimovo delayed-release tablets Store Vimovo delayed-release tablets at room temperature between and degrees F and degrees C.Store in the original packaging until just before use.Store away from heat moisture and light.Do not store in the bathroom.Keep Vimovo delayed-release tablets out of the reach of children and away from pets.General information If you have any questions about Vimovo delayed-release tablets please talk with your doctor pharmacist or other health care provider.Vimovo delayed-release tablets is to be used only by the patient for whom it is prescribed.Do not share it with other people.If your symptoms do not improve or if they become worse check with your doctor.Check with your pharmacist about how to dispose of unused medicine.This information should not be used to decide whether or not to take Vimovo delayed-release tablets or any other medicine.Only your health care provider has the knowledge and training to decide which medicines are right for you.This information does not endorse any medicine as safe effective or approved for treating any patient or health condition.This is only a brief summary of general information about Vimovo delayed-release tablets.It does NOT include all information about the possible uses directions warnings precautions interactions adverse effects or risks that may apply to Vimovo delayed-release tablets.This information is not specific medical advice and does not replace information you receive from your health care provider.You must talk with your healthcare provider for complete information about the risks and benefits of using Vimovo delayed-release tablets.Issue Date April Database Edition ..Copyright © Wolters Kluwer Health Inc.Disclaimer This information should not be used to decide whether or not to take this medicine or any other medicine.Only your health care provider has the knowledge and training to decide which medicines are right for you.This information does not endorse any medicine as safe effective or approved for treating any patient or health condition.This is only a brief summary of general information about this medicine.It does NOT include all information about the possible uses directions warnings precautions interactions adverse effects or risks that may apply to this medicine.This information is not specific medical advice and does not replace information you receive from your health care provider.You must talk with your healthcare provider for complete information about t he risks and benefits of using this medicine.Next Page → Side Effects More Vimovo delayed-release tablets resources Compare Vimovo Vimovo Modified release tablets is a brand of medicine containing the active ingredients naproxen - esomeprazole.Developed by the pharmaceutical company responsible for this medicine in Australia according to TGA regulations.Naproxen and esomeprazole magnesium trihydrate Consumer Medicine Information What is in this leaflet This leaflet answers some common questions about Vimovo.It does not contain all the available information.It does not take the place of talking to your doctor or pharmacist.All medicines have risks and benefits.Your doctor has weighed the risks of you taking Vimovo against the benefits they expect it will have for you.If you have any concerns about taking this medicine ask your doctor or pharmacist.Keep this leaflet with the medicine.You may need to read it again.Back to topWhat Vimovo is used for Vimovo is used to treat the symptoms of rheumatoid arthritis osteoarthritis and ankylosing spondylitis.Although Vimovo can relieve the symptoms of pain and inflammation swelling redness and heat it will not cure your condition.VIMOVO contains two different medicines called naproxen and esomeprazole.Each of these medicines works in a different way. Would tobacco companies give away free cigarettes to children if they could get them hooked. Why should a third party to pay for it since that drives up everyone else's insurance and government costs.

Childs-Pugh C.Apresentação Comprimidos revestidos de mg de naproxeno e mg de esomeprazol magnésio em embalagens com comprimidos acompanhados de sachê com dessecante sílica gel.Número do registro no Ministério da Saúde Número e data do Registro Data da publicação global voltada para inovação com foco principal na descoberta desenvolvimento e na comercialização de medicamentos de prescrição nas seguintes linhas terapêuticas gastrointestinal cardiovascular neurológica respiratória e inflamatória oncológica reumatológica e doenças infecciosas.A By Jason Napodano CFAShares of Pozen POZN peaked in April and have been in a steady decline ever since.The sell-off was accelerated by sales figures in late October from Vimovo partner AstraZeneca AZN showing limited market acceptance for the combination mg naproxen and mg delayed-release esomeprazole product.AstraZeneca's financial results showed that Vimovo generated only million in sales in the third quarter and million for the first nine months of Sales of Vimovo totaled only million in the U.S.during the third quarter.AstraZeneca has turned its attention to international markets for Vimovo as it is clear the opportunity for Vimovo in the U.S.is limited.The single biggest question we receive from investors on Pozen is "If Vimovo is such a commercial failure in the U.S why should we expect any different from PA?" It's a valid question.Pozen designed Vimovo as a "safer NSAID" product for patients either taking daily naproxen or branded medications such as Pfizer's PFE Celebrex celecoxib.Similar to aspirin naproxen has nasty gastrointestinal side-effects and the Vimovo formulation which includes a delayed-release esomeprazole the active ingredient in AstraZeneca's Nexium protects the stomach from potential harm. Talk to your healthcare provider about your risk for fractures if you take VIMOVO for a long period of time.Low magnesium levels in your body.This problem can be serious.Low magnesium can happen in some people who take a proton pump inhibitor medicine for at least months.If low magnesium levels happen it is usually after a year of treatment.You may or may not have symptoms of low magnesium.Tell your doctor right away if you have any of these symptoms seizures dizziness abnormal or fast heart beat jitteriness jerking movements or shaking tremors muscle weakness spasms of the hands and feet cramps or muscle aches spasm of the voice box Your doctor may check the level of magnesium in your body before you start taking VIMOVO during treatment or if you will be taking VIMOVO for a long period of time.

If you are about to start taking any new medicine tell your doctor and pharmacist that you are taking using Vimovo.Tell all of the doctors dentists and pharmacists that are treating you that you are taking Vimovo.If you are going to have surgery tell your doctor you are taking Vimovo.If you are going to have laboratory tests e.g.blood or urine tests tell your doctor you are taking Vimovo. 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 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. Vimovo should be avoided in patients with severe hepatic impairment seeDosage and Administration Use in Specific Populations and Clinical Pharmacology .Hematological Effects Anemia is sometimes seen in patients receiving NSAIDs.This may be due to fluid retention occult or gross GI blood loss or an incompletely described effect upon erythropoiesis.Patients on long-term treatment with NSAIDs should have their hemoglobin or hematocrit checked if they exhibit any signs or symptoms of anemia.NSAIDs inhibit platelet aggregation and have been shown to prolong bleeding time in some patients.Unlike aspirin their effect on platelet function is quantitatively less of shorter duration and reversible.Patients receiving Vimovo who may be adversely affected by alterations in platelet function such as those with coagulation disorders or patients receiving anticoagulants or antiplatelets should be carefully monitored.Pre-existing Asthma Patients with asthma may have aspirin-sensitive asthma.The use of aspirin in patients with aspirin-sensitive asthma has been associated with severe bronchospasm which can be fatal.Since cross reactivity including bronchospasm between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients Vimovo should not be administered to patients with this form of aspirin sensitivity and should be used with caution in patients with pre-existing asthma.Concomitant NSAID Use Vimovo contains naproxen as one of its active ingredients.It should not be used with other naproxen-containing products since they all circulate in the plasma as the naproxen anion.The concomitant use of Vimovo with any dose of a non-aspirin NSAID should be avoided due to the potential for increased risk of adverse reactions.Corticosteroid Treatment Vimovo cannot be expected to substitute for corticosteroids or to treat corticosteroid insufficiency. Listing Requested Life Saving Drugs Program LSDP Treatment of Type Gaucher disease in a patient who meets certain criteria.Comment To be considered for the LSDP the drug must have been accepted by the PBAC as clinically effective but rejected for PBS listing because it failed to meet the required cost effectiveness criteria.Comparator Imiglucerase.Accepted as previously.Clinical claim Velaglucerase is non-inferior in terms of comparative effectiveness and equivalent in terms of comparative safety compared to imiglucerase.Accepted as previously.Economic claim Cost-minimisation.Accepted.Sponsor’s comments Shire Australia welcomes the PBAC decision that Velaglucerase alfa has met all the criteria for inclusion on the Life Saving Drugs Program LSDP.Shire VIMOVO™ naproxen esomeprazole magnesium delayed-release tablets 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 PPI indicated for the relief of signs and symptoms of osteoarthritis OA rheumatoid arthritis RA and ankylosing spondylitis AS and to decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.Twenty-seven million Americans are affected by osteoarthritis which is the most common form of arthritis.While many patients with osteoarthritis treat their symptoms with NSAIDS adverse gastrointestinal events affect -of chronic NSAID users.VIMOVO is an important new treatment option that aligns with the current recommendations of the American College of Gastroenterology and the American College of Rheumatology’s Ad Hoc Group on the use of selective and non-selective NSAIDs for patients who are at risk to develop gastric ulcers but who need to take an NSAID.The U.S.Food and Drug Administration FDA approval of VIMOVO is supported by data from a comprehensive clinical trials program including results from the six-month studies PN-and PN-studies.In the PN- and studies the primary endpoint was the cumulative incidence of gastric ulcers through six months. Gastrointestinal bleeding can occur.Hypertension acute renal failure respiratory depression and coma may occur but are rare.Anaphylactic reactions have been reported with therapeutic ingestion of NSAIDs and may occur following an overdose.A few patients have experienced convulsions but it is not clear whether or not these were drug-related.It is not known what dose of the drug would be life threatening. 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 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. Visit the FDA MedWatch website or call FDA-.Need help identifying pills and medications. 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. 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 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 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.These laboratory abnormalities may progress may remain essentially unchanged or may be transient with continued therapy.The SGPT ALT test is probably the most sensitive indicator of liver dysfunction.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 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.

Take Vimovo exactly as your healthcare provider tells you to take it.Your healthcare provider may tell you to take Vitamin D and Calcium supplements during treatment with Vimovo.Your healthcare provider will tell you how many Vimovo to take and when to take them.Do not change your dose or stop Vimovo without first talking to your healthcare provider.Swallow Vimovo tablets whole with liquid.Do not split chew crush or dissolve the Vimovo tablet.Tell your healthcare provider if you cannot swallow the tablet whole.You may need a different medicine.You may use antacids while taking Vimovo.If you forget to take a dose of Vimovo take it as soon as you remember. Naproxen is a nonsteroidal anti-inflammatory drug NSAID.It works by reducing substances in the body that cause inflammation pain and fever.Esomeprazole is a proton pump inhibitor.It decreases the amount of acid produced in the stomach.The combination of esomeprazole and naproxen is used to treat symptoms of osteoarthritis rheumatoid arthritis and ankylosing spondylitis. 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 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 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 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 in different parts of the body. Why should a third party to pay for it since that drives up everyone else's insurance and government costs. If it is almost time for your next dose do not take the missed dose.Take the next dose on time.Do not take doses at one time to make up for a missed dose.If you take too much Vimovo tell your healthcare provider or go to the closest hospital emergency room right away.Symptoms that you have taken too much Vimovo may include feeling weak and tired dizziness feeling sleepy upper stomach-area pain or discomfort heartburn indigestion or nausea a change in breathing or you stop breathing vomiting bleeding movements of a body part that you cannot control coordination problems and decreased movement If you take more Vimovo than your healthcare provider prescribes call your Poison Control Center at -.Your healthcare provider may do certain tests from time to time to check you for side effect of Vimovo.What should I avoid while taking Vimovo. These laboratory abnormalities may progress may remain essentially unchanged or may be transient with continued therapy.The SGPT ALT test is probably the most sensitive indicator of liver dysfunction. Vimovo may cause serious side effects including See What is the most important information I should know about Vimovo.

Aspirin can cause bleeding in the brain stomach and intestines.Aspirin can also cause ulcers in the stomach and intestines.Some of these NSAID medicines are sold in lower doses without a prescription over-the-counter.Talk to your healthcare provider before using over-the-counter NSAIDs for more than days.NSAID medicines that need a prescription Generic Name TRADENAME Celecoxib Celebrex Diclofenac Cataflam Voltaren Arthrotec combined with misoprostol Voltaren Diflunisal Dolobid Etodolac Lodine Lodine XL Fenoprofen Nalfon Nalfon Flurbiprofen Ansaid Ibuprofen Motrin Tab-Profen Vicoprofen combined with hydrocodone Combunox combined with oxycodone Indomethacin Indocin Indocin SR Indo-Lemmon Indomethagan Ketoprofen Oruvail Ketorolac Toradol Mefenamic Acid Ponstel Meloxicam Mobic Nabumetone Relafen Naproxen Naprosyn Anaprox Anaprox DS EC-Naprosyn Naprelan Vimovo Oxaprozin Daypro Piroxicam Feldene Sulindac Clinoril Tolmetin Tolectin Tolectin DS Tolectin Vicoprofen contains the same dose of ibuprofen as over-the-counter OTC NSAIDs and is usually used for less than days to treat pain.The OTC NSAID label warns that long-term continuous use may increase the risk of heart attack or stroke.What other important information should I know about Vimovo.

Enterochromaffin-like ECL Cell Effects In over patients treated with esomeprazole or mg day up to -months the prevalence of ECL cell hyperplasia increased with time and dose.No patient developed ECL cell carcinoids dysplasia or neoplasia in the gastric mucosa.Endocrine Effects Esomeprazole had no effect on thyroid function when given in oral doses of or mg for weeks.

Plachetka expressed a desire to have a partnership in place on PA before the end of the second quarter Pozen has been very good at signing commercialization partnerships.The company landed pharmaceutical giant GlaxoSmithKline GSK in June to help develop and commercialize the U.S.

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. American College of Gastroenterology ACG."Understanding Ulcers NSAIDs and GI Bleeding." Global Burden of Osteoarthritis in the year Symmons Mathers Pfleger Global Burden of Disease Mayo Clinic.Osteoarthritis Causes.Mayo Clinic.Rheumatoid Arthritis.Definition.Mayo Clinic.Ankylosing Spondylitis. One side effect of long-term use of naproxen is the risk of stomach ulcers and the esomeprazole treats ulcers by reducing the amount of acid produced by the stomach.Vimovo is manufactured by AstraZeneca and was approved by the U.S.Food and Drug Administration FDA in Vimovo and Bone Fractures There is a growing amount of scientific evidence linking Proton Pump Inhibitors PPIs to an increased risk of bone fractures.One study published in January by the British Medical Journal found that women who took a PPI for at least two years were more likely to have a hip fracture.In May the FDA also issued warnings that using a PPI for more than one year increases the risk of bone fractures of the hip wrist and spine.The FDA has recently updated these warnings to recommend to limit the use of PPIs to one year until long-term safety studies can be conducted.Vimovo and Low Magnesium March — The FDA has issued a warning that Proton Pump Inhibitors PPIs such as Vimovo may increase the risk of having low magnesium levels hypomagnesemia if the drug is taken for more than one year.Very low levels of magnesium may increase the risk of several serious side effects including muscle spasms irregular heartbeat arrhythmias and convulsions.The FDA is recommending that doctors test new patients for normal blood-magnesium levels before prescribing Vimovo or other PPIs when the patient is expected to be taking the drug for at least one year.The risk of hypomagnesemia may be greatest for patients who combine Vimovo with other medications that can cause low magnesium levels such as diuretics digoxin and more.Vimovo Side Effects Side effects of Vimovo include but are not limited to the following Bone fractures of the hip wrist or spine Low magnesium levels hypomagnesemia Heart attack Stroke Life-threatening allergic reaction Inflammation of the stomach lining Diarrhea Stomach ulcers Abdominal pain Nausea And more Do I have a Vimovo Lawsuit. Visit the FDA MedWatch website or call FDA-.Need help identifying pills and medications. But from where I stand each and every drug listed above is a well deserving inclusion into my Hall of Shame.What do you think. 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. Take the missed dose as soon as you remember.Skip the missed dose if it is almost time for your next scheduled dose.Do not take extra medicine to make up the missed dose.Back to Top Show reviews of VIMOVO for Sort by AllRheumatoid Arthritis reviews Most RecentHighest Primary Outcome Measures Change in area under the plasma concentration-time curve AUC from time zero to infinity Time Frame Pre-dose to Day Designated as safety issue No Secondary Outcome Measures Number of subjects with Adverse Events as a measure of Safety and Tolerability Time Frame Day Designated as safety issue Yes Number of subjects with Adverse Events as a measure of Safety and Tolerability Time Frame Day Designated as safety issue Yes Number of subjects with Adverse Events as a measure of Safety and Tolerability Time Frame Day Designated as safety issue Yes Number of subjects with Adverse Events as a measure of Safety and Tolerability Time Frame Day Designated as safety issue Yes A Phase I Open-label Randomised -way Crossover Study to demonstrate Bioequivalence of a Single Oral Dose of Naproxen administered as VIMOVO manufactured at AstraZeneca AB compared to that of VIMOVO manufactured by Patheon Pharmaceuticals and a marketed enteric-coated Naproxen Formulation Manufactured by Roche in Healthy Volunteers. 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 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.

Following multiple doses of atazanavir mg once a day and omeprazole mg once a day hr before atazanavir AUC was decreased by Cmax by and Cmin by Concomitant administration with omeprazole and drugs such as atazanavir and nelfinavir is therefore not recommended.For other antiretroviral drugs such as saquinavir elevated serum levels have been reported with an increase in AUC by in Cmax by and in Cmin by following multiple dosing of saquinavir ritonavir mg twice a day for days with omeprazole mg once a day co-administered on days to Therefore clinical and laboratory monitoring for saquinavir toxicity is recommended during concurrent use with esomeprazole.Dose reduction of saquinavir should be considered from the safety perspective for individual patients.There are also some antiretroviral drugs of which unchanged serum levels have been reported when given with omeprazole.Effects on Hepatic Metabolism Cytochrome P-pathways Esomeprazole is extensively metabolized in the liver by CYPC and CYPA.In vitro and in vivo studies have shown that esomeprazole is not likely to inhibit CYPs A A C D E and A.No clinically relevant interactions with drugs metabolized by these CYP enzymes would be expected.Drug interaction studies have shown that esomeprazole does not have any clinically significant interactions with phenytoin warfarin quinidine clarithromycin or amoxicillin.However post-marketing reports of changes in prothrombin measures have been received 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.Esomeprazole may potentially interfere with CYPC the major esomeprazole metabolizing enzyme.Co-administration of esomeprazole mg and diazepam a CYPC substrate resulted in a decrease in clearance of diazepam.Clopidogrel Clopidogrel is metabolized to its active metabolite in part by CYPC.Concomitant use of esomeprazole mg results in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition.

If we assume essentially no growth in the U.S.and only modest growth internationally the royalties from Vimovo alone are still worth an estimated million.Don't believe. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor delivery.Naproxen passes into breast milk.It is unknown if esomeprazole passes into breast milk.Consult your doctor before breast-feeding.Drug interactions The effects of some drugs can change if you take other drugs or herbal products at the same time.This can increase your risk for serious side effects or may cause your medications not to work correctly.These drug interactions are possible but do not always occur.Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.To help your doctor and pharmacist give you the best care be sure to tell your doctor and pharmacist about all the products you use including prescription drugs nonprescription drugs and herbal products before starting treatment with this product.While using this product do not start stop or change the dosage of any other medicines you are using without your doctor's approval.Some products that may interact with this drug include aliskiren ACE Inhibitors such as lisinopril angiotensin II receptor blockers such as valsartan losartan corticosteroids such as prednisone lithium methotrexate especially high-dose treatment pemetrexed probenecid rifampin St John's wort.This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding.Examples include anti-platelet drugs such as clopidogrel "blood thinners" such as dabigatran enoxaparin warfarin among others.Some products need stomach acid so that the body can absorb them properly.These include atazanavir digoxin erlotinib nelfinavir rilpivirine certain azole antifungals itraconazole ketoconazole posaconazole among others.Esomeprazole decreases stomach acid so it may change how well these other products work.Before using esomeprazole consult your doctor or pharmacist about the other medications you take and for advice on how to reduce or avoid these types of interactions.Do not take other products containing naproxen or proton pump inhibitors such as omeprazole.Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers fever reducers aspirin NSAIDs such as celecoxib or ibuprofen.These drugs are similar to the naproxen in this product and may increase your risk of side effects if taken together.However if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke usually at dosages of -milligrams a day you should continue taking the aspirin unless your doctor instructs you otherwise.Ask your doctor or pharmacist for more details.This product can affect the results of certain lab tests.Make sure laboratory personnel and your doctors know you use this drug.This document does not contain all possible drug interactions.Keep a list of all the products you use.Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.Side effects See also Warning section.Upset stomach heartburn diarrhea drowsiness or dizziness may occur.If any of these effects persist or worsen notify your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects including easy bruising bleeding lightheadedness fainting signs of a lung infection such as fever cough trouble breathing difficult painful swallowing swelling of the hands feet sudden unexplained weight gain change in amount of urine symptoms of a low magnesium blood level such as unusually fast slow irregular heartbeat persistent muscle spasms seizures.This drug may rarely cause serious possibly fatal liver disease.Stop taking this medication and get medical help right away if you have any symptoms of liver damage including persistent nausea vomiting dark urine yellowing eyes skin.This medication may rarely cause a severe intestinal condition Clostridium difficile-associated diarrhea due to a type of bacteria.Do not use anti-diarrhea products or narcotic pain medications if you have any of the following symptoms because these products may make them worse.Tell your doctor right away if you develop persistent diarrhea abdominal or stomach pain cramping fever blood mucus in your stool.A very serious allergic reaction to this drug is rare.However get medical help right away if you notice any symptoms of a serious allergic reaction including rash blisters unexplained fever itching swelling especially of the face tongue throat severe dizziness trouble breathing.This is not a complete list of possible side effects.If you notice other effects not listed above contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects.You may report side effects to FDA at FDA-.In Canada Call your doctor for medical advice about side effects.You may report side effects to Health Canada at -.Missed dose If you miss a dose use it as soon as you remember.If it is near the time of the next dose skip the missed dose and resume your usual dosing schedule.Do not double the dose to catch up.Overdose If overdose is suspected contact a poison control center or emergency room immediately.US residents can call their local poison control center at -.Canada residents can call a provincial poison control center.Symptoms of overdose may include severe stomach pain coffee ground-like vomit trouble breathing extreme drowsiness loss of consciousness seizures.Notes Do not share this medication with others.Laboratory and or medical tests such as blood pressure complete blood count-CBC and magnesium liver and kidney function tests should be performed periodically to monitor your progress or check for side effects. VIMOVO vi-moh-voh naproxen and esomeprazole magnesium Delayed Release Tablets Read this Medication Guide before you start taking VIMOVO and each time you get a refill.There may be new information.This information does not take the place of talking with your healthcare provider about your medical condition or your treatment.What is the most important information I should know about VIMOVO. Vimovo co-developed y 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. First of all it is not known if Vimovo is safe or effective for children under years old.Also people who have had an asthma attack hives or other allergic reaction while taking aspirin or other NSAIDs should not take Vimovo.If you have known allergies to any ingredients in Vimovo or any proton pump inhibitor you should not take Vimovo.Vimovo should not be taken right before or after coronary bypass surgery.The drug is also not recommended for women in their third trimester of pregnancy.What common side effects and severe side effects can occur with Vimovo.



Vimovo webmd

31.05.2013, admin
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29.05.2013, admin
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26.05.2013, admin
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26.05.2013, admin
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23.05.2013, admin
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Can i take ibuprofen with vimovo

23.05.2013, admin
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21.05.2013, admin
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