Vimovo Dosage, forms & strengths

Vimovo (esomeprazole/naproxen) is a combination of a nonsteroidal anti-inflammatory drug (naproxen) and a proton pump inhibitor (esomeprazole magnesium). It is indicated by the U.S. Food and Drug Administration (FDA) to treat adults with inflammatory diseases such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis while protecting the stomach from naproxen-induced ulcers. It is also used to treat juvenile idiopathic arthritis (JIA) in patients 12 years of age and older that weigh at least 38kg (84lbs). Vimovo should not be used as the initial treatment for acute pain.

How does Vimovo work?

The naproxen component of Vimovo is an NSAID that inhibits cyclooxygenase (COX-1 and COX-2). It is a potent inhibitor in the synthesis of prostaglandins, which play a key role in your body’s inflammatory response.

Esomeprazole is a proton pump inhibitor (PPI) that blocks gastric acid production by binding to and inhibiting the hydrogen-potassium ATPase pump (proton pump) that resides on the parietal cells in the stomach. PPIs like esomeprazole are the most potent inhibitors of acid secretion available.

Vimovo dosage forms and strengths

• 375mg enteric-coated naproxen /20mg immediate-release esomeprazole
• 500mg enteric-coated naproxen /20mg immediate-release esomeprazole

Vimovo dosage

Vimovo should be dosed using the lowest naproxen dose for the shortest duration possible to achieve your treatment goals. If the total daily dose of esomeprazole needed is less than 40mg, your doctor should consider a different treatment.

Vimovo adult dosage

Indication

Recommended Dosage

Rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis

1 tablet of 375mg naproxen/20mg esomeprazole or 500mg naproxen/20mg esomeprazole by mouth twice daily at least 30 minutes before meals.

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Vimovo pediatric dosage chart

table

Indication

Weight

Starting dosage

Juvenile idiopathic arthritis in patients 12 years of age and older

38kg to less than 50kg

1 tablet of 375mg naproxen/20mg esomeprazole by mouth twice daily at least 30 minutes before meals.

Juvenile idiopathic arthritis in patients 12 years of age and older

Greater than 50kg

1 tablet of 375mg naproxen/20mg esomeprazole or 500mg naproxen/20mg esomeprazole by mouth twice daily at least 30 minutes before meals.

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Vimovo dosage restrictions

• Avoid Vimovo use if you have moderate to severe renal (kidney) impairment.
• Consider a dose reduction based on the naproxen component of Vimovo if you have mild to moderate hepatic (liver) impairment.
• Avoid Vimovo use if you have severe hepatic (liver) impairment.

How to take Vimovo

• Read the Full Prescribing Information, Patient Information, Instructions for Use, and Medication Guide that comes with your prescription.
• Take Vimovo exactly as prescribed by your doctor.
• Take 1 Vimovo tablet 2 times each day at least 30 minutes before a meal. You should swallow the Vimovo tablet whole. Do not cut, chew, or crush the Vimovo tablet. You can take antacids such as Tums (calcium carbonate) with Vimovo.
• If you forget a dose of Vimovo, take it right away. If it’s almost time for your next dose, do not take the missed dose. Skip it and take your next dose at its regular time. Do not take extra doses to make up for a missed dose.

Vimovo dosage FAQs

What are the most common side effects of Vimovo?

The most common adverse effects of Vimovo include:

• Stomach pain
• Diarrhea
• Indigestion
• Nausea
• Gas
• Heartburn
• Drowsiness
• Constipation
• Headache
• Muscle spasms
• Lightheadedness

Sometimes Vimovo can cause more serious side effects, including:

• Severe allergic reaction (hives, angioedema, and shortness of breath)
• Chest pain
• Heart failure (swelling of the ankles/feet, unusual fatigue, unexplained weight gain)
• Lupus (butterfly rash on nose and cheeks, new or worsening joint pain)
• Increased risk of heart attack or stroke
• Stomach ulcers or gastrointestinal bleeding
• Liver or kidney impairment
• Increased risk of osteoporosis-related bone fractures
• Severe skin reaction (hives, peeling, or blistering) or skin rash
• Long-term use of high-dose Vimovo may also cause vitamin B-12 deficiency, low magnesium levels, or polyps

Contact your healthcare provider for medical advice about any adverse effects you experience while taking Vimovo. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What drug interactions occur with Vimovo?

When Vimovo is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. Discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:

• Diuretics (furosemide)
• Corticosteroids (prednisone)
• St. John’s Wort
• Warfarin
• Clopidogrel
• Cyclosporine
• Antiretrovirals (rilpivirine, atazanavir, erlotinib, or nelfinavir)
• SSRIs (sertraline)
• ACE inhibitors (enalapril)
• ARBs (valsartan)
• Beta-blockers (atenolol)
• Tacrolimus
• Digoxin
• Diazepam
• Lithium
• Ketoconazole
• Methotrexate
• Rifampin

Are there any contraindications or precautions with Vimovo?

Vimovo should not be taken by patients:

• with a known allergy to naproxen, esomeprazole, omeprazole, or any other ingredients in Vimovo.
• with a history of asthma or other allergic-like reactions to aspirin or other NSAIDs.
• with severe heart failure.
• undergoing coronary artery bypass graft (CABG) surgery.
• who are taking rilpivirine-containing products.

Caution should be used in the following conditions:

• Liver problems such as jaundice (yellowing of the skin or eyes)
• Kidney problems
• Heart disease or high blood pressure
• Asthma
• Low electrolyte levels
• Ulcerative colitis
• Crohn’s disease or inflammatory bowel disease
• Cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE)
• Anemia
• Active GI bleed (vomiting blood or vomit that looks like coffee grounds or black, tarry stools)
• Are pregnant or plan on becoming pregnant

Can you take Vimovo while you are pregnant or during lactation?

Vimovo use should be avoided if you are in the third trimester of pregnancy as it may harm your fetus. It should be also used with extreme caution between the second and third trimesters. If it must be used during this time, use it at the lowest effective dose for the shortest duration possible.

Naproxen is known to be excreted in breast milk so its use during lactation is not recommended. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

Who should not take Vimovo?

You should not take Vimovo if you have an allergy to any of the ingredients in Vimovo or omeprazole. You should also avoid this medication if you have asthma, severe heart failure, are undergoing CABG surgery, or are taking rilpivirine-containing products.

Does Vimovo affect your blood pressure?

Because of the naproxen in Vimovo, it may raise your blood pressure. You should check your blood pressure regularly and notify your doctor if the readings are high.

Related resources for Vimovo dosage:

• https://reference.medscape.com/drug/vimovo-esomeprazole-naproxen-999561
• https://www.hzndocs.com/VIMOVO-Medication-Guide.pdf
• https://www.hzndocs.com/VIMOVO-Patient-Information.pdf
• https://www.pdr.net/drug-summary/Vimovo-esomeprazole-magnesium-naproxen-2319
• https://www.drugs.com/vimovo.html
• https://www.webmd.com/search/search_results/default.aspx?query=vimovo

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