Indications 

Vimovo is a prescription medicine used to alleviate the symptoms of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis in adults, and juvenile idiopathic arthritis (JIA) in adolescents while reducing the risk of naproxen-induced stomach ulcers. 

Vimovo is a combination of naproxen, a nonsteroidal anti-inflammatory drug (NSAID), and esomeprazole magnesium, a proton pump inhibitor (PPI).  

Naproxen alleviates inflammation, pain, and fever by reducing certain substances in the body. On the other hand, esomeprazole functions by inhibiting stomach acid production. This dual action combines the advantages of naproxen while potentially lowering the risk of ulcers or bleeding associated with its use. 

Uses and Dosage 

Before taking Vimovo and with every prescription refill, carefully review the medication guide and patient information leaflet provided by your pharmacist. For any questions, do not hesitate to consult with your healthcare provider or pharmacist. 

The dosage of Vimovo is determined based on the patient’s medical condition and treatment response, considering weight in children. 

Typically, Vimovo is taken twice daily, in the morning and evening, at least 30 minutes prior to a meal as directed by the doctor. 

Ingest the tablet with a full glass of water without breaking, chewing, crushing, or dissolving it to maintain the slow release of the drug and minimize potential side effects.  

To maximize the effectiveness of Vimovo, take it consistently and at around the same times each day. 

To minimize the chance of stomach bleeding and other adverse reactions, take this medication at the lowest effective amount for the shortest duration possible. Do not exceed the prescribed dose, frequency, or duration of intake. 

Side Effects 

Listed below are the potential adverse effects of Vimovo. If any of these symptoms persist or worsen, promptly notify your doctor. 

Common Side Effects 

• Stomach discomfort 
• Diarrhea 

Serious Side Effects 

• Severe stomach pain or watery/bloody diarrhea 
• Bloody or tarry stools, coughing up blood, or vomit resembling coffee grounds 
• Heart-related issues:  
  • Swelling 
  • Rapid weight gain 
  • Shortness of breath 
• Kidney problems: 
  • Fever 
  • Rash 
  • Nausea 
  • Loss of appetite 
  • Joint pain 
  • Reduced urination 
  • Blood in urine 
  • Weight gain 
• Liver problems:  
  • Loss of appetite 
  • Upper right stomach pain 
  • Dark urine 
  • Jaundice (yellowing of skin/eyes) 
• Low magnesium symptoms: 
  • Dizziness 
  • Rapid/irregular heart rate 
  • Tremors 
  • Jitteriness 
  • Muscle cramps 
  • Hand/foot spasms 
  • Cough 
  • Choking sensation 
• Low red blood cell count (anemia):  
  • Pale skin 
  • Unusual fatigue 
  • Lightheadedness 
  • Shortness of breath 
  • Cold extremities 
• New or worsening lupus symptoms:  
  • Joint pain 
  • Skin rash on cheeks or arms worsening in sunlight 

Promptly contact your doctor should you experience any of the above-listed serious side effects. 

Seek immediate medical assistance if you experience severe skin reactions while using Vimovo, such as: 

• Fever 
• Sore throat 
• Burning eyes 
• Skin pain 
• Presence of a red or purple rash with blistering and peeling 

Stop taking Vimovo and seek immediate medical attention if you exhibit symptoms suggestive of a heart attack or stroke, including: 

• Chest pain radiating to the jaw or shoulder 
• Sudden numbness or weakness on one side of the body 
• Slurred speech 
• Breathlessness 

Allergic Reactions 

In rare instances, Vimovo may cause a severe allergic reaction. Promptly seek medical assistance upon observing any indications of an allergic reaction, including: 

• Hives 
• Sneezing 
• Runny or congested nose 
• Wheezing 
• Labored breathing 
• Facial or throat swelling 

Not all side effects of Vimovo are included in this list. Tell your doctor if any unlisted effects arise. 

Cautions 

Before starting treatment with Vimovo, inform your doctor if you have any known allergies, particularly to: 

• Naproxen 
• Esomeprazole magnesium 
• Aspirin 
• Other NSAIDs (e.g., ibuprofen, celecoxib) 
• Other proton-pump inhibitors (e.g., omeprazole, pantoprazole) 

Ask your pharmacist for more details about Vimovo, as it may contain inactive components that may cause allergic reactions or other complications. 

To ensure Vimovo is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Asthma (including worsened breathing with aspirin or NSAIDs) 
• Liver disease 
• Gastrointestinal issues (bleeding, ulcers, recurrent heartburn) 
• Heart disease (e.g., heart attack) 
• Hypertension (high blood pressure) 
• Stroke 
• Edema (swelling, fluid retention) 
• Low sodium levels in the blood 
• Blood disorders (anemia, bleeding/clotting problems) 
• Nasal polyps  
• Lupus 

Disclose all your medication usage, including prescription and over-the-counter drugs, vitamins, and herbal products to your healthcare providers to minimize the risk of drug interaction with Vimovo. 

Some of the products that may interact with Vimovo include: 

• Aliskiren 
• ACE inhibitors (e.g., captopril, lisinopril) 
• Angiotensin II receptor blockers (e.g., valsartan, losartan) 
• Corticosteroids (e.g., prednisone) 
• Lithium 
• Mavacamten 
• Methotrexate (particularly at high doses) 
• Rifampin 
• St. John’s Wort 
• Diuretics (e.g., furosemide) 

Vimovo can heighten the risk of bleeding when used alongside medications that may also induce bleeding, such as anti-platelet drugs like clopidogrel and blood thinners like dabigatran, enoxaparin, and warfarin. 

Esomeprazole reduces stomach acid, potentially affecting the absorption of certain products that require stomach acid for proper absorption. These products may include: 

• Atazanavir 
• Erlotinib 
• Levoketoconazole  
• Nelfinavir 
• Pazopanib 
• Rilpivirine 
• Sparsentan 
• Specific azole antifungals (itraconazole, ketoconazole, and posaconazole) 

Regardless of existing risk factors, naproxen may heighten the likelihood of a fatal heart attack or stroke. Refrain from using Vimovo before or after undergoing coronary artery bypass graft (CABG) surgery. 

Carefully review the labels of all your medications, as many contain pain relievers or fever reducers like aspirin or NSAIDs such as celecoxib, ibuprofen, or ketorolac. These drugs are similar to naproxen and may heighten the risk of side effects if used concurrently.  

However, if your doctor has prescribed low-dose aspirin (typically 81-162 milligrams per day) for heart attack or stroke prevention, continue taking it unless advised. Consistent naproxen use may diminish aspirin’s ability to prevent heart attack or stroke, so consult your doctor about the associated risks and benefits and inquire about alternative pain/fever relief medications. 

Inform laboratory personnel and healthcare providers about your use of Vimovo, as it can potentially interfere with certain lab tests and lead to inaccurate results. 

Prolonged use of Vimovo may lead to the development of fundic gland polyps in the stomach. Discuss this risk with your healthcare provider.  

Using Vimovo for over two years may lead to a vitamin B-12 deficiency. Discuss the management of this condition with your doctor if it arises. 

Pregnant individuals should only use Vimovo under the guidance of a healthcare professional. The use of NSAIDs during the final 20 weeks of pregnancy may lead to severe heart or kidney issues in the unborn child and potential pregnancy complications. 

Naproxen transfers to breast milk, while the passage of esomeprazole remains uncertain. Seek medical advice prior to breastfeeding.