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NSAID + PPI

Naproxen with esomeprazole

Brand names: Vimovo

Adult dose

Dose: 500/20mg BD
Route: PO
Frequency: BD

Clinical pearls

  • Patients requiring NSAID with high upper-GI risk; OA, RA, AS
  • Step down PPI when NSAID stopped

Contraindications

  • Active GI bleeding/peptic ulcer
  • Severe heart failure
  • Severe renal impairment
  • Aspirin/NSAID hypersensitivity
  • 3rd trimester pregnancy

Side effects

  • GI upset (lower GI risk than naproxen alone — not zero)
  • Cardiovascular events
  • Renal impairment
  • Long-term PPI effects

Interactions

  • Anticoagulants
  • ACEi/ARB
  • Lithium
  • Methotrexate
  • Clopidogrel (esomeprazole interaction — minor)

Monitoring

  • U&E
  • FBC
  • BP

Reference: BNF; NICE CG177; https://bnf.nice.org.uk/drugs/naproxen-with-esomeprazole/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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