esomeprazole + naproxen at a glance
Medicine class
A non-steroidal anti-inflammatory drug combined with a proton pump inhibitor.
Licensed role
Symptom relief in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis when gastrointestinal protection is needed.
Administration
Swallow the modified-release tablet whole with water before food; do not split, chew or crush it.
Important limitation
Delayed naproxen release means it is unsuitable for rapid relief of acute pain.
What is esomeprazole + naproxen used for?
Licensed use is restricted to adults who need anti-inflammatory symptom control and are at risk of NSAID-associated stomach or duodenal ulcers.
Osteoarthritis
Rheumatoid arthritis
Ankylosing spondylitis
How does esomeprazole + naproxen work?
Naproxen reduces prostaglandin production, easing inflammation and pain. Esomeprazole blocks the stomach’s acid pump. The tablet releases esomeprazole first in the stomach, while its gastro-resistant naproxen core dissolves later in the small intestine. This reduces, but does not remove, gastrointestinal risk.
esomeprazole + naproxen preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 500 mg + 20 mg
How to take esomeprazole + naproxen
Follow the prescription label. Take the tablet before food and swallow it whole with water to preserve its sequential-release design.
Do not split, chew or crush the tablet.
Do not substitute separate naproxen or esomeprazole products without prescriber or pharmacist advice.
Check before using non-prescription painkillers because many contain another NSAID.
esomeprazole + naproxen side effects
Common or expected effects
- Indigestion, abdominal pain or wind
- Nausea or vomiting
- Diarrhoea or constipation
- Headache or dizziness
- Skin rash
- Raised blood pressure or ankle swelling
Get urgent medical advice
- Stomach or intestinal ulceration, bleeding or perforation
- Severe allergic reaction or NSAID-related bronchospasm
- Kidney injury, including tubulointerstitial nephritis
- Heart attack, stroke or worsening heart failure
- Serious blistering skin reactions or DRESS
- Hepatitis, jaundice or liver failure
esomeprazole + naproxen in pregnancy
Avoid this combination during pregnancy unless a clinician decides it is necessary. NSAID exposure from 20 weeks can affect fetal kidney function and amniotic fluid, and the product is contraindicated in the third trimester. Exposure after 20 weeks may require specialist antenatal assessment.
esomeprazole + naproxen while breastfeeding
The product-specific information says this fixed combination should not be used while breastfeeding. Naproxen enters milk in small amounts but is not usually preferred. Discuss an alternative anti-inflammatory with the prescriber.
esomeprazole + naproxen interactions
Check all prescribed, non-prescription and herbal products before treatment. Important interactions include:
Other NSAIDs, including ibuprofen and COX-2 inhibitors
Combining them increases gastrointestinal, kidney and other NSAID-related risks and should be avoided.
Warfarin, heparins and other anticoagulants
Bleeding risk can increase; warfarin may require closer INR monitoring.
Clopidogrel
Esomeprazole can reduce formation of clopidogrel’s active metabolite, so concomitant use is discouraged.
Common questions about esomeprazole + naproxen
Answers are fully visible for fast scanning and source review.
Why are esomeprazole and naproxen combined?
Naproxen reduces pain and inflammation, while esomeprazole suppresses stomach acid to reduce upper gastrointestinal injury associated with naproxen.
Does esomeprazole completely prevent naproxen stomach ulcers?
No. It reduces the risk, but ulcers, bleeding and perforation can still occur.
Can it be used for sudden pain?
It is not intended for rapid relief because naproxen is released after a delay.
Can the tablets be crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.