Contraindicated in:
Use Cautiously in:
CNS: dizziness, drowsiness, headache.
CV: HF, MYOCARDIAL INFARCTION, STROKE, edema, hypertension, palpitations.
Derm: DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, photosensitivity, rash, sweating.
EENT: tinnitus, visual disturbances.
F and E: hyperkalemia.
GI: DRUG-INDUCED HEPATITIS, GI BLEEDING, constipation, dyspepsia, nausea, abdominal pain, anorexia, diarrhea, dry mouth, flatulence, vomiting.
GU: cystitis, hematuria, renal failure.
Hemat: blood dyscrasias, prolonged bleeding time.
MS: bone fracture.
Resp: dyspnea.
Drug-Drug:
(Generic available)
Therapeutic Classification: antirheumatics, nonopioid analgesics, antiulcer agents
Pharmacologic Classification: benzimidazoles, nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors
Naproxen
Absorption: Completely absorbed from the GI tract.
Distribution: Crosses the placenta; enters breast milk in low concentrations.
Protein Binding: >99%.
Metabolism/Excretion: Mostly metabolized by the liver.
Half-life: 1020 hr.
Esomeprazole
Absorption: 90% absorbed following oral administration; food ↓ absorption.
Distribution: Unknown.
Protein Binding: 97%.
Metabolism/Excretion: Extensively metabolized by the liver (primarily by the CYP2C19 isoenzyme, but also the CYP3A4 isoenzyme) (the CYP2C19 enzyme system exhibits genetic polymorphism; 1520% of Asian patients and 35% of Caucasian and Black patients may be poor metabolizers and may have significantly ↑ esomeprazole concentrations and an ↑ risk of adverse effects); <1% excreted unchanged in urine.
Half-life: 1.01.5 hr.
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
Esomeprazole (blood levels) | rapid | 1.6 hr | 24 hr |
Naproxen (analgesia) | 1 hr | unknown | 812 hr |
Naproxen (anti-inflammatory | 14 days | 24 wk | unknown |