Drug
Naproxen-Esomeprazole Mag
Pronounced
"na-PROX-en/ES-oh-MEP-ra-zole"
Drug Interactions
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as valsartan, losartan), corticosteroids (such as prednisone), lithium, mavacamten, methotrexate (especially high-dose treatment), rifampin, St John's wort, "water pills" (diuretics such as furosemide).
This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.
Some products need stomach acid so that the body can absorb them properly. Esomeprazole decreases stomach acid, so it may change how well these products work. Some affected products include atazanavir, erlotinib, levoketoconazole, nelfinavir, pazopanib, rilpivirine, sparsentan, certain azole antifungals (itraconazole, ketoconazole, posaconazole), among others.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to naproxen and may increase your risk of side effects if taken together. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Daily use of naproxen may decrease aspirin's ability to prevent heart attack/stroke. Talk with your doctor about the risks and benefits. Ask about other medications that can be used to treat pain/fever.
This medication may interfere with certain lab tests, possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
Negative Interactions
2- Potential Negative Interaction
Naproxen
Sodium
Naproxen may cause sodium and water retention. It is healthful to reduce dietary salt intake by decreasing the use of table salt and avoiding heavily salted foods.
SodiumNaproxen- Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 251n-1o.
- Potential Negative Interaction
Naproxen
White Willow
White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs. Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.
White WillowNaproxen- Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172-90.
Supportive Interactions
13- Replenish Depleted Nutrients
Naproxen-Esomeprazole Mag
Calcium
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but did not alter the concentration of vitamin D. One controlled study showed that flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones. Further research is needed to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy people.
CalciumNaproxen-Esomeprazole Mag- Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
- Replenish Depleted Nutrients
Esomeprazole
Calcium
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
In a study of elderly women, administration of omeprazole decreased the absorption of calcium, presumably because the drug decreased the stomach's production of hydrochloric acid, which is necessary for calcium absorption. The form of calcium used in the study to test calcium absorption was calcium carbonate. Drugs that reduce stomach acid secretion may not inhibit other forms of calcium, such as calcium citrate.
CalciumEsomeprazole- O'Connell MB, Madden DM, Murray AM, et al. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 2005;118:778-81.
- Recker RR. Calcium absorption and achlorhydria. N Engl J Med 1985;313:70-3.
- Replenish Depleted Nutrients
Naproxen-Esomeprazole Mag
Folic Acid
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Indomethacin has been reported to decrease absorption of folic acid and vitamin C. Under certain circumstances, indomethacin may interfere with the actions of vitamin C.Calcium and phosphate levels may also be reduced with indomethacin therapy. It remains unclear whether people taking this drug need to supplement any of these nutrients.
Folic AcidNaproxen-Esomeprazole Mag- Hodges R. Nutrition in Medical Practice. Philadelphia: W. B. Saunders, 1980, 323-31 [review].
- Ogilvy CS, DuBois AB, Douglas JS. Effects of ascorbic acid and indomethacin on the airways of healthy male subjects with and without induced bronchoconstriction. J Allergy Clin Immunol 1981;67:363-9.
- Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138,140.
- Replenish Depleted Nutrients
Naproxen
Iron
NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and naproxen are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.
IronNaproxen- Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
- Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.
- Replenish Depleted Nutrients
Naproxen-Esomeprazole Mag
Iron
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.
IronNaproxen-Esomeprazole Mag- Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
- Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.
- Replenish Depleted Nutrients
Esomeprazole
Magnesium
In a case report, a man developed severe magnesium deficiency after long-term treatment with a proton pump inhibitor (pantoprazole or lansoprazole). Severe magnesium deficiency as a result of the use of proton pump inhibitors appears to be rare among people who have no other risk factors for magnesium deficiency. However, in a study of hospitalized patients, the prevalence of low serum magnesium levels was significantly greater among users of proton pump inhibitors than among nonusers (23% vs. 11%). People taking proton pump inhibitors (PPIs) should ask their doctor whether to take a magnesium supplement or whether to have their magnesium levels monitored.MagnesiumEsomeprazole- Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia during long-term treatment with a proton pump inhibitor. Am J Kidney Dis 2010;56:168-74.
- Gau JT, Yang YX, Chen R, Kao TC. Uses of proton pump inhibitors and hypomagnesemia. Pharmacoepidemiol Drug Saf 2012;21:553-9.
- FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs). U.S. Food and Drug Administration [cited 2011 Sept 13]. Available from URL: http://www.fda.gov/drugs/drugsafety/ucm245011.htm#Additional_Information_for_Patients on.
- Replenish Depleted Nutrients
Esomeprazole
Vitamin C
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Treatment of healthy volunteers with omeprazole for four weeks resulted in a 12.3% decrease in blood levels of vitamin C.
Vitamin CEsomeprazole- Henry EB, Carswell A, Wirz A, et al. Proton pump inhibitors reduce the bioavailability of dietary vitamin C. Aliment Pharmacol Ther2005;22:539-5.
- Replenish Depleted Nutrients
Naproxen-Esomeprazole Mag
Vitamin D
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but did not alter the concentration of vitamin D. One controlled study showed that flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones. Further research is needed to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy people.
Vitamin DNaproxen-Esomeprazole Mag- Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
- Support Medicine
Naproxen
Stinging Nettle
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
Stinging NettleNaproxen- Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.
- Support Medicine
Naproxen-Esomeprazole Mag
Stinging Nettle
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
Stinging NettleNaproxen-Esomeprazole Mag- Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.
- Reduce Side Effects
Naproxen
Licorice
The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.
LicoriceNaproxen- Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
- Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.
- Reduce Side Effects
Naproxen-Esomeprazole Mag
Licorice
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.
LicoriceNaproxen-Esomeprazole Mag- Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
- Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.
- Reduce Side Effects
Naproxen-Esomeprazole Mag
N-Acetyl Cysteine
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Nonsteroidal anti-inflammatory drugs commonly cause damage to stomach and intestinal tissue. Though the mechanism by which NSAIDs cause this side effect is unknown, some researchers believe that free-radical damage is involved. A test tube study showed that flurbiprofen increases free-radical activity in stomach cells, which is blocked by the antioxidant N-acetyl cysteine. Additional research is needed to determine whether people taking flurbiprofen together with N-acetyl cysteine might experience fewer gastrointestinal side effects.
N-Acetyl CysteineNaproxen-Esomeprazole Mag- Kusuhara H, Komatsu H, Sumichika H, Sugahara K. Reactive oxygen species are involved in the apoptosis induced by nonsteroidal anti-inflammatory drugs in cultured gastric cells. Eur J Pharmacol 1999;383:331-7.
Explanation Required
3- Needs Explanation
Naproxen
Copper
Supplementation with copper may enhance the anti-inflammatory effects of NSAIDs while reducing their ulcerogenic effects. One study found that when various anti-inflammatory drugs were chelated with copper, the anti-inflammatory activity was increased. Animal models of inflammation have found that the copper chelate of aspirin was active at one-eighth the effective dose of aspirin. These copper complexes are less toxic than the parent compounds, as well.
CopperNaproxen- Sorenson JRJ. Copper chelates as possible active forms of the antiarthritic agents. J Medicinal Chem 1976;19:135-48.
- Needs Explanation
Naproxen-Esomeprazole Mag
Folic Acid
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Piroxicam may prevent inflammation by blocking the activity of enzymes that depend on folic acid. However, other studies show that people taking NSAIDs such as aspirin have lower than normal levels of folic acid in their red blood cells. Further research is needed to determine whether supplemental folic acid prevents a deficiency of the vitamin or indirectly reduces the beneficial effects of piroxicam.
Folic AcidNaproxen-Esomeprazole Mag- Baggott JE, Morgan SL, Ha T, et al. Inhibition of folate-dependent enzymes by non-steroidal anti-inflammatory drugs. Biochem J 1992;282:197-202.
- Alter HJ, Zvaifler MJ, Rath CE. Interrelationship of rheumatoid arthritis, folic acid and aspirin. Blood 1971;38:405-16.
- Needs Explanation
Naproxen
Potassium
Naproxen has caused kidney problems and increased blood potassium levels, especially in older people. People taking naproxen should not supplement potassium without consulting with their doctor.
PotassiumNaproxen- Bailie GR. Acute renal failure. In Applied Therapeutics: The Clinical Use of Drugs, 6th ed. Vancouver, WA: Applied Therapeutics, 1995, 29-33.
- Perazella MA. Drug-induced hyperkalemia: Old culprits and new offenders. Am J Med 2000;109:307-14 [review].