Comparative Pharmacology
Head-to-head clinical analysis: MEFENAMIC ACID versus VIMOVO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MEFENAMIC ACID versus VIMOVO.
MEFENAMIC ACID vs VIMOVO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Reversible inhibition of cyclooxygenase (COX-1 and COX-2) leading to decreased prostaglandin synthesis; exhibits both central and peripheral analgesic effects.
VIMOVO (esomeprazole and naproxen) is a fixed-dose combination. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), decreasing prostaglandin synthesis, thereby reducing inflammation, pain, and fever. Esomeprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by inhibiting the H+/K+ ATPase in gastric parietal cells. The combination is intended to reduce the risk of NSAID-associated gastric ulcers.
500 mg orally as an initial dose, followed by 250 mg every 6 hours as needed, not to exceed 1 week.
One tablet (naproxen 500 mg/esomeprazole 20 mg) orally twice daily.
None Documented
None Documented
Clinical Note
moderateMefenamic acid + Gatifloxacin
"Mefenamic acid may increase the neuroexcitatory activities of Gatifloxacin."
Clinical Note
moderateMefenamic acid + Rosoxacin
"Mefenamic acid may increase the neuroexcitatory activities of Rosoxacin."
Clinical Note
moderateMefenamic acid + Levofloxacin
"Mefenamic acid may increase the neuroexcitatory activities of Levofloxacin."
Clinical Note
moderateMefenamic acid + Trovafloxacin
Terminal half-life is 2-4 hours; prolonged in hepatic impairment and overdose.
Naproxen: 12-17 hours (prolonged in elderly and renal impairment; dosing interval typically 12 hours). Esomeprazole: 1-1.5 hours (metabolized by CYP2C19 and CYP3A4; no accumulation after repeated dosing).
Primarily renal (52% as glucuronide metabolites, <6% unchanged) and fecal (20-30% via biliary elimination).
Renal 50% as naproxen metabolites, <1% unchanged naproxen; less than 1% excreted unchanged in feces as esomeprazole; esomeprazole metabolites excreted in urine 80% and feces 20%.
Category D/X
Category C
NSAID
NSAID/PPI Combination
"Mefenamic acid may increase the neuroexcitatory activities of Trovafloxacin."