Comparative Pharmacology
Head-to-head clinical analysis: MELOXICAM versus VIMOVO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MELOXICAM versus VIMOVO.
MELOXICAM vs VIMOVO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selective inhibitor of cyclooxygenase-2 (COX-2), reducing prostaglandin synthesis and inflammation.
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.
7.5-15 mg orally once daily; maximum 15 mg/day. For osteoarthritis, rheumatoid arthritis: 7.5 mg once daily, may increase to 15 mg/day if needed. For juvenile rheumatoid arthritis, weight-based dosing.
One tablet (naproxen 500 mg/esomeprazole 20 mg) orally twice daily.
None Documented
None Documented
Clinical Note
moderateMeloxicam + Gatifloxacin
"Meloxicam may increase the neuroexcitatory activities of Gatifloxacin."
Clinical Note
moderateMeloxicam + Rosoxacin
"Meloxicam may increase the neuroexcitatory activities of Rosoxacin."
Clinical Note
moderateMeloxicam + Levofloxacin
"Meloxicam may increase the neuroexcitatory activities of Levofloxacin."
Clinical Note
moderateMeloxicam + Trovafloxacin
"Meloxicam may increase the neuroexcitatory activities of Trovafloxacin."
Terminal elimination half-life: 15–20 hours. Clinical context: Allows once-daily dosing; steady-state achieved in 3–5 days.
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).
Approximately 50% renal excretion of unchanged drug and metabolites; 50% fecal excretion via bile. Renal elimination accounts for ~5% unchanged meloxicam; the remainder as metabolites (primarily oxidative and glucuronide conjugates).
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