Comparative Pharmacology
Head-to-head clinical analysis: NAPROSYN versus VIMOVO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NAPROSYN versus VIMOVO.
NAPROSYN vs VIMOVO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, thereby reducing prostaglandin synthesis. This results in decreased inflammation, pain, and fever.
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.
250-500 mg orally twice daily; maximum 1500 mg/day. For extended-release: 750-1000 mg orally once daily.
One tablet (naproxen 500 mg/esomeprazole 20 mg) orally twice daily.
None Documented
None Documented
Terminal elimination half-life is 12-17 hours. This long half-life allows twice-daily dosing, but may lead to drug accumulation in elderly or renally impaired patients.
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).
Renal excretion of conjugated metabolites accounts for approximately 95% of a dose, with 1-2% as unchanged naproxen. Fecal excretion is minimal (<5%).
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 C
Category C
NSAID
NSAID/PPI Combination