What is the most important information I should know about naproxen and esomeprazole magnesium delayed-release tablets?
You should take naproxen and esomeprazole magnesium delayed-release tablets exactly as prescribed, at the lowest dose possible and for the shortest time needed. Naproxen and esomeprazole magnesium delayed-release tablets may help your acid-related symptoms, but you could still have serious stomach problems. Talk with your healthcare provider.
 
Naproxen and esomeprazole magnesium delayed-release tablets contain naproxen, a nonsteroidal anti-inflammatory drug (NSAID) and esomeprazole magnesium, a proton pump inhibitor (PPI) medicine.
Naproxen and esomeprazole magnesium delayed-release tablets can cause serious side effects including:

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Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase:

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with increasing doses of NSAIDs

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with longer use of NSAIDs

Do not take naproxen and esomeprazole magnesium delayed-release tablets right before or after a heart surgery called a “coronary artery bypass graft (CABG).” Avoid taking naproxen and esomeprazole magnesium delayed-release tablets after a recent heart attack, unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.

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Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines:

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anytime during use

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without warning symptoms

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that may cause death

The risk of getting an ulcer or bleeding increases with:

Talk to your healthcare provider or pharmacist before using other medicines that contain NSAIDs, including low-dose aspirin, during treatment with naproxen and esomeprazole magnesium delayed-release tablets. Some NSAIDs are sold in lower doses without a prescription (over-the-counter).

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A type of kidney problem (acute tubulointerstitial nephritis). Some people who take proton pump inhibitor (PPI) medicines, including naproxen and esomeprazole magnesium delayed-release tablets, may develop a kidney problem called acute tubulointerstitial nephritis that can happen at any time during treatment with naproxen and esomeprazole magnesium delayed-release tablets. Call your healthcare provider right away if you have a decrease in the amount that you urinate or if you have blood in your urine.

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Diarrhea caused by an infection (Clostridium difficile) in your intestines. Call your healthcare provider right away if you have watery stools or stomach pain that does not go away. You may or may not have a fever.

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Bone fractures (hip, wrist, or spine). Bone fractures in the hip, wrist, or spine may happen in people who take multiple daily doses of PPI medicines and for a long period of time (a year or longer). Tell your healthcare provider if you have a bone fracture, especially in the hip, wrist, or spine.

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Certain types of lupus erythematosus. Lupus erythematosus is an autoimmune disorder (the body’s immune cells attack other cells or organs in the body). Some people who take PPI medicines, including naproxen and esomeprazole magnesium delayed-release tablets, may develop certain types of lupus erythematosus or have worsening of the lupus they already have. Call your healthcare provider right away if you have new or worsening joint pain or a rash on your cheeks or arms that gets worse in the sun.

Talk to your healthcare provider about your risk of these serious side effects.
Naproxen and esomeprazole magnesium delayed-release tablets can have other serious side effects. See “What are the possible side effects of naproxen and esomeprazole magnesium delayed-release tablets?”

What is naproxen and esomeprazole magnesium delayed-release tablets?
Naproxen and esomeprazole magnesium delayed-release tablet is a prescription medicine used in adults and adolescents, 12 years of age and older who weigh at least 84 pounds (38 kg), who need to take naproxen for relief of symptoms of arthritis and who also need to decrease the risk of developing stomach ulcers caused by naproxen.
The naproxen in naproxen and esomeprazole magnesium delayed-release tablets is used for the relief of signs and symptoms of:

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osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis in adults

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juvenile idiopathic arthritis (JIA) in adolescents

The esomeprazole magnesium in naproxen and esomeprazole magnesium delayed-release tablets is used to:

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decrease the risk of developing stomach ulcers in people who are taking naproxen

It is not known if naproxen and esomeprazole magnesium delayed-release tablets are safe and effective in children less than 12 years of age or who weigh less than 84 pounds (38 kg).
 
You should not take a naproxen tablet and an esomeprazole magnesium tablet together instead of taking naproxen and esomeprazole magnesium delayed-release tablets, because they will not work the same way.
Studies in people who take naproxen and esomeprazole magnesium delayed-release tablets have not extended past 6 months.

Do not take naproxen and esomeprazole magnesium delayed-release tablets:

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if you are allergic to naproxen, esomeprazole magnesium, omeprazole, any other PPI medicine, or any of the ingredients in naproxen and esomeprazole magnesium delayed-release tablets. See the end of this Medication Guide for a complete list of ingredients in naproxen and esomeprazole magnesium delayed-release tablets.

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if you have had an asthma attack, hives, or other allergic reaction after taking aspirin or any other NSAIDs.

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right before or after heart bypass surgery.

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if you are taking a medicine that contains rilpivirine (Edurant, Complera, Odefsey) used to treat HIV-1 (Human Immunodeficiency Virus).

Before taking naproxen and esomeprazole magnesium delayed-release tablets, tell your healthcare provider about all of your medical conditions, including if you:

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have liver, kidney, or heart problems.

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have high blood pressure.

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have asthma.

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have low magnesium levels, low calcium levels and low potassium levels in your blood.

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have ulcerative colitis or Crohn’s disease (inflammatory bowel disease or IBD).

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are pregnant or plan to become pregnant. Taking naproxen and esomeprazole magnesium delayed-release tablets at about 20 weeks of pregnancy or later may harm your unborn baby. If you need to take naproxen and esomeprazole magnesium delayed-release tablets for more than 2 days when you are between 20 weeks and 30 weeks of pregnancy, your healthcare provider may need to monitor the amount of fluid in your womb around your baby. You should not take naproxen and esomeprazole magnesium delayed-release tablets after about 30 weeks of pregnancy.

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are breastfeeding or plan to breastfeed. The naproxen in naproxen and esomeprazole magnesium delayed-release tablets can pass into your breast milk. It is not known if naproxen and esomeprazole magnesium delayed-release tablets will harm your baby. Talk to your healthcare provider about the best way to feed your baby if you take naproxen and esomeprazole magnesium delayed-release tablets.

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 are a female who can become pregnant. Naproxen and esomeprazole magnesium delayed-release tablets may be related to infertility in some women that is reversible when treatment with naproxen and esomeprazole magnesium delayed-release tablets are stopped.

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Naproxen and esomeprazole magnesium delayed-release tablets and some other medicines can interact with each other and cause serious side effects. Do not start taking any new medicine without talking to your healthcare provider first. Especially tell your healthcare provider if you take:

•  steroid hormones (corticosteroids)
•  St. John’s Wort
•  rifampin (Rifater, Rifamate, Rimactane, Rifadin)
•  medicine for high blood pressure or heart problems
•  a water pill (diuretic)
•  aspirin
• antidepressant medicine
• medicine used to reduce the risk of blood clots, such as warfarin (Coumadin, Jantoven)
• methotrexate (Otrexup, Rasuvo, Trexall, Xatmep)
• digoxin (Lanoxin)
• clopidogrel (Plavix)

How should I take naproxen and esomeprazole magnesium delayed-release tablets?

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Take naproxen and esomeprazole magnesium delayed-release tablets exactly as prescribed by your healthcare provider.

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Take 1 naproxen and esomeprazole magnesium delayed-release tablet 2 times each day.

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Take naproxen and esomeprazole magnesium delayed-release tablets at least 30 minutes before a meal.

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Swallow naproxen and esomeprazole magnesium delayed-release tablets whole with liquid. Do not split, chew, crush or dissolve naproxen and esomeprazole magnesium delayed-release tablets.

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You may use antacids while taking naproxen and esomeprazole magnesium delayed-release tablets.

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If you forget to take your dose of naproxen and esomeprazole magnesium delayed-release tablets, take it as soon as you remember. If it is almost time for your next dose, do not take the missed dose. Take the next dose on time. Do not take 2 doses at one time to make up for a missed dose.

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If you take too much naproxen and esomeprazole magnesium delayed-release tablets, call your healthcare provider or your poison control center at 1-800-222-1222 right away or go to the nearest emergency room.

What are the possible side effects of naproxen and esomeprazole magnesium delayed-release tablets?
Naproxen and esomeprazole magnesium delayed-release tablets can cause serious side effects, including:
See “What is the most important information I should know about naproxen and esomeprazole magnesium delayed-release tablets?”

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liver problems, including liver failure.

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new or worsening high blood pressure.

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heart failure.

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kidney problems, including kidney failure.

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life-threatening allergic reactions.

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asthma attacks in people who have asthma.

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life-threatening skin reactions.

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low red blood cells (anemia).

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hiding (masking) symptoms of an infection, such as swelling and fever.

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Low vitamin B-12 levels in your body can happen in people who have taken naproxen and esomeprazole magnesium delayed-release tablets for a long time (more than 3 years). Tell your healthcare provider if you have symptoms of low vitamin B-12 levels, including shortness of breath, lightheadedness, irregular heartbeat, muscle weakness, pale skin, feeling tired, mood changes, and tingling or numbness in the arms or legs.

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Low magnesium levels in your body can happen in people who have taken naproxen and esomeprazole magnesium delayed-release tablets for at least 3 months. Tell your healthcare provider if you have symptoms of low magnesium levels, including seizures, dizziness, irregular heartbeat, jitteriness, muscle aches or weakness, and spasms of hands, feet or voice.

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Stomach growths (fundic gland polyps) People who take PPI medicines for a long time have an increased risk of developing a certain type of stomach growths called fundic gland polyps, especially after taking PPI medicines for more than 1 year.

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Severe skin reactions. Naproxen and esomeprazole magnesium delayed-release tablets can cause rare but severe skin reactions that may affect any part of your body. These serious skin reactions may need to be treated in a hospital and may be life threatening:

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Skin rash which may have blistering, peeling or bleeding on any part of your skin (including your lips, eyes, mouth, nose, genitals, hands or feet).

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You may also have fever, chills, body aches, shortness of breath, or enlarged lymph nodes.

Stop taking naproxen and esomeprazole magnesium delayed-release tablets and call your doctor right away. These symptoms may be the first sign of a severe skin reaction.  
The most common side effects of naproxen and esomeprazole magnesium delayed-release tablets include: inflammation of the lining of the stomach and diarrhea
Get emergency help right away if you get any of the following symptoms:
 

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shortness of breath or trouble breathing

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chest pain

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weakness in one part or side of your body

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slurred speech

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swelling of the face or throat

Stop taking naproxen and esomeprazole magnesium delayed-release tablets and call your healthcare provider right away if you get any of the following symptoms:

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nausea

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more tired or weaker than usual

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diarrhea

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itching

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your skin or eyes look yellow

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indigestion or stomach pain

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flu-like symptoms

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vomit blood

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there is blood in your bowel movement or it is black and sticky like tar

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unusual weight gain

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skin rash or blisters with fever

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swelling of the arms, legs, hands, and feet

If you take too much naproxen and esomeprazole magnesium delayed-release tablets, call your healthcare provider or get medical help right away.  
These are not all the possible side effects of naproxen and esomeprazole magnesium delayed-release tablets. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store naproxen and esomeprazole magnesium delayed-release tablets?

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Store naproxen and esomeprazole magnesium delayed-release tablets at room temperature between 68ºF to 77ºF (20ºC to 25ºC).

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 Store naproxen and esomeprazole magnesium delayed-release tablets in the original container.

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Keep the bottle of naproxen and esomeprazole magnesium delayed-release tablets tightly closed to protect from moisture.

Keep naproxen and esomeprazole magnesium delayed-release tablets and all medicines out of the reach of children.

What are the ingredients in naproxen and esomeprazole magnesium delayed-release tablets?
Active ingredients: naproxen and esomeprazole magnesium
Inactive ingredients: microcrystalline cellulose, croscarmellose sodium, povidone, colloidal silicon dioxide, magnesium stearate, methacrylic acid and ethyl acrylate copolymer, talc, triethy citrate, hypromellose, macrogol, sodium lauryl sulfate, magnesium oxide, polyethylene glycol, ferric oxide yellow. The imprinting ink contains shellac glaze, black iron oxide, propylene glycol, ammonium hydroxide.