Naproxen/esomeprazole (By mouth)


Esomeprazole Magnesium (es-oh-MEP-ra-zole mag-NEE-zee-um), Naproxen (na-PROX-en)

Treats pain caused by arthritis or ankylosing spondylitis. This medicine is a combination of a nonsteroidal anti-inflammatory drug (NSAID) and a proton pump inhibitor (PPI) that helps protect against ulcers in your stomach or intestines.

Brand Name(s)


When This Medicine Should Not Be Used

How to Use This Medicine

Delayed Release Tablet

  • Take your medicine as directed.
  • Take this medicine at least 30 minutes before a meal.
  • Swallow the tablet whole with water. Do not break, crush, chew, or dissolve it.
  • Your doctor may tell you to take vitamin D and calcium supplements while you are using this medicine.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you also use clopidogrel (Plavix®), rifampin (Rifadin®, Rimactane®), St John's wort, a blood thinner (such as dicumarol, heparin, warfarin, Coumadin®, Jantoven), a steroid medicine (such as hydrocortisone, methylprednisolone, prednisolone, prednisone), or a diuretic (water pill, such as furosemide, hydrochlorothiazide, torsemide, Lasix®).
  • Do not use any other NSAID medicine unless your doctor tells you to. Some examples of other NSAIDs are aspirin, diclofenac, ibuprofen, Advil®, Aleve®, Celebrex®, Voltaren®.
  • Make sure your doctor knows if you also use cholestyramine (Questran®), cilostazol (Pletal®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), diazepam (Valium®), digoxin (Lanoxin®), erlotinib (Tarceva®), ketoconazole (Nizoral®), lithium (Eskalith®, Lithobid®), methotrexate (Rheumatrex®), probenecid (Benemid®), tacrolimus (Prograf®), or voriconazole (Vfend®).
  • Tell your doctor if you use iron supplements, blood pressure medicine (such as atenolol, benazepril, enalapril, lisinopril, metoprolol, propranolol, Bystolic®, Lotrel®, Tenormin®, Vasotec®, Zestoretic®, Zestril®), medicine to treat depression (such as citalopram, fluoxetine, sertraline, Cymbalta®, Effexor®, Lexapro®, Pristiq®), diabetes medicine that you take by mouth (such as glimepiride, glipizide, glyburide, Amaryl®), medicine for seizures (such as phenytoin, Dilantin®), or medicine to treat HIV infection (such as atazanavir, nelfinavir, saquinavir, Reyataz®).

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding. Do not use this medicine during the later part (third trimester) of pregnancy unless your doctor tells you to.
  • Make sure your doctor knows if you have kidney disease, liver disease, anemia, asthma, bleeding problems, osteoporosis, congestive heart failure, fluid retention or swelling, high blood pressure, or any other heart or circulation problems. Tell your doctor if you have seizures, a history of low magnesium levels in your blood, Crohn disease, or ulcers or other stomach problems.
  • Naproxen may increase your risk of a heart attack or stroke. This is more likely in people who already have heart disease or who use this medicine for a long time. Get emergency help right away if you have any symptoms of a heart attack or stroke. Some possible symptoms are chest pain or discomfort, uneven heartbeat, pain that spreads to your arm or jaw, unusual sweating, feeling faint, trouble breathing, slurred speech, or weakness on one side of your body.
  • Naproxen may cause bleeding in your stomach or intestines. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, are older than 60 years of age, are in poor health, or use certain medicines (such as steroids or a blood thinner).
  • Tell your doctor right away if you have seizures, dizziness, a fast or pounding heartbeat, or muscle spasms. These may be symptoms of hypomagnesemia (low magnesium in the blood). This is more likely to occur if you take this medicine longer than 1 year or if you take it with digoxin or certain diuretics (water pills).
  • Tell your doctor right away if you have diarrhea that does not go away, stomach pain, and fever. These may be symptoms of Clostridium difficile colitis (also called C diff). C diff is an inflammation of your large intestine that causes diarrhea. This medicine can cause diarrhea. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor. Diarrhea can occur 2 months or more after you stop taking this medicine.
  • Serious allergic reactions can occur. Check with your doctor right away if you have any of the following symptoms: blistering, peeling, or loose skin, chills, fever, itching, joint or muscle pain, red skin rash, or sores, ulcers, or white spots in the mouth or on the lips.
  • Check with your doctor right away if you have any symptoms of liver problems, such as dark urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, or yellow skin or eyes.
  • This medicine may increase your risk of broken bones in the hip, wrist, and spine. This is more likely if you are older than 50 years of age, if you receive high doses of this medicine, or if you use it for longer than 1 year.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • This medicine may make you dizzy or drowsy. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments. You may need blood or other lab tests to check for side effects.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, red skin rash, sometimes with a fever
  • Bloody, black, or tarry stools
  • Change in how much or how often you urinate, bloody or cloudy urine
  • Chest pain, trouble breathing, or coughing up blood
  • Dark urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellow skin or eyes
  • Fast, slow, pounding, or uneven heartbeat
  • Numbness or weakness in your arm or leg, or on one side of your body
  • Seizures, tremors, muscle spasms or cramps
  • Severe diarrhea that does not go away, stomach pain, and fever
  • Sudden or severe headache, problems with vision, speech, or walking
  • Unexplained weight gain, swelling in your hands, ankles, or feet
  • Unusual bleeding, bruising, or weakness
  • Vomiting of blood or something that looks like coffee grounds

If you notice these less serious side effects, talk with your doctor:

  • Diarrhea, heartburn, indigestion, gas, stomach pain or upset
  • Mild skin rash or itching

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last reviewed on 8/4/2014

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ( URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2013 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.