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Vimovo is a pain medication that contains naproxen and esomeprazole, the active ingredient in Nexium. Recent studies have suggested that long-term use of Nexium and other proton pump inhibitors may be associated with an increased risk of chronic kidney disease and kidney failure.

What is Vimovo Used For?

Vimovo is used to treat symptoms associated with:

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis

Naproxen is an NSAID pain reliever that works by reducing substances in the body that cause inflammation, pain, and fever. Esomeprazole is a proton pump inhibitor that decreases the amount of acid produced by the stomach. It helps help reduce the risk of stomach ulcers in people who may be at risk for them while taking an NSAID.

Vimovo Black Box Warning

The Vimovo prescribing information includes a Black Box Warning regarding the following:

• NSAIDs may increase the risk for a fatal heart attack and stroke. The risk may occur early in treatment, and may increase with duration of use.
• Vimovo is contraindicated in patients undergoing coronary artery bypass surgery.
• Naproxen and other NSAIDs may cause serious gastrointestinal complications, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.

How is Vimovo Used?

Vimovo is a tablet that is taken twice per day. It should be used at the lowest effective dose for the shortest time possible.

Vimovo Side Effects

Side effects commonly associated with Vimovo include upset stomach, stomach pain, heartburn, nausea, gas, diarrhea, constipation, drowsiness, or dizziness. Patients should contact their doctor if they experience:

• Easy bruising/bleeding
• Lightheadedness/fainting
• Signs of a lung infection (such as fever, cough, trouble breathing)
• Difficult/painful swallowing
• Swelling of the hands/feet
• Sudden/unexplained weight gain
• Symptoms of a low magnesium levels (unusually fast/slow/irregular heartbeat, persistent muscle spasms or seizures)

Serious Vimovo side effects may include:

• Cardiovascular thrombotic events
• GI bleeding, ulceration and perforations
• Hepatotoxicity (liver toxicity
• Hypertension
• Heart Failure and Edema
• Kidney toxicity and hyperkalemia (high potassium level)
• Anaphylactic reactions
• Serious skin reactions
• Hematologic toxicity
• Active bleeding
• Acute interstitial nephritis (sudden kidney inflammation)
• Vitamin B 12 deficiency
• Clostridium difficile associated diarrhea
• Bone fracture
• Hypomagnesemia (low magnesium levels)

Proton Pump Inhibitors and the Kidneys

Proton pump inhibitors, including esomeprazole, have been linked to acute interstitial nephritis, a sudden inflammation of the kidney tubules that can progress to kidney disease and renal failure if not recognized and treated. The condition is usually associated with a hypersensitivity reaction to a medication. Symptoms may include:

• Blood in the urine
• Fever
• Changes in urine output
• Drowsiness or confusion
• Nausea, vomiting
• Rash
• Swelling of the body
• Weight gain from fluid-retention

In 2016, two studies found possible links between the long-term use of proton pump inhibitors and serious kidney complications:

• January 2016: Research published in JAMA: Internal Medicine suggested that patients who took twice-daily doses of proton pump inhibitors were 46% more likely to develop chronic kidney disease. Patients who used the drugs just once per day had a 15% higher risk. Read More
• April 2016: A study published in the Journal of the American Society of Nephrology suggested that patients who use proton pump inhibitors were 96% more likely to develop kidney failure and 28% more likely to suffer chronic kidney disease compared to those who took another class of heartburn medications.   The findings also indicated that the overall risk increases with higher doses and longer duration of use. Read More

Vimovo Case Report Details Kidney Complications, Other Side Effects

In July 2016, the journal Reactions Weekly detailed the case of 44-year-old Vimovo patients who developed a wide range of serious side effects, including kidney failure, while using the medication. “Over the course of a week, his clinical situation deteriorated with worsening renal function and appearance of a widespread rash. His abdominal pain also became more distressing and he mounted a severe inflammatory response, renal failure and liver impairment with significant oedema,” his doctors wrote. A kidney biopsy later confirmed severe eosinophilic interstitial nephritis and mesangial glomerulonephritis. Read More