制造商: 药理分类: 活性成分(补): 药理作用: 临床试验: 其他的研究进行了治疗的成立标志/对膝关节骨关节炎症状的商品名Vimovo疗效。 法律分类: 成人: 儿童: 禁忌(补): 警告/注意事项: 互动(补): 不良反应(补): 如何提供:
Manufacturer:AstraZeneca Pharmaceuticals Pharmacological Class:NSAID + proton pump inhibitor Active Ingredient(s):Naproxen 375mg + esomeprazole (as magnesium trihydrate) 20mg; naproxen 500mg + esomeprazole (as magnesium trihydrate) 20mg; delayed-release tablets. Indication(s):Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis: to improve symptoms and reduce risk of gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers. Pharmacology:Vimovo is a delayed-release formulation of an NSAID plus a proton pump inhibitor. The tablets combine an enteric-coated core containing naproxen surrounded by an immediate-release coating of esomeprazole magnesium. Upon oral administration, esomeprazole is released first in the stomach, and the naproxen is released later in the small intestine. With twice-daily dosing, naproxen levels reach steady-state in about 4–5 days. Clinical Trials:Two randomized, double-blind studies were conducted to compare the incidence of gastric ulcer in patients taking this product or enteric-coated naproxen. Subjects had conditions that were expected to require daily NSAID therapy for at least 6 months and, if they were under age 50, had a history of GI or duodenal ulcer within the past 5 years. These studies showed that Vimovo 500/20 twice daily significantly reduced the 6-month cumulative incidence of gastric ulcers, compared to enteric-coated naproxen 500mg twice daily. Other studies were conducted that established the efficacy of Vimovo in treating the signs/symptoms of osteoarthritis of the knee. Legal Classification:Rx Adults:Swallow whole. Take at least 30min before meals. >18 years: One 375/20 or 500/20 tab twice daily. Use lowest effective dose for the shortest duration. Consider dose reduction in mild to moderate hepatic impairment. Children:<18 years: not recommended. Contraindication(s):Aspirin allergy/triad. Coronary artery bypass surgery. Late pregnancy (≥30 weeks gestation). Warnings/Precautions:Increased risk of serious cardiovascular thrombotic events, MI, stroke, gastrointestinal adverse events (bleeding, ulceration, perforation); may be fatal. Moderate to severe renal impairment (CrCl <30mL/min) or severe hepatic impairment: not recommended. History of ulcer disease, GI bleeding, or inflammatory bowel disease (eg, ulcerative colitis, Crohn’s disease). Hypertension; monitor BP. CHF. Edema. Bleeding disorders. Pre-existing asthma. Impaired renal or hepatic function. Monitor blood, liver, and renal function in chronic use. Discontinue if liver or renal dysfunction, or serious rash occurs. Increased risk of osteoporosis-related fractures with high-doses or on long-term therapy. Elderly. Debilitated. Pregnancy (Cat.C <30 weeks gestation, Cat.D ≥30 weeks gestation). Labor & delivery, nursing mothers: not recommended. Interaction(s):Concomitant atazanavir, nelfinavir: not recommended. May potentiate saquinavir (monitor; consider reducing saquinavir dose), protein-bound drugs (eg, hydantoins, sulfonamides, sulfonylureas). Increases lithium levels. Methotrexate excretion reduced. May antagonize diuretics, beta-blockers (eg, propranolol), ACE inhibitors. Increased renal toxicity with ACE inhibitors. Increased risk of GI bleed with oral corticosteroids, smoking, alcohol, SSRIs. Monitor aspirin and oral anticoagulants. May affect CYP2C19 substrates (eg, diazepam, cilostazol). May affect absorption of pH-dependent drugs (eg, ketoconazole, digoxin, iron salts). Probenecid increases plasma levels and delays elimination. Adverse Reaction(s):Erosive gastritis, dyspepsia, gastritis, diarrhea, gastric ulcer, upper abdominal pain, nausea; renal papillary necrosis; see literature re: risk of cardiovascular events, serious gastrointestinal events. How Supplied:Tabs—60, 500 萘普生/埃索美拉唑复方制剂获准用于治疗关节炎 2010年5月13日,一种同时含有延释肠溶型萘普生(naproxen)和速释型埃索美拉唑镁(esomeprazole magnesium)的混合剂量片剂(商品名为Vimovo,生产商为阿斯利康和Pozen公司)获得美国食品药品监督管理局(FDA)批准用于治疗关节炎。 这种非甾体抗炎药(NSAID)/质子泵抑制剂的复方制剂适用于缓解骨关节炎(osteoarthritis)、类风湿性关节炎(rheumatoid arthritis)和强直性脊椎炎(ankylosing spondylitis)的体征和症状,同时在易感患者中可降低因NSAID引起的胃溃疡风险。骨关节炎常用诸如萘普生之类的NSAID进行治疗,大约有2700万美国人患有此病。根据阿斯利康公司所发布的消息称,有50%之多的NSAID长期使用者伴有胃肠道溃疡的风险。阿斯利康的首席医疗专家Howard Hutchinson博士在一份公司新闻发布稿中说到,“通过一种单独的药丸,Vimovo可提供一种有效的疼痛缓解剂和一种嵌入式的‘质子泵抑制剂’,以用于治疗伴有NSAID相关性胃溃疡风险的关节炎患者。” 据PN400-301和PN400-302两项为期6个月的关键性研究的数据显示,与每天给予2次500mg肠溶型萘普生相比,每天2次使用萘普生/埃索美拉唑延释片可降低内镜检查下的胃溃疡的发生率(分别为4.1%比23.1%,和7.1%比24.3%;两项研究的P值均小于0.001)。 VIMOVO的重要安全信息 心血管风险 VIMOVO的其中一个组份萘普生,可能会增加严重心血管血栓事件,心肌梗死和中风的风险,而且这可能是致命的。患有心血管疾病或心血管疾病的危险因素的患者可能会面临更大的风险。 VIMOVO是不应用于治疗冠状动脉旁路移植血管(CABG)手术时的围手术期疼痛。
NSAIDs(非甾体抗炎药),包括萘普生,会增加了严重的消化道不良反应的风险,包括出血、溃疡。而且这可以发生在任何时间,并且其在使用过程中,没有任何警告症状。老年患者存在更大的风险。 |
Vimovo(萘普生/埃索美拉唑)复方缓释片简介:
制造商: 阿斯利康制药公司
药理分类: 质子泵抑制剂类固醇消炎药+
活性成分(补): 萘普生375mg +埃索美拉唑(如镁三水)20毫克,500毫克+萘普生埃索美拉唑(如镁三水)20毫克;缓释片。 指示(补 ... 责任编辑:admin |
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