Drug

Naproxen-Esomeprazole Mag

Summary of Interactions with Vitamins, Herbs, & Foods

  • Negative Interactions

    2
    • Naproxen

      Sodium

      Potential Negative Interaction

      Naproxen may cause sodium and water retention. It is healthful to reduce dietary salt intake by decreasing the use of table salt and avoiding heavily salted foods.

      Sodium
      Naproxen
      ×
      1. Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Mar 1993, 251n-1o.
    • Naproxen

      White Willow

      Potential Negative Interaction

      White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs. Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.

      White Willow
      Naproxen
      ×
      1. Olin BR, ed. Central Nervous System Drugs, Analgesics and Anti-inflammatory Drugs, Nonsteroidal Anti-inflammatory Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1172-90.
  • Supportive Interactions

    13
    • Esomeprazole

      Calcium

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a study of elderly women, administration of omeprazole decreased the absorption of calcium, presumably because the drug decreased the stomach's production of hydrochloric acid, which is necessary for calcium absorption. The form of calcium used in the study to test calcium absorption was calcium carbonate. Drugs that reduce stomach acid secretion may not inhibit other forms of calcium, such as calcium citrate.

      Calcium
      Esomeprazole
      ×
      1. O'Connell MB, Madden DM, Murray AM, et al. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 2005;118:778-81.
      2. Recker RR. Calcium absorption and achlorhydria. N Engl J Med 1985;313:70-3.
    • Naproxen-Esomeprazole Mag

      Calcium

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but did not alter the concentration of vitamin D. One controlled study showed that flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones. Further research is needed to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy people.

      Calcium
      Naproxen-Esomeprazole Mag
      ×
      1. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
    • Naproxen-Esomeprazole Mag

      Folic Acid

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Indomethacin has been reported to decrease absorption of folic acid and vitamin C. Under certain circumstances, indomethacin may interfere with the actions of vitamin C.Calcium and phosphate levels may also be reduced with indomethacin therapy. It remains unclear whether people taking this drug need to supplement any of these nutrients.

      Folic Acid
      Naproxen-Esomeprazole Mag
      ×
      1. Hodges R. Nutrition in Medical Practice. Philadelphia: W. B. Saunders, 1980, 323-31 [review].
      2. Ogilvy CS, DuBois AB, Douglas JS. Effects of ascorbic acid and indomethacin on the airways of healthy male subjects with and without induced bronchoconstriction. J Allergy Clin Immunol 1981;67:363-9.
      3. Holt GA. Food & Drug Interactions. Chicago, Precept Press, 1998, 138,140.
    • Naproxen

      Iron

      Replenish Depleted Nutrients

      NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and naproxen are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.

      Iron
      Naproxen
      ×
      1. Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
      2. Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.
    • Naproxen-Esomeprazole Mag

      Iron

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.

      Iron
      Naproxen-Esomeprazole Mag
      ×
      1. Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
      2. Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.
    • Esomeprazole

      Magnesium

      Replenish Depleted Nutrients
      In a case report, a man developed severe magnesium deficiency after long-term treatment with a proton pump inhibitor (pantoprazole or lansoprazole). Severe magnesium deficiency as a result of the use of proton pump inhibitors appears to be rare among people who have no other risk factors for magnesium deficiency. However, in a study of hospitalized patients, the prevalence of low serum magnesium levels was significantly greater among users of proton pump inhibitors than among nonusers (23% vs. 11%). People taking proton pump inhibitors (PPIs) should ask their doctor whether to take a magnesium supplement or whether to have their magnesium levels monitored.
      Magnesium
      Esomeprazole
      ×
      1. Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia during long-term treatment with a proton pump inhibitor. Am J Kidney Dis 2010;56:168-74.
      2. Gau JT, Yang YX, Chen R, Kao TC. Uses of proton pump inhibitors and hypomagnesemia. Pharmacoepidemiol Drug Saf 2012;21:553-9.
      3. FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs). U.S. Food and Drug Administration [cited 2011 Sept 13]. Available from URL: http://www.fda.gov/drugs/drugsafety/ucm245011.htm#Additional_Information_for_Patients on.
    • Esomeprazole

      Vitamin C

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Treatment of healthy volunteers with omeprazole for four weeks resulted in a 12.3% decrease in blood levels of vitamin C.

      Vitamin C
      Esomeprazole
      ×
      1. Henry EB, Carswell A, Wirz A, et al. Proton pump inhibitors reduce the bioavailability of dietary vitamin C. Aliment Pharmacol Ther2005;22:539-5.
    • Naproxen-Esomeprazole Mag

      Vitamin D

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Elevated calcium and vitamin D blood levels are commonly found in people with sarcoidosis. In one individual with sarcoidosis, taking flubiprofen lowered elevated blood calcium levels, but did not alter the concentration of vitamin D. One controlled study showed that flurbiprofen reduced blood levels of vitamin D in people with frequent calcium kidney stones. Further research is needed to determine whether flurbiprofen reduces blood calcium and vitamin D levels in healthy people.

      Vitamin D
      Naproxen-Esomeprazole Mag
      ×
      1. Brown RC, Heyburn PJ, Littlewood TJ, Beck P. Prostaglandin synthetase inhibition in hypercalcaemia with sarcoidosis. Lancet 1984;2:37.
    • Naproxen

      Stinging Nettle

      Support Medicine

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.

      Stinging Nettle
      Naproxen
      ×
      1. Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.
    • Naproxen-Esomeprazole Mag

      Stinging Nettle

      Support Medicine

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.

      Stinging Nettle
      Naproxen-Esomeprazole Mag
      ×
      1. Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.
    • Naproxen

      Licorice

      Reduce Side Effects

      The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.

      Licorice
      Naproxen
      ×
      1. Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
      2. Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.
    • Naproxen-Esomeprazole Mag

      Licorice

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.

      Licorice
      Naproxen-Esomeprazole Mag
      ×
      1. Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
      2. Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.
    • Naproxen-Esomeprazole Mag

      N-Acetyl Cysteine

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Nonsteroidal anti-inflammatory drugs commonly cause damage to stomach and intestinal tissue. Though the mechanism by which NSAIDs cause this side effect is unknown, some researchers believe that free-radical damage is involved. A test tube study showed that flurbiprofen increases free-radical activity in stomach cells, which is blocked by the antioxidant N-acetyl cysteine. Additional research is needed to determine whether people taking flurbiprofen together with N-acetyl cysteine might experience fewer gastrointestinal side effects.

      N-Acetyl Cysteine
      Naproxen-Esomeprazole Mag
      ×
      1. Kusuhara H, Komatsu H, Sumichika H, Sugahara K. Reactive oxygen species are involved in the apoptosis induced by nonsteroidal anti-inflammatory drugs in cultured gastric cells. Eur J Pharmacol 1999;383:331-7.
  • Explanation Required

    3
    • Naproxen

      Copper

      Needs Explanation

      Supplementation with copper may enhance the anti-inflammatory effects of NSAIDs while reducing their ulcerogenic effects. One study found that when various anti-inflammatory drugs were chelated with copper, the anti-inflammatory activity was increased. Animal models of inflammation have found that the copper chelate of aspirin was active at one-eighth the effective dose of aspirin. These copper complexes are less toxic than the parent compounds, as well.

      Copper
      Naproxen
      ×
      1. Sorenson JRJ. Copper chelates as possible active forms of the antiarthritic agents. J Medicinal Chem 1976;19:135-48.
    • Naproxen-Esomeprazole Mag

      Folic Acid

      Needs Explanation

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Piroxicam may prevent inflammation by blocking the activity of enzymes that depend on folic acid. However, other studies show that people taking NSAIDs such as aspirin have lower than normal levels of folic acid in their red blood cells. Further research is needed to determine whether supplemental folic acid prevents a deficiency of the vitamin or indirectly reduces the beneficial effects of piroxicam.

      Folic Acid
      Naproxen-Esomeprazole Mag
      ×
      1. Baggott JE, Morgan SL, Ha T, et al. Inhibition of folate-dependent enzymes by non-steroidal anti-inflammatory drugs. Biochem J 1992;282:197-202.
      2. Alter HJ, Zvaifler MJ, Rath CE. Interrelationship of rheumatoid arthritis, folic acid and aspirin. Blood 1971;38:405-16.
    • Naproxen

      Potassium

      Needs Explanation

      Naproxen has caused kidney problems and increased blood potassium levels, especially in older people. People taking naproxen should not supplement potassium without consulting with their doctor.

      Potassium
      Naproxen
      ×
      1. Bailie GR. Acute renal failure. In Applied Therapeutics: The Clinical Use of Drugs, 6th ed. Vancouver, WA: Applied Therapeutics, 1995, 29-33.
      2. Perazella MA. Drug-induced hyperkalemia: Old culprits and new offenders. Am J Med 2000;109:307-14 [review].
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

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