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Prescribed Vimovo For Pain In Hips And Back. Take Citalopram. Having Stomach Upset. What To Do?

Posted on Sun, 25 Aug 2013

Question: Hello. I have been prescribed vimovo for pain after falling on my hips and back. I take 10mg citalopram daily. Is this safe? I've read about the drug interaction warnings. I have taken arthrotec but it really causes stomach upset Vimovo is prescribed at 500 mg twice daily.

Answered by Dr. Sudhir Kumar (1 hour later)

Hi,
Thank you for posting your query.

Vimovo (naproxen/esomeprazole) is a safe medicine for relieving pain. I often use a dose of 250 mg twice daily, and increase it to 500 mg twice daily, if there is inadequate response to 250 mg twice daily.

It can be safely used with citalopram, and no significant adverse effects are noted, when both are used together.

I hope it helps.
Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: YYYY@YYYY
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (3 minutes later)

Ok then why are there posting for adverse drug interactions such as irregular heartbeat when taking the two together? It's very hard to know what to do. I researched the interactions on WWW.WWWW.WW

Answered by Dr. Sudhir Kumar (8 minutes later)

Thank you for getting back.

These are anecdotal incidences, and are only seen in a minority of patients. If you have a history of heart disease, then, we can avoid the combination. However, since you have no such history, it is safe to continue them.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (1 hour later)

Would it not be safer to continue using ibuprofen and Zantac as needed? Can I take more than two 150 zantacs per day safely?

Answered by Dr. Sudhir Kumar (1 hour later)

Thank you for getting back.

I would agree with you that Ibuprofen would be safer than naproxen.
Normally, you should not take more than two zantac per day (maximum safe dose per day is 300 mg).

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (6 hours later)

Thanks. Is there a better option for Zantac

Answered by Dr. Sudhir Kumar (51 minutes later)

Pantoprozole 40 mg OR Rabeprozole 20 mg once daily are better options than zantac (ranitidine).

Best wishes,
Dr Sudhir Kumar MD DM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (9 hours later)

So I have now been prescribed pantoprazole and naproxen. No warning of interaction was given at the pharmacist I've read that naproxen enteric coated should not be given with proton pump inhibitors as the enteric coating will render the med inefficient. Please help with this query. Thanks.

Answered by Dr. Sudhir Kumar (1 hour later)

Thank you for getting back.
You are partially correct (the medicine becomes less effective, and not ineffective), that is why, in your case Ibuprofen with pantoprozole would be a better option.

Best wishes,
Dr Sudhir Kumar MD DM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (9 minutes later)

Thank you, I think I am comfortable with that. However, I did talk to my pharmacist just now and she indicated that I could take the naproxen at least one or two hours apart from thepantoloc. She said they are often prescribed together. It's all very confusing.

Answered by Dr. Sudhir Kumar (0 minute later)

Thank you and best wishes,
Dr Sudhir Kumar MD DM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (48 hours later)

Hello. Day two on the pantaloc. No side effects. However I took one 500 mg Advil yesterday and had to end up taking a 150mg Zantac because of the pain in my gut. Today I took a 500mg of naproxen, as per dr prescription , pain was worse than with the Advil. So have taken 75mg of Zantac and will take 150mg before bed. Is it ok to take the Zantac when needed like this? I have a disc pressing on a nerve so have to take the pain meds. How long does it take for the pantaloc to quiet the stomach?

Answered by Dr. Sudhir Kumar (2 hours later)

Thank you for getting back.

Pantalocc generally works within 30-60 minutes after taking the medicine. It is alright to take zantac as and when needed in a short term, but long-term, it is better to be on one drug, say pantaloc twice a day.

For the pain due to a pressed nerve by a herniated disc, it may be better to take pregabalin or gabapentin, as they are more specific for neuropathic pain. Please discuss this with your doctor.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar