Wechselwirkungen von Naproxen und Esomeprazol

• Gastric Acid Reducing Agents: Avoid co-administration with proton pump inhibitors (PPIs). (Fachinformation zu Acalabrutinib, Arzneimittelwechselwirkungen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

…risk of developing epidural or spinal hematomas in these patients include: • use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis, such as nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants • a history of traumatic or repeated epidural or spinal punctures • a history of spinal deformity… (Fachinformation zu Apixaban, Boxed Warning (umrahmter Warnhinweis))

In HIV-treatment-experienced adult patients: Coadministration of REYATAZ with PPIs is not recommended. (Fachinformation zu Atazanavir, Arzneimittelwechselwirkungen)

Intervention: The concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with other NSAIDs or salicylates is not recommended. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention: The concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with other NSAIDs or salicylates is not recommended. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Histamine-2 (H 2 ) antagonists and proton pump inhibitors should be avoided. (Fachinformation zu Cefuroxim, Arzneimittelwechselwirkungen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Nephrotoxic agents Concomitant administration of cidofovir injection and agents with nephrotoxic potential [e.g., intravenous aminoglycosides (e.g., tobramycin, gentamicin, and amikacin), amphotericin B, foscarnet, intravenous pentamidine, vancomycin, and nonsteroidal anti-inflammatory agents] is contraindicated. (Fachinformation zu Cidofovir, Arzneimittelwechselwirkungen)

Avoid use of Citalopram Capsules in CYP2C19 poor metabolizers, patients receiving concomitant cimetidine or another CYP2C19 inhibitor, patients with hepatic impairment, and patients who are greater than 60 years of age, because Citalopram Capsules are only available in a 30 mg dose strength and dosage adjustments are not possible [see Drug Interactions ( 7 ),… (Fachinformation zu Citalopram, Warnhinweise und Vorsichtsmaßnahmen)

Interaction with Clopidogrel : Avoid concomitant use. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

…the risk of developing epidural or spinal hematomas in these patients include: use of indwelling epidural catheters concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants a history of traumatic or repeated epidural or spinal punctures a history of spinal deformity… (Fachinformation zu Dabigatran, Boxed Warning (umrahmter Warnhinweis))

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

…the risk of developing epidural or spinal hematomas in these patients include: use of indwelling epidural catheters concomitant use of other drugs that affect hemostasis, such as nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants a history of traumatic or repeated epidural or spinal punctures a history of spinal deformity… (Fachinformation zu Edoxaban, Boxed Warning (umrahmter Warnhinweis))

Avoid SYMFI with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.3) ] . (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• Proton pump inhibitors (PPIs), including esomeprazole magnesium, are contraindicated in patients receiving rilpivirine-containing products [see Drug Interactions ( 7 ) ]. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

…the risk of developing epidural or spinal hematomas in these patients include: Use of indwelling epidural catheters Concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, and other anticoagulants A history of traumatic or repeated epidural or spinal punctures A history of spinal deformity… (Fachinformation zu Enoxaparin, Boxed Warning (umrahmter Warnhinweis))

For proton pump inhibitors, avoid concomitant use if possible. (Fachinformation zu Erlotinib, Arzneimittelwechselwirkungen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

…risk of developing epidural or spinal hematomas in these patients include: • use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, or other anticoagulants • a history of traumatic or repeated epidural or spinal puncture • a history of spinal deformity… (Fachinformation zu Fondaparinux, Boxed Warning (umrahmter Warnhinweis))

Fosamprenavir calcium/ritonavir: ↔ Amprenavir ↔ Esomeprazole Sedative/hypnotics: Midazolam, triazolam ↑Midazolam ↑Triazolam Coadministration is contraindicated due to potential for serious and/or life-threatening reactions such as prolonged or increased sedation or respiratory depression [see Contraindications (4)]. (Fachinformation zu Fosamprenavir, Arzneimittelwechselwirkungen)

• Drugs Affecting Gastric pH: Avoid concomitant use of IRESSA with proton pump inhibitors, if possible. (Fachinformation zu Gefitinib, Arzneimittelwechselwirkungen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Intervention: The concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with other NSAIDs or salicylates is not recommended. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention: The concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with other NSAIDs or salicylates is not recommended. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Unexpectedly severe and fatal gastrointestinal toxicity can occur with concomitant administration of XATMEP (primarily at high dosage) and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions ( 7.1 )] . (Fachinformation zu Methotrexat, Warnhinweise und Vorsichtsmaßnahmen)

Intervention Concomitant use of methylphenidate extended-release orally disintegrating tablets with a gastric pH modulator (i.e., a H2-blocker or a proton pump inhibitor) is not recommended. (Fachinformation zu Methylphenidat, Arzneimittelwechselwirkungen)

MISOPROSTOL SHOULD NOT BE TAKEN BY PREGNANT WOMEN TO REDUCE THE RISK OF ULCERS INDUCED BY NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) (see CONTRAINDICATIONS , WARNINGS , and PRECAUTIONS ). (Fachinformation zu Misoprostol, Boxed Warning (umrahmter Warnhinweis))

Patients with known aspirin sensitivity should continue to avoid aspirin or non-steroidal anti-inflammatory agents while taking SINGULAIR ( 5.4 ). (Fachinformation zu Montelukast, Warnhinweise und Vorsichtsmaßnahmen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

It should not be used with other naproxen-containing products since they all circulate in the plasma as the naproxen anion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Naproxen and esomeprazole magnesium delayed-release tablets are contraindicated in the following patients: • Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to naproxen, esomeprazole magnesium, substituted benzimidazoles, or to any components of the drug product, including omeprazole. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Naproxen and esomeprazole magnesium delayed-release tablets are contraindicated in the following patients: • Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to naproxen, esomeprazole magnesium, substituted benzimidazoles, or to any components of the drug product, including omeprazole. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Concomitant Use With Gastric Acid-Reducing Agents : Avoid concomitant use of VOTRIENT with gastric acid-reducing agents. (Fachinformation zu Pazopanib, Arzneimittelwechselwirkungen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Prevention or Management Avoid concomitant use of Noxafil oral suspension with cimetidine or esomeprazole unless the benefit outweighs the risks. (Fachinformation zu Posaconazol, Arzneimittelwechselwirkungen)

Avoid coadministration with probenecid or nonsteroidal anti-inflammatory drugs. (Fachinformation zu Pralatrexat, Arzneimittelwechselwirkungen)

Additional risk factors for bleeding include: body weight <60 kg, propensity to bleed, concomitant use of medications that increase the risk of bleeding (e.g . , warfarin, heparin, fibrinolytic therapy, chronic use of nonsteroidal anti-inflammatory drugs [NSAIDs]) [see Warnings and Precautions (5.1) ] . (Fachinformation zu Prasugrel, Boxed Warning (umrahmter Warnhinweis))

John’s Wort or Rifampin : Avoid concomitant use. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Proton pump inhibitors (PPIs), including esomeprazole magnesium, are contraindicated in patients receiving rilpivirine-containing products [see Drug Interactions ( 7 ) ]. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Concomitant administration of Risedronate sodium delayed-release and H 2 blockers or PPIs is not recommended. (Fachinformation zu Risedronsäure, Arzneimittelwechselwirkungen)

…risk of developing epidural or spinal hematomas in these patients include: • use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis, such as non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, other anticoagulants • a history of traumatic or repeated epidural or spinal punctures • a history of spinal deformity… (Fachinformation zu Rivaroxaban, Boxed Warning (umrahmter Warnhinweis))

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Intervention: The concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with other NSAIDs or salicylates is not recommended. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

It should not be used with other naproxen-containing products since they all circulate in the plasma as the naproxen anion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

VIREAD should be avoided with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.1) ] . (Fachinformation zu Tenofovir, Warnhinweise und Vorsichtsmaßnahmen)

• History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. (Fachinformation zu Naproxen und Esomeprazol, Gegenanzeigen)

Intervention : Voriconazole : Avoid concomitant use with naproxen and esomeprazole magnesium delayed-release tablets. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Strong Inhibitors of CYP2C19 : The recommended dosage is 50 mg once daily or 100 mg once daily for those patients who are not responding to 50 mg once daily. (Fachinformation zu Abrocitinib, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

However, this is of special importance in patients at risk of or having underlying renal dysfunction and patients taking concomitant nephrotoxic agents such as cyclosporine, tacrolimus, aminoglycosides, vancomycin and non-steroidal anti-inflammatory drugs [See Adverse Reactions (6.2) and Clinical Pharmacology (12.3) ]. (Fachinformation zu Adefovir, Warnhinweise und Vorsichtsmaßnahmen)

Patients receiving concomitant corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs) or anti-angiogenic agents, or patients with increasing age or who have an underlying history of gastrointestinal ulceration, underlying diverticular disease or bowel metastases may be at increased risk of perforation. (Fachinformation zu Afatinib, Warnhinweise und Vorsichtsmaßnahmen)

Use caution when co-prescribing aspirin/nonsteroidal anti- inflammatory drugs that may worsen gastrointestinal irritation. (Fachinformation zu Alendronsäure, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Proton Pump Inhibitors Clinical Impact Time to maximum concentration (T max ) of amphetamine is decreased compared to when administered alone. (Fachinformation zu Amfetamin und Dexamfetamin, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Monitor patients for bleeding, including those receiving concomitant therapy with other drugs known to cause bleeding (e.g., anticoagulants, PDE3 inhibitors, NSAIDs, antiplatelet agents, selective serotonin reuptake inhibitors) [see Drug Interactions (7.3) , Clinical Pharmacology (12.3) ] . (Fachinformation zu Anagrelid, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Proton Pump Inhibitors (PPI) As an alternative to PPIs, use short-acting antacids or H2 blockers and separate dosing by more than 2 hours from BOSULIF dosing. (Fachinformation zu Bosutinib, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-administration of CYP2C19 inhibitors, such as omeprazole or fluvoxamine, with carisoprodol could result in increased exposure of carisoprodol and decreased exposure of meprobamate. (Fachinformation zu Carisoprodol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Drug Interactions As with other cephalosporins, cefotaxime may potentiate the nephrotoxic effects of nephrotoxic drugs such as aminoglycosides, NSAIDs and furosemide. (Fachinformation zu Cefotaxim, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Cyclosporine Clinical Impact : Concomitant use of naproxen and cyclosporine may increase cyclosporine’s nephrotoxicity. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Cilostazol Clinical Impact : Increased exposure of cilostazol and one of its active metabolites (3,4-­dihydro-cilostazol) when coadministered with omeprazole magnesium, the racemate of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

NSAIDs Use with caution Non-steroidal anti-inflammatory drugs (but not acetyl salicylic acid) in combination of very high doses of quinolones have been shown to provoke convulsions in pre-clinical studies and in postmarketing. (Fachinformation zu Ciprofloxacin, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

…↔ ↔ Valsartan (320 mg) 20 mg ↓12% [↓3%, ↓20%] ↔ Simvastatin (40 mg) 20 mg ↔ ↔ Anti-infective Agent Rifampin (600 mg once daily for 6 days) 10 mg ↓7% [↓22%, ↑11%] ↓22% [↓27%, ↓17%] Nonsteroidal Anti-inflammatory Agent Mefenamic Acid (loading dose of 500 mg followed by 14 doses of 250 mg every 6 hours) 10 mg ↑13% [↑3%, ↑24%] ↑51% [↑44%, ↑58%] ↔ = no change (geometric… (Fachinformation zu Dapagliflozin, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, mycophenoloate mofetil, ketoconazole) Clinical Impact: Esomeprazole magnesium can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole magnesium is an enantiomer,… (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, mycophenoloate mofetil, ketoconazole) Clinical Impact: Esomeprazole magnesium can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole magnesium is an enantiomer,… (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

…Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Fachinformation zu Desmopressin, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Proton Pump Inhibitors Time to maximum concentration (T max ) of amphetamine is decreased compared to when administered alone. (Fachinformation zu Dexamfetamin, Arzneimittelwechselwirkungen)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Diazepam Clinical Impact: Increased exposure of diazepam [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Therefore, patients should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers, e.g., those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs). (Fachinformation zu Donepezil, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Medications that may increase serum potassium concentration include ACE inhibitors, angiotensin-II receptor antagonists, potassium-sparing diuretics, potassium supplementation, heparin, aldosterone antagonists, and NSAIDS. (Fachinformation zu Drospirenon und Ethinylestradiol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, mycophenoloate mofetil, ketoconazole) Clinical Impact: Esomeprazole magnesium can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole magnesium is an enantiomer,… (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, mycophenoloate mofetil, ketoconazole) Clinical Impact: Esomeprazole magnesium can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole magnesium is an enantiomer,… (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

In order to prevent gout flares when ULORIC is initiated, concurrent prophylactic treatment with an NSAID or colchicine is recommended [see Dosage and Administration (2.4) ]. (Fachinformation zu Febuxostat, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Strong CYP2C19 Inhibitors Examples Proton pump inhibitors, selective serotonin reuptake inhibitors, benzodiazepines, antifungals Clinical Implications The concomitant use of ADDYI with strong CYP2C19 inhibitors may increase flibanserin exposure which may increase the risk of hypotension, syncope, and CNS depression. (Fachinformation zu Flibanserin, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Naproxen Coadministration (N=18) of naproxen sodium capsules (250 mg) with NEURONTIN (125 mg) appears to increase the amount of gabapentin absorbed by 12% to 15%. (Fachinformation zu Gabapentin, Arzneimittelwechselwirkungen)

Therefore, patients should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those with an increased risk for developing ulcers, e.g., those with a history of ulcer disease or patients using concurrent nonsteroidal anti-inflammatory drugs (NSAIDS). (Fachinformation zu Galantamin, Warnhinweise und Vorsichtsmaßnahmen)

Drug Interactions The hypoglycemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents, ACE inhibitors, disopyramide, fluoxetine, clarithromycin, and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, monoamine oxidase inhibitors, and beta adrenergic blocking… (Fachinformation zu Glibenclamid, Arzneimittelwechselwirkungen)

…steroids and androgens, cyclophosphamide, phenyramidol, guanethidine, fluconazole, sulfinpyrazone, tetracyclines, clarithromycin, disopyramide, quinolones, and those drugs that are highly protein-bound, such as fluoxetine, nonsteroidal anti-inflammatory drugs, salicylates, sulfonamides, chloramphenicol, coumarins, probenecid and monoamine oxidase inhibitors. (Fachinformation zu Glimepirid, Arzneimittelwechselwirkungen)

…angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, propoxyphene, salicylates, somatostatin analogs (e.g., octreotide), sulfonamide antibiotics, nonsteroidal anti-inflammatory agents, chloramphenicol, probenecid, coumarins, voriconazole, H2 receptor antagonists, and quinolones. (Fachinformation zu Glipizid, Arzneimittelwechselwirkungen)

Glipizide: The hypoglycemic action of sulfonylureas may be potentiated by certain drugs, including nonsteroidal anti-inflammatory agents, some azoles, and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, and beta-adrenergic blocking agents. (Fachinformation zu Glipizid und Metformin, Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Use caution when co-prescribing aspirin/nonsteroidal anti-inflammatory drugs that may worsen gastrointestinal irritation. (Fachinformation zu Ibandronsäure, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Nonsteroidal anti-inflammatory drugs: Monitor for hyperkalemia ( 7.3 ) (Fachinformation zu Kaliumchlorid, Arzneimittelwechselwirkungen)

Nonsteroidal Anti-inflammatory drugs (NSAIDs) monitor for hyperkalemia (7.4) (Fachinformation zu Kaliumcitrat, Arzneimittelwechselwirkungen)

Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, mycophenoloate mofetil, ketoconazole) Clinical Impact: Esomeprazole magnesium can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole magnesium is an enantiomer,… (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

However, esomeprazole, a proton pump inhibitor, administered at a dose of 40 mg once daily for 7 days, did not result in a clinically meaningful reduction in lapatinib steady-state exposure. (Fachinformation zu Lapatinib, Arzneimittelwechselwirkungen)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Concomitant Drug Class: Drug Name Effect on Concentration ↓ = decrease, ↑ = increase Clinical Comment tenofovir DF = tenofovir disoproxil fumarate Acid Reducing Agents: ↓ ledipasvir Ledipasvir solubility decreases as pH increases. (Fachinformation zu Ledipasvir und Sofosbuvir, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Non-Steroidal Anti-Inflammatory Drugs The concomitant administration of a non-steroidal anti-inflammatory drug with a fluoroquinolone, including Levofloxacin in 5% Dextrose Injection, may increase the risk of CNS stimulation and convulsive seizures [see Warnings and Precautions (5.4) ]. (Fachinformation zu Levofloxacin, Arzneimittelwechselwirkungen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Lithium Clinical Impact : NSAIDs have produced elevations of plasma lithium levels and reductions in renal lithium clearance. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients treated with NAMZARIC should be monitored closely for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers, e.g., those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs). (Fachinformation zu Memantin und Donepezil, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Although not observed with moxifloxacin in preclinical and clinical trials, the concomitant administration of a nonsteroidal anti-inflammatory drug with a quinolone may increase the risks of CNS stimulation and convulsions [see Warnings and Precautions ( 5.4 ), and Patient Counseling Information ( 17 )]. (Fachinformation zu Moxifloxacin, Arzneimittelwechselwirkungen)

…mycophenoloate mofetil, ketoconazole) Clinical Impact: Esomeprazole magnesium can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole magnesium is an enantiomer, in healthy subjects and in transplant patients receiving MMF has been… (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 2: Clinically Significant Drug Interactions with Nateglinide Drugs That May Increase the Blood-Glucose-Lowering Effect of Nateglinide and Susceptibility to Hypoglycemia Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs), salicylates, monoamine oxidase inhibitors, non-selective beta-adrenergic-blocking agents, anabolic hormones (e.g., methandrostenolone),… (Fachinformation zu Nateglinid, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Use OFEV with caution when treating patients with recent abdominal surgery, previous history of diverticular disease or receiving concomitant corticosteroids or NSAIDs. (Fachinformation zu Nintedanib, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Proton Pump Inhibitors, H2-receptor Antagonists, or Antacids: may decrease bioavailability of MYCAPSSA and the MYCAPSSA dose may need to be increased (‎ 7 ). (Fachinformation zu Octreotid, Arzneimittelwechselwirkungen)

Non Steroidal Anti-Inflammatory Drugs The concomitant administration of a non-steroidal anti-inflammatory drug with a quinolone, including ofloxacin, may increase the risk of CNS stimulation and convulsive seizures (see WARNINGS and PRECAUTIONS , General ). (Fachinformation zu Ofloxacin, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Pemetrexed Clinical Impact : Concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and pemetrexed may increase the risk of pemetrexed-associated myelosuppression, renal, and GI toxicity (see the pemetrexed prescribing information). (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

DRUG INTERACTIONS Bleeding has been reported in patients treated with pentoxifylline extended-release tablets with or without concomitant NSAIDs, anticoagulants, or platelet aggregation inhibitors. (Fachinformation zu Pentoxifyllin, Arzneimittelwechselwirkungen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

…steroids and androgens, cyclophosphamide, phenyramidol, guanethidine, fluconazole, sulfinpyrazone, tetracyclines, clarithromycin, disopyramide, quinolones, and those drugs that are highly protein-bound, such as fluoxetine, nonsteroidal anti-inflammatory drugs, salicylates, sulfonamides, chloramphenicol, coumarins, probenecid and monoamine oxidase inhibitors. (Fachinformation zu Pioglitazon und Glimepirid, Arzneimittelwechselwirkungen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Bone Fracture : Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Monitor patients using rivastigmine tartrate for symptoms of active or occult gastrointestinal bleeding, especially those at increased risk for developing ulcers, e.g., those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs). (Fachinformation zu Rivastigmin, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Clinical Effect/Recommendation Acid Reducing Agents: ↓ velpatasvir Velpatasvir solubility decreases as pH increases. (Fachinformation zu Sofosbuvir und Velpatasvir, Arzneimittelwechselwirkungen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

CYP2C19 or CYP3A4 Inhibitors Clinical Impact : Increased exposure of esomeprazole [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Tacrolimus Clinical Impact : Concomitant use of esomeprazole magnesium and tacrolimus may increase exposure of tacrolimus Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and tacrolimus, monitor tacrolimus whole blood concentrations. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : • During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Promptly evaluate patients treated with XELJANZ/XELJANZ XR who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis or taking NSAIDs) and who present with new onset abdominal symptoms for early identification of gastrointestinal perforation [see Adverse Reactions (6.1) ] . (Fachinformation zu Tofacitinib, Warnhinweise und Vorsichtsmaßnahmen)

Table 4: Clinically Significant Interactions with Esomeprazole Magnesium - Affecting Co-Administered Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact : Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Increased Risk of Bleeding: Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk ( 5.5 ). (Fachinformation zu Trazodon, Warnhinweise und Vorsichtsmaßnahmen)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Monitor RINVOQ/RINVOQ LQ-treated patients who may be at risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis and those taking concomitant medications including NSAIDs or corticosteroids). (Fachinformation zu Upadacitinib, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Other factors that increase the risk for GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

Co-morbid conditions such as coagulation disorders or concomitant use of warfarin and other anticoagulants, antiplatelet agents (e.g., aspirin), and serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase the risk. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

This diagnosis should be considered if clinical symptoms consistent with cyanocobalamin deficiency are observed. (Fachinformation zu Naproxen und Esomeprazol, Warnhinweise und Vorsichtsmaßnahmen)

• Increased Risk of Bleeding : Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, other antiplatelet drugs, warfarin, or other drugs that affect coagulation may increase risk ( 5.3 ). (Fachinformation zu Vortioxetin, Warnhinweise und Vorsichtsmaßnahmen)

Esomeprazole Magnesium • Increased INR and prothrombin time in patients treated with PPIs, including esomeprazole, and warfarin concomitantly. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ]. (Fachinformation zu Naproxen und Esomeprazol, Arzneimittelwechselwirkungen)

Nephrotoxic Drugs Caution is indicated when Reclast is used with other potentially nephrotoxic drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs). (Fachinformation zu Zoledronsäure, Arzneimittelwechselwirkungen)

The selective serotonin reuptake inhibitors sertraline (weak CYP3A4 inducer) and fluoxetine (CYP2D6 inhibitor), and the anti-epileptic drug felbamate (CYP2C19 inhibitor and CYP3A4 inducer) do not affect the pharmacokinetics of clonazepam. (Fachinformation zu Clonazepam, Arzneimittelwechselwirkungen)

…angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives without evidence of clinically significant adverse interactions. (Fachinformation zu Finasterid, Arzneimittelwechselwirkungen)

Examples: Nonsteroidal anti-inflammatory agents and other highly protein-boind drugs, salicylcates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, beta-adrenergic blocking agents; potentially with ciprofloxacin, micronazole. (Fachinformation zu Glibenclamid und Metformin, Arzneimittelwechselwirkungen)

In RA, concomitant medications besides MTX were nonsteroidal anti-inflammatory agents (NSAIDs), folic acid, corticosteroids and/or narcotics. (Fachinformation zu Infliximab, Arzneimittelwechselwirkungen)

Patients with Grade 1 and 2 TFR may also be treated with corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs) and/or narcotic analgesics for management of TFR symptoms. (Fachinformation zu Lenalidomid, Warnhinweise und Vorsichtsmaßnahmen)

Other drugs: Carbamazepine Furosemide (> 80 mg IV) Heparin Hydantoins Non-Steroidal Anti-Inflammatory Drugs - Fenamates These drugs may cause protein-binding site displacement. (Fachinformation zu Levothyroxin, Arzneimittelwechselwirkungen)

Other drugs: Carbamazepine Furosemide (>80 mg IV) Heparin Hydantoins Non-Steroidal Anti-inflammatory Drugs Fenamates These drugs may cause protein binding site displacement. (Fachinformation zu Liothyronin, Arzneimittelwechselwirkungen)

Protonenpumpenhemmer, die ein Jahr oder länger eingenommen werden, können einen niedrigen Magnesiumspiegel verursachen; Nahrungsergänzungsmittel gleichen ihn möglicherweise nicht aus, solange der PPI weiter eingenommen wird. (NIH Office of Dietary Supplements, Magnesium)

…performed, the following concomitant drugs were used in at least 10% of patients in either or both Sjogren's efficacy studies: acetylsalicylic acid, artificial tears, calcium, conjugated estrogens, hydroxychloroquine sulfate, ibuprofen, levothyroxine sodium, medroxyprogesterone acetate, methotrexate, multivitamins, naproxen, omeprazole, paracetamol, and prednisone. (Fachinformation zu Pilocarpin, Arzneimittelwechselwirkungen)

These include agents such as indomethacin, acetaminophen, naproxen, ketoprofen, meclofenamate, lorazepam, and rifampin. (Fachinformation zu Probenecid, Arzneimittelwechselwirkungen)

These include agents such as indomethacin, acetaminophen, naproxen, ketoprofen, meclofenamate, lorazepam, and rifampin. (Fachinformation zu Probenecid und Colchicin, Arzneimittelwechselwirkungen)

Examples: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, nonsteroidal anti-inflammatory agents (NSAIDs), pentoxifylline, pramlintide, propoxyphene, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics. (Fachinformation zu Repaglinid, Arzneimittelwechselwirkungen)

Concomitant Drugs for Treatment of Adult Indications In RA patients, population pharmacokinetic analyses did not detect any effect of methotrexate (MTX), non-steroidal anti-inflammatory drugs or corticosteroids on tocilizumab clearance. (Fachinformation zu Tocilizumab, Arzneimittelwechselwirkungen)

Drug-drug interaction studies in healthy subjects have been conducted with zileuton immediate-release tablets and digoxin, phenytoin, sulfasalazine, and naproxen. (Fachinformation zu Zileuton, Arzneimittelwechselwirkungen)

Effects of Concomitant Acid Blockers or Antibiotics A population pharmacokinetic analysis suggests that the pharmacokinetics of alvimopan were not affected by concomitant administration of acid blockers (proton pump inhibitors (PPIs), histamine-2 (H 2 ) receptor antagonists) or antibiotics. (Fachinformation zu Alvimopan, Arzneimittelwechselwirkungen)

Effect of Other Drugs on Micafungin in Sodium Chloride Injection CYP3A4, CYP2C9 and CYP2C19 Inhibitors Co-administration of Micafungin in Sodium Chloride Injection with cyclosporine, itraconazole, voriconazole and fluconazole did not alter the pharmacokinetics of micafungin. (Fachinformation zu Micafungin, Arzneimittelwechselwirkungen)