Neso 500 Tablet - (20mg + 500mg) contains a combination of two active ingredients:  

• Esomeprazole (as Esomeprazole Magnesium Trihydrate): 20 mg  
• Naproxen Sodium: 500 mg  

It is manufactured by Eskayef Pharmaceuticals Ltd.

Indications:

Neso 500 is indicated for the relief of signs and symptoms of:  

• Osteoarthritis  
• Rheumatoid arthritis  
• Ankylosing spondylitis  
• To decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.  

Pharmacology:

• Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body.  
• Esomeprazole is a proton pump inhibitor (PPI) that reduces the amount of acid produced in the stomach. This helps to protect the stomach lining from irritation and damage that can be caused by naproxen. The formulation is designed with an immediate-release esomeprazole layer and an enteric-coated naproxen core, so esomeprazole is released first in the stomach before naproxen dissolves in the small intestine.  

Dosage and Administration:

The usual recommended dose for adults is one tablet twice daily.  

• The tablet must be swallowed whole with water and should not be split, chewed, crushed, or dissolved.  
• Neso 500 should be taken at least 30 minutes before meals.  
• The lowest effective dose should be used for the shortest duration consistent with individual patient treatment goals.  

Contraindications:

Neso 500 is contraindicated in patients with:  

• Known hypersensitivity to any component of the product or substituted benzimidazoles.  
• History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.  
• Use during the peri-operative period in the setting of coronary artery bypass graft (CABG) surgery.  
• Late pregnancy (third trimester).  

Side Effects:

Common side effects may include:  

• Erosive gastritis  
• Dyspepsia (indigestion)  
• Gastritis (inflammation of the stomach lining)  
• Diarrhea  
• Gastric ulcer  
• Upper abdominal pain  
• Nausea  

Less common or serious side effects can occur. It's important to consult your doctor if you experience any unusual symptoms.  

Precautions:

• Patients with known cardiovascular disease or risk factors may be at greater risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.  
• Use with caution in patients with fluid retention or heart failure.  
• Monitor patients with mild to moderate hepatic impairment closely. Neso 500 is not recommended in patients with severe hepatic impairment.  
• Naproxen-containing products are not recommended for use in patients with moderate to severe renal impairment.  
• Caution should be used when high doses are required in elderly patients, and some dosage adjustment may be needed.  
• Avoid concomitant use with other NSAIDs, including COX-2 selective inhibitors.  
• Inform your doctor about all other medications you are taking, as there can be drug interactions.  

Pregnancy and Lactation:

• The use of Neso 500 should be avoided during pregnancy, especially in the third trimester, due to potential risks to the fetus.  
• Due to the naproxen component, Neso 500 should not be taken by nursing mothers.  

Note: This information is for general knowledge and informational purposes only and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication.