Vimovo: n-said with a "magic" coating? To good to be true?

 Hello everyone! I have been a sufferer of debilitating osteoarthritis since the ripe old age of 20. Now, at 32, I am handicapped. I've tried all the n-saids out there to no avail, had injections, radio-frequency(nerves burnt along lumbar spine), epidurals, etc., and nothing has helped to relieve my pain. Not even the strongest narcotics known would touch it, so right now I'm on a rather controversial, off label, opiate drug.

  As I was letting my toes dry after a pedi, I came across an ad for Vimovo. I had never heard of it before and to tell you the truth I was surprised, as my pain management team is very current in their treatment options. I guess they already figured out that n-saids were of no good to me. It seems nothing is. That is why I had no hesitancy in having RNY. I don't use them and I'm tired of taking things that don't work, just for the sake of taking it.

  Vimovo is a n-said used for patients with OA, RA, and ankylosing spondylitis to decrease the risk of gastric ulcers from the treatment of n-saids. Although the ad did say that is not supposed to be used for more than 6 months because controlled studies have not extended beyond that time. Vimovo is made of naproxen as the "inside of the pill" and esomeprazole magnesium as the outer coating, so to speak.

  I just wanted to post this info in case some of you out there haven't heard of it. I know that some Dr's are prescribing RNY patients n-saids at times and having them take PPI's while they are. At first, I thought, well great I'll have to tell everyone about this, but then I started to wonder about the efficacy of this for RNY patients because it seems to be the kind of pill that has to have the "outer shell" dissipated before the n-saids would become available to work. With the system of an RNY patient, I wasn't sure if we would be able to do that in time before it works it way out because of the stomach acid issue. I won't pretend that I'm an ace at anatomy, so what I stated above, about the RNY system, and breaking through the pills, is just my guess. I know that some you "smarties" out there can tell me because I'm curious about that.

  Anyway, I just thought I'd post about it because it seemed pretty ingenious when I read it. An n-said with a candy coating off a PPI!!! Whattayaknow!! Thanks for reading this long 'ol post, but I wanted to see if anyone had heard of it, or what they thought about it, or even if anyone was on it.  

Annie ... what is a PPI?

I'm no expert but from what I understand NSAIDs are a no go even if they are taken by another route like IV.  They affect us systemically so they don't have to come into contact with the stomach to be dangerous.
Also, I have heard that we can't take coated medications because it doesn't stay in the stomach long enough, and there isn't enough acid to break down.
Might be wrong, just what I think I understood.

No, I think you're right. That's what I was sating at the end of the post. That after I thought about it a minute, I figured we probably can't "melt" the coating before it goes through our system. I, however, did forget about the fact that n-saids affect us either way. Whether it be orally or intravenously. Thanks, I knew I was missing something!

It's called a proton pump inhibitor, or PPI. Basically it is a medicine that help you stomach not to get ulcers if you are on n-saids. I used to take a PPI, omeprazole, which is basically the same thing they are talking about in this drug too, when I was pre-op for acid-reflux.

As you have realized, this is still an NSAID and is absorbed systemically, and does not avoid the ulcer problem, especially in the blind stomach.  Plus you probably won't absorb it properly.

The coating is mostly irrelevant.

If an NSAID is working it is also thinning the mucosal lining of your stomach.  It doesn't matter if it's a pill or a liquid or a patch or coated in Kryptonite or titanium or milk chocolate or if you shove it up your nose or sit in pool of it...it there is enough of it in your system to reduce pain, it is thinning the mucosal lining of your stomach.

And therein lies the problem.

 It's just a marketing ploy to throw two generics together and make it a branded product.  It's not worth what they charge and doesn't protect against the deleterious effects of NSAIDs.  It's not an enteric coating, so it dissolves immediately leaving the NSAID in the unprotected sleeve or pouch depending on the type of surgery you had.  PPI's also don't work immediately -- another reason this is a gimmick -- by the time the NSAID has inflicted its damage, the PPI is starting to work.  Also, NSAIDs can cause the same symptoms intravenously, transdermally, and orally; therefore, route of administration is not as important as whether or not you are taking NSAIDs at all.  With any luck, maybe the PPI candy coating will help the NSAID melt in our mouths and not our hands.  Oh wait, that's already been taken!