Espra Xh Tablet belongs to a group of medicines called Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or painkillers used to reduce and relieve pain. Pain is a highly unpleasant physical sensation caused by illness or injury.

Espra Xh Tablet combines Naproxen (painkiller) and esomeprazole (antacid). Naproxen is an anti-inflammatory drug that works by blocking the action of the body's cyclo-oxygenase (COX) enzyme to produce certain chemical substances (prostaglandins) that cause pain and swelling. This helps reduce mild to moderate pain and inflammation at the injured or damaged site, decreasing joint stiffness. Naproxen has been reported to cause gastric discomfort, acidity, and risk of stomach ulcers. Hence, combined with esomeprazole (proton pump inhibitors), it reduces the amount of acid made by the stomach, thus preventing damage to the stomach. Thus, the combination helps alleviate pain with minimal gastric irritation caused due to Naproxen alone.

Take Espra Xh Tablet as prescribed by your doctor. You are advised to take Espra Xh Tablet for as long as your doctor has prescribed it for you based on your medical condition. In some cases, you may experience indigestion, stomach pain, constipation, dizziness, nausea, and diarrhoea. Most of these side effects of Espra Xh Tablet do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.

Before taking this medicine, inform your doctor if you have any known allergy to Naproxen, esomeprazole, other NSAIDs, or other medications. If pregnant or breastfeeding, please inform your doctor before taking the Espra Xh Tablet. Also, inform the doctor if you have a history of heart rhythm problems or ulcers due to painkillers. Patients with age above 65 years, with pre-existing cardiac diseases such as heart failure, hypertension or stroke, gastrointestinal bleeding (due to pain killers), gastric ulcers, respiratory diseases such as asthma, liver diseases, kidney diseases, or bleeding disorders should use Espra Xh Tablet only when prescribed by a doctor. Keep your doctor informed about your health condition and all the medicines you take before taking Espra Xh Tablet to rule out any side effects.

Espra Xh Tablet contains Naproxen and esomeprazole (antacid). Naproxen is an anti-inflammatory (reduces inflammation) and an analgesic (relieves pain) agent that works by blocking the action of the cyclo-oxygenase (COX) enzyme in the body that is involved in the production of certain chemical substances (prostaglandins) that cause pain and swelling. This helps reduce mild to moderate pain and inflammation at the injured or damaged site, decreasing joint stiffness. It also treats fibrositis (muscle pain and stiffness), tenosynovitis (swelling of tendons), low back pain, strains, and sprains. NSAIDs such as Naproxen have been reported to cause gastric discomfort, acidity, and risk of stomach ulcers. To reduce gastric discomfort and stomach ulceration risk, it is combined with esomeprazole (a proton pump inhibitor that inhibits gastric acid secretion) to reduce stomach acid production during long-term treatment for people with pre-existing stomach ulcers or for people having a history of developing stomach ulcers while using NSAIDs. Thus, the combination helps alleviate pain with minimal gastric irritation caused due to Naproxen alone.

• Confusion
• Headaches
• Ringing in the ears
• Changes in vision
• Tiredness and feeling sleepy
• Dizziness
• Rashes

Do not take Espra Xh Tablet if you are allergic to Espra Xh Tablet. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin), such as naproxen, may increase the risk of heart attack, stroke, and stomach ulcers. The risk of developing ulcers is higher if you have a history of ulcers, have bleeding disorders, are older, are alcoholics, or have multiple diseases. Elderly patients are at greater risk for gastrointestinal bleeding problems, so the doctor can limit their dose. It should not be used by a patient who has undergone recent heart bypass surgery or going to have it. Espra Xh Tablet is not recommended for pregnant women, especially in the third trimester, as it may cause harm to the baby. Therefore, pregnant or breastfeeding women are advised to consult a doctor before taking Espra Xh Tablet. Espra Xh Tablet should not be given to children unless prescribed by a doctor. Do not take any other NSAIDs for pain relief along with Espra Xh Tablet unless prescribed. Prolonged proton pump inhibitors like esomeprazole may cause brittle bones, so your doctor may recommend taking Vitamin D and calcium while using Espra Xh Tablet. Do not consume alcohol with Espra Xh Tablet as it may increase the risk of stomach bleeding or ulcer.

Drug-Drug Interactions: Espra Xh Tablet may have interaction with anti-inflammatory medicines (e.g. aspirin, ibuprofen), blood thinners (e.g. warfarin, rivaroxaban), steroids (e.g. prednisolone), diuretic medicines (e.g. furosemide), medicines used to treat heart problems and high blood pressure-lowering medicines (e.g. propranolol, enalapril, losartan, candesartan), antidepressants (e.g. citalopram), and medicine used to treat rheumatoid arthritis (e.g. methotrexate)

Drug-Food Interactions: Espra Xh Tablet may interact with alcohol. Therefore, avoid alcohol intake while taking Espra Xh Tablet as it may increase the risk of stomach bleeding and drowsiness, and dizziness.

Drug-Disease Interactions: People with diabetes, stomach ulcer, gastrointestinal bleeding, asthma, kidney, liver, or heart problems, and an autoimmune condition, such as systemic lupus erythematosus (joint pain, fever, and skin rashes), colitis or Crohn’s disease (conditions causing swelling of the bowel, diarrhoea, bowel pain, vomiting, and weight loss) should consult a doctor before taking Espra Xh Tablet.

• ASPIRIN
• IBUPROFEN
• WARFARIN
• RIVAROXABAN
• PREDNISOLONE
• FUROSEMIDE
• PROPRANOLOL
• ENALAPRIL
• LOSARTAN
• CANDESARTAN
• CITALOPRAM
• METHOTREXATE

• Physical activity helps strengthen muscles and relieves joint stiffness. Gentle activities like 20-30minutes of walking or swimming would be helpful.
• Performing yoga may also help in improving joint flexibility and pain management.
• Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
• Get adequate sleep, as resting the muscles can help reduce inflammation and swelling.
• Follow heat or cold therapy, and apply a cold or hot compress on the joints for 15-20minutes regularly.
• Acupuncture, massage and physical therapy may also be helpful.
• Foods containing flavonoids, such as soy, berries, broccoli, grapes and green tea, help reduce inflammation.
• Include high-fibre-containing foods, berries, cherries, leafy green veggies and black peppers in your meal. These foods are full of antioxidants, calcium and vitamin B12 that can help cope with the long-term effects of the medicine. Fermented dairy products like miso, sauerkraut and kimchi contain probiotics that help prevent excess stomach acid production.
• Avoid acid or heartburn-triggering foods or drinks like onions, peppermint, chocolate, caffeinated beverages, citrus fruits or juices, tomatoes and high-fat and spicy foods.
• Avoid smoking and alcohol consumption.

• If you are elderly, a smoker who had a stroke previously, or have high blood pressure, diabetes or high cholesterol, please inform your doctor, as these conditions may increase the risk of heart problems.
• Your doctor may monitor liver and kidney function if you take Espra Xh Tablet for the long-term.
• Individuals at risk for osteoporosis-related fractures should receive adequate calcium and vitamin D intake.
• Esomeprazole in Espra Xh Tablet may interfere with specific laboratory tests (including urine test for tetrahydrocannabinol-THC, a blood test to find certain tumours), possibly causing false test results. Make sure laboratory personnel and all your doctors know you are using Espra Xh Tablet.
• Regular monitoring of vitamin B-12, rarely, esomeprazole in Espra Xh Tablet has chased vitamin B-12 deficiency. The risk increases if they take Espra Xh Tablet every day for a long time.

Osteoarthritis: Osteoarthritis is a degenerative joint disease in which the two ends of the joints come together due to the breakdown of a protective covering of cartilage. Due to the absence of this protective covering, the joints rub against each other, leading to pain and stiffness. Symptoms of osteoarthritis include pain, stiffness, inflammation, and tenderness. The main reason for osteoarthritis is age. The older you are, the more likely you could get osteoarthritis, thus known as degenerative disease, meaning that the joints wear out as a person ages. Other reasons include past injuries such as torn cartilage, dislocated joints, and ligaments. 

Rheumatoid arthritis: Rheumatoid arthritis is an auto-immune disease (the body's immune system attacks its tissue) that leads to joint pain and damage. Symptoms of rheumatoid arthritis include pain, swelling, stiffness, deformities, and loss of joint function. 

Ankylosing spondylitis: It causes pain and stiffness in the spine. The pain usually starts in the lower back and can spread to the neck, damaged joints, or other body parts. Symptoms of ankylosing spondylitis include decreased flexibility which usually leads to a hunched-forward posture, pain, and the back and joints.