You’ve got persistent heartburn happening two or more days a week — something generally diagnosed as acid reflux disease these days. Which of the many available drugs should you take:
Or something else?
Sounds confusing, doesn’t it?
It isn’t, really. These drugs all do the same thing in basically the same way. And I hate to say it, but a big reason there are so many variations on the market has less to do with helping you than with lining the pockets of big pharmaceutical companies.
You see, two of the best-selling acid reflux drugs — Prilosec and Nexium — are essentially the same drug marketed by the same company, AstraZeneca. Nexium is derived from Prilosec, and AstraZeneca argues that it’s more effective, and has been aggressively making its case to doctors (helped by its wine-’em-and-dine-’em sales force.)
However, many critics believe AstraZeneca is full of it. For example, Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine, last year accused AstraZeneca of doctoring its comparative studies to produce a difference that wasn’t there.
I know — you’re probably not interested in the politics. Just understand that a lot of things go into the creation of new drug brands besides a concern for helping the patient.
The bottom line is that all of these drugs are something called “proton pump inhibitors,” and while there are some chemical differences among them, there is no definitive research that shows one more effective than another. That said, you as an individual patient may respond differently to each of the drugs — in terms of efficacy and side effects. So try one, and if it isn’t effective, try another. Zegerid, for example, combines the active ingredient with a sodium bicarbonate, which allows it to be sold as chewable tablets. This is good for folks seeking immediate relief.
As always, consult with your doctor and rely on his or her guidance in making a decision.
One other note: There’s a very important step you should take before getting a prescription for ANY of these medications. You should change your diet. A big reason acid reflux disease is rampant in the United States today is because our diets are terrible. Please follow these diet tips before starting on any medication.
Remember, taking an acid reflux drug caused by a poor diet only treats the symptom. It doesn’t make you healthier. That acid reflux may be your body’s way of telling you to feed it something else.
29 responses so far ↓
1 Gerd diet // Nov 11, 2008 at 10:47 am
I’m on prilosec, but I have terrible belching and problems with gases. I’m on diet too, but still, I can’t seem to get any better. The whole thing is so depressing…
2 Chris // Jan 3, 2009 at 8:17 am
I have taken Prilosec, Prevacid, Zegerid, and now Nexium and all seems to cause the acid refux more than help. I am on a law fat and bland diet, have lost 12 pounds and am exercising. I wonder if I stopped taking Nexium for a while if there would be any problems.
3 Andy // Jan 24, 2009 at 10:42 am
I had terrible acid reflux about five years ago and was put on 2x per day Nexium and it helped greatly. I was switched over to Prevacid 1x per day for long term care and it helped. Just went to a gastroentorologist and he put me on Zegerid 1x at night and I feel awful. Am going back to Prevacid. Also just read the link to Diet Myths and, yes, cutting way back or no alcohol helps. But avoiding coffee also seems to help me personally a good deal and they list that as a ‘myth’ – Makes me question whatever study ‘debunked’ it.
4 Betsy Braver // Feb 3, 2009 at 8:06 pm
I have been on Zegerid 40ml.for 3 years with great results but now my prescription supplier,Prescription Solutions will no longer allow it to be sold to me .Do you have a suggestion for a substitute? My MD has even written a new prescription for Zegerid.
5 Lawbug1 // Nov 20, 2009 at 12:46 pm
Yes Betsy Braver i use Perscription Solutions you can try Omeprazole which is a generic drug or Nexium- Protonix which are basicley the same as drugs according to a cross refference drugs as only your DR.can tell you which is best for you to use.
6 Larry // Jan 25, 2010 at 6:50 pm
I tried prilosic, prevecid and was still living on Rolaids till starting with Nexium 5 years ago, 1 tablet at bedtime. Only one that’s been effective for me. However, I have to keep getting insurer “exceptions” via my doc for approval before they’ll ok rx. Costs them more than generics.
7 Mack // Feb 25, 2010 at 3:34 pm
I take Protonix 40MG because it is suppose to have a healing effect in addition to a Proton Blocker. I had Pancreas Cancer and had the “Whipple” surgery. So far I have survived the cancer with little problems as long as I have Protonix. I lost my insurance so I switched to Prevacid. After 4 months I developed a stomach ulser. I resumed taking Protonix and the pain and ulcer went away! I think there is a big difference between Protonix and the others.
8 Kay Salberg // Mar 3, 2010 at 10:17 am
Are Prilosec, pepcid and Zantac interchangable??
9 maria // Mar 20, 2010 at 10:31 pm
i was taking protonix and it stopped my acid reflux immediately. health america made me change to nexium because it is on their “preferred” list? I have been taking it for about 12 days until i realized i was experiencing serious side effects such as a dry mouth so serious that i couldn’t swallow,dizziness, and trouble breathing. 3 months ago i was diagnosed with COPD and i think it very irresponsible of health america to make me switch from a medication that to me it seemed a miracle that protonix worked so efficiently to a drug that had these side effects posted on their leaflet!just who is running the show here. It seems to me that Nexium somehow got on health america’s “preferable” list {kickback perhaps?) It’s bad enough they charged me $25.00 for nexium
10 linda // Apr 4, 2010 at 10:00 am
I started decades ago with tagamet. Have been through many others & tried prilosec diff times even taking twice the dose–no good. Last time ended up in emergency room with chest pain. Nexium only thing really works but will have to battle insurance company annually now for it to be covered.
11 Suzanne // Apr 5, 2010 at 8:19 am
I have Barret’s esophagus and have been using Nexium for nearly 5 years. I have had no side effects, it seems to work as my condition has not gotten worse…It can not be healed, only controlled. good old Medicare D – Humana will no longer cover it as of 2/2010. I notice that companies do not tell you in december that they will be dropping your medicine for the new year.
12 Loren // Apr 22, 2010 at 12:31 pm
I have been looking for a solution for hearburn for several years. My Docotr suggested I get a gasto exam-looking for GERDS. I found I had a slight issue – I find that Nexium is the only real medication that works for me. I eat right etc.. without Nexium I am up at least a couple times a night with heart burn. Health Partners just notifyed me that Nexium is now off thier prefered list. I am currently trying to get a exception… Looking for alternatives…I see advertizing saying that Zegerid OTC – says “NEW” is the a better solution now? or has something changed- Would appreciate you opinions & options.
13 mrs.p // May 17, 2010 at 5:52 pm
Idon’t get the sour taste.I just get the pain in my neck and throat and hard to swollow.And my upper back and shoulders hurt,just don’t know which one to take wore when I go to bed need to get a otc med. can you help.
14 Summer // May 23, 2010 at 8:15 am
I was diagnosed with a hiatal hernia and was prescribed protinix, but lost my insurance, so my doctor tole be to take prevacid. After a couple of months, I was talking to the pharmacist and I was told that prevacid is more simular to Protonix. I feel awful by the evening, I have stomach cramps and more reflux than before. I am switching back to prevacis until I get some more insurance.
15 Suzanne // May 23, 2010 at 11:19 am
I have Barretts esophagus and Nexium is the only drug that works for me. I have Humana drug coverage and also have to go for exceptions each year. I actually paid out of pocket this year while I and my doctor fought with them for coverage which has now been reinstated.
16 Charlotte // Jun 12, 2010 at 3:10 pm
Just started Nexium…looking for a less expensive PPI, but that is as good.
17 mary corrigan // Jul 6, 2010 at 3:40 pm
Had a endoscopy done and they found a blockage in my esophagus and a small hiatal hernia…I am taking prontonix 40 mg and I still have the pain in the esophagus and stomach…
18 leonard carrico // Jul 27, 2010 at 2:02 pm
I have tried most GERD meds.& while on Zantac,Pepcid,
Carafate,Acifex,Prilosec,I had to live on Baby Food,Could barely swallow that & rest of time Drank ensure.& Bland Cream Soups.
I couldn’t eat real food til I took Prevacid 30 mg,for over a yr.then I could swallow what i can mash with a FORK. Now the V A Wants me to take a “JUNK” Pill the same & most say worse than Acifex,called Potonix & most Comment has it worse than Acifex!! I told &will pay $300 if I have to to keep eating good food with Previd.
19 Richard Dearth // Jul 30, 2010 at 11:06 am
I have been taking Protonix 40mg for a couple of years, at $145 a bottle (30 day supply) for an Ulcer. My question is, is Prilosec Over-The-Counter really an Equivilant or not?
20 Aaron // Sep 9, 2010 at 9:29 pm
Was just recommended to take Protonix 40mg for 4 weeks for a stomach ulcer. I went with the Prilosec 20mg instead. I am REALLY hoping they do the same thing
21 mike // Sep 29, 2010 at 6:32 pm
How is the Prilosec working for you?
22 Anthony // Jan 5, 2011 at 3:21 pm
Hi
I don’t think the manufacturer is totally wrong I think it depends on the individual and how severe.
My docs have tried me on Prevacid,Prilosec,Aciphex, etc. but the only ones that have worked are Nexium and Zegerid and my dosage is higher than 90% of other people.
23 KMarshall // Jan 19, 2011 at 8:17 pm
I’ve been taking Protonix for an ulcer for over 5 years. Lost health insurance and can’t afford it. Was told to try prilosec otc and got tongue swelling and horrible issue swallowing..any other suggestions?
24 Sherry // Mar 11, 2011 at 4:57 pm
I was on Nexium 40mg. 2 a day, It made me so nauseated. The doc then told ne to try otc prilosec 2, 20 mg. in the morning. Worked great! for a couple of days, I woke up alot during the night, well a few days later, NO SLEEP!, 3 days and nights, NO SLEEP! I even cut it back to 1 20mg. pill per day, no good. So, now he told me to try otc prevacid, the active ingredient is diffrent the nexium and prilosec. My fingers are crossed. One thing to keep in mind when you decide to stop taking these is to go off of them SLOWLY, other wise all the symptoms come back. At first I told my doc, that I would Not take any of these because of all the negitive comments on these web sites, he told me the reason was you can not just up and stop one day, you need to gradually stop. I asked if the directions said that, IT DOES NOT! I asked the pharmacy, same answer as the docs. What is wrong that they can not tell us about the things that will matter to all of us who use their products. If this does not work I am trying integrative medicine,they tend to understand there is more out there than big pharmacies with deep pockets and little concern for our health.
25 Julie // Aug 12, 2011 at 10:51 am
I’ve been taking Prilosec OTC (20mg) every day for just over 7 years. It works great and I’ve had no side effects. Recently, though, I’ve been experiencing some breakthrough symptoms, so I’m going to try Protonix. Any comments? Has anyone had any nasty side effects from it?
26 Cary Byrd // Aug 15, 2011 at 1:00 pm
Please register and submit all your drug reviews and feedback here: http://www.edrugsearch.com/drug-ratings-reviews
We would love to here what you’ve learned so you can help others
27 TC // Sep 7, 2011 at 6:46 am
I’ve been on Nexium for years. Unfortunately my insurance stopped covering it and as I’m sure you know its really expensive. I’ve tried Omeprazole and prilosec and it did a job on my stomach. I’m now trying Zegerid. Still having issues. I might miention that I also suffer from Crohns Disease. Pharmacist claims there’s no difference between the pills but if you look them up there is.
28 Carol // Oct 4, 2011 at 10:37 pm
Nexium is great, but can cause hypomagnism with long term use. Does anyone know of something for bad aced reflux.
29 Chris // Oct 8, 2011 at 2:13 am
I used Protonix for over 3 years and then my gastro dropped it and changed me to nexium I feel weird side effects and the back pain caused by my ulcers is back to me the best medicine is Protonix and I got to this website while looking for generic Protonix cause Nexium is not helping me at all. I hope this helps.
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