Is the alphabet soup of acid reflux giving you heartburn of the brain?


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.

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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.

About Cary Byrd

eDrugSearch founder, Cary Byrd, has been called an “e-health innovator” by MarketIntellNow, interviewed by top pharmaceutical industry journalists, invited to Matthew Holt’s Health 2.0 Conference and a Consumer Report's health summit, and highlighted on numerous health blogs.

acid reflux drugs

0 thoughts on “Is the alphabet soup of acid reflux giving you heartburn of the brain?

  • 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…

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • mary corrigan says:

    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…

  • leonard carrico says:

    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.

  • Richard Dearth says:

    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?

  • 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.

  • 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?

    • I cannot take prilosec because it gives me terrible stomach cramps and chest pains so my doctor switched me to 30mg prevacid once a day in the morning.  However, I still have to be careful not to ingest coffee, chocolate, spicy foods or mints because they relax the sphincter and promote reflux.  I know this, that an eroded esophagus could take 3 months to heal.  So if you are new on the medication, give it time to really set in and work.

  • 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.

  • 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?

    • My suggestion, take more Prilosec.  Prilosec is exactly Nexium just in a lower dose from my research. I am currently on Protonix and it does not work as well as doubling up on Prilosec. I am switching back.

  • 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.

  • 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.

  • Started with Nexium years it…but one daymy insurance refused to pay for it. Had to get the scope done to prove I had acid reflux…my insurance still gave me a hard time with the Nexium. My doctor switched me to Prilosec. It’s a good med, have no side affects…but it’s still no where near as good as the Nixium. I only had to take Nexium once every other day compared to Prilosec everyday.I’m now on Protonix…it’s okay but I noticed I’ve been getting heart burn and other side affect while taking. So I’m going to see about getting back on Nexium, because it worked best for me.

  • Maxine Sherrard says:

    ten years ago went to cardio doctor with symtoms of heartattack, after many tests was determined acid reflux diease. He gave me samples of Prilosec, and told me to take 0ne at bedtime for 21 days then stop, and don’t take again unless it comes back, then to take for 21 days and keep doing this. I don’t belive in alot of pills so this worked for me. now after a bout of allergies sinus, and running to doctors for relief of a cough, I finally had a bad attack of acid reflux, My husband gets pantoprozole(protonix) from the VA, so being desperate I took one of his and got immediate relief, now I will get a script, from my doctor and take for 21 days and stop, if it comes back I will take for another 21days. I have an irratated esphacus , and got careless about my diet. My love for the wrong foods is not worth the agonie also my cough i had for months is gone. I got information about GERD on a medical web site. No doctor even questioned the possibility of acid reflux. I wonder why.

  • A few years back I had a rash for 9 months that was finally determined to be from Nexium. I switched to prevacid.No problems until it seemed to be missing from all shelves of all stores. Got prilosec thinking it was the same. Took it for over 6 weeks. 4 weeks ago I started with an ugly rash on my lower back with some on my forehead. The rash has worsened and spread a lot. I remembered the timing and stopped it after discussion with doctor. We didn’t know if they are similar or not but tonight I read they are from same manufacturer and have same main ingredient. These drug companies are criminals. Be careful folks. They are dangerous and I look like a leper.

  • I can’t take Nexium or Protonix because they both trigger symptoms resembling a heart attack. I have no such problems with Zegerid or, if I recall correctly, Prevacid. It was nearly a week before I realized those symptoms started about the same time I started on samples of Nexium to try for my GERD and sure enough, they went away when I stopped the Nexium. My GI doc later gave me the others to try and it took trial and error to find out which of those I could take without those side effects.

  • Have LOTS of gas in the form of belching and farting. Abdominal pains as well. Dr had me take Miralax for 2 wks which did not make a difference. Next dr gave me samples of Dexilant to try. Caused diarrhea. Going to try over the counter acid reflux product but do not know if I should try Zegerid, Prilosec, or Prevacid. Any suggestions?

  • SayingItLikeItIs says:

    I don’t know which is worse: The effects of acid reflux on my body or of the prescription cost on my wallet! I live in Ohio and have good insurance with prescription coverage. My doctor has me on one 20mg Nexium tablet per day. When I looked into getting a 90-day supply of Nexium 20mg tablets through my plan’s mail-order program, I learned that the cost is $626. This compares to a 30-day supply from a retail pharmacy for $236. Currently, in the U.S., there are NO GENERICS for Nexium, which is manufactured by AstraZeneca. That’s when I started researching and discovered that I can get the same medication through Canadian Pharmacy Online for a mere fraction of the cost! This is a Canadian pharmaceutical company with toll-free access, to whom you email or fax your prescriptions and get them delivered right to your door. What is Canadian Pharmacy Online’s cost for the very same 90-day supply of Nexium 20mg tablets? It’s only $38. This is for the brand name Nexium, manufactured by AstraZeneca — just not AstraZeneca in the U.S. Even better is the fact that, unlike in the U.S., Nexium comes in generic form (under the name Esomeprazole) through Canada. The cost for a 90-day supply of Esomeprazole 20mg tablets? It’s just $30. Shipping for all orders is a flat rate of $10. To date, I have ordered a number of prescription drugs using this Canadian Pharmacy, including the hormone replacement Premarin and anti-depressant Effexor XR. In EVERY case, the medication from Canadian Pharmacy Online has worked identical to that which I used to get through my insurance plan’s mail-order program or from my local pharmacy here in the U.S. There are other Canadian pharmacies available, but I have found this one seems to be the biggest/most popular and consistently offers the best prices (at least as far as the medications I use). And you know what else? Express Scripts (the company that manages the prescription benefits for my insurance carrier) has applied 100% of the prescription costs (excluding the $10 shipping fee) I’ve incurred in using this Canadian pharmacy to my deductible. Unfortunately, the Obama Administration is attempting to outlaw our access to such out-of-the-country pharmacies. I signed a petition aimed at stopping his efforts, but am worried this is just one more freedom we may soon have to kiss good-bye.

  • Kristyne Haver says:

    There is also another reason a person may have acid reflux, and it is not necessarily diet so don’t let the ignorance of the author of this article make you feel bad. I first experienced heartburn when pregnant with my first child, which is entirely understandable. However, I didn’t have it on a regular basis other than when I was pregnant. However, I began to experience some unusual pain in my abdomen so my doctor ordered an ultrasound and a barium study. Other than a large supply of gallstones, guess what else they say with the barium study? A hiatal hernia! The doctor performing the study noticed it right away and said he thought I must experience a significant amount of heartburn. I told him no, really only when I was pregnant. He was very surprised. So, for all of you suffering from heartburn, you may have a hiatal hernia, which basically means the flap at the end of your esophagus does not close all the way. Sure, there might be some foods which will make your heartburn worse, but you may or may not experience heartburn even if you have the healthiest diet in the world. I am lucky, I don’t have it very often. I have never taken any meds for it, but what seems to work for me is to get out of bed and suck on a cherry popsicle. It’s cool, it’s soothing, lasts for a little while if you don’t eat it, just suck on it, and does the trick for me for a mild case. The only reason I looked at this site was to find a substitute for Zegerid, which the owner of my company takes. He just went on Medicare and I am attempting to find a Part D plan for him. I was shocked at how much these plans estimated his out-of-pocket costs to be so I went to my own pharmacist and found out why. Where I live in PA, the retail price of the brand name Zegerid is $3,498.99 for a 30-day supply, and the generic is still $3,023.29! Makes you wonder if the doctors prescribing it over another drug are receiving some sort of kickback. For those of you taking it, heaven help you when you have to go on Medicare!

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