They cited concerns such as:. The authors analyzed 41 studies on the effectiveness of PPIs. Until March , Nexium was available only by prescription and at a significantly higher price. However, generic omeprazole may be less expensive than Prilosec OTC.
Work with your doctor or pharmacist to decide which PPI is best for you. In addition to cost, consider things like:. A link to possible dementia risk was reported in , but a larger confirmatory study in determined that there was no increased risk of dementia from using PPIs.
Many people experience excess acid production when they stop using PPIs. At the end of the recommended treatment duration, you should taper off of the medication gradually. Work with your doctor to do so. Before taking either medication, talk to your doctor to learn about the risk factors and drug interactions associated with them. Always tell your doctor about all the drugs, herbs, and vitamins you take. Prilosec and Nexium can interact with other medications you might be taking.
The U. Food and Drug Administration FDA has issued a warning that the drug in Prilosec reduces the effectiveness of the blood thinner clopidogrel Plavix. Other drugs can interact with Nexium or Prilosec, but may still be taken with either drug. Tell your doctor if you take any of these drugs so they can evaluate your risk:. Lifestyle changes should be your first steps in controlling GERD and heartburn. You may want to try:. If you make less stomach acid, you are at increased risk for gastro-intestinal infections.
Staller says that's not enough reason to stop taking PPIs if someone's deriving real benefits from them. If you have new heartburn symptoms, don't jump to PPI use. Staller, "try some pill-free changes: quitting smoking, losing weight, and avoiding food and drink that triggers heartburn. If that doesn't give enough relief, start with antacids. If they aren't effective, move up to an H2 blocker for a few weeks.
If that doesn't work, try a PPI. If you're still having heartburn after two weeks of PPI use, talk to your doctor to get to the root of the problem. You may need more diagnostic tests and different treatments.
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No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Thanks for visiting. Don't miss your FREE gift. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health , plus the latest advances in preventative medicine, diet and exercise , pain relief, blood pressure and cholesterol management, and more. Most Medicare and insurance plans will cover the generic version of Protonix, pantoprazole.
Some Medicare and insurance plans may cover Nexium or its generic version, esomeprazole. The most common side effects of Protonix are headache, diarrhea, nausea, abdominal pain, vomiting, gas, dizziness, and joint pain.
Common side effects of Nexium include headache, diarrhea, nausea, gas, abdominal pain, constipation, and dry mouth. Serious side effects of PPIs are often associated with long-term use. Serious side effects may include osteoporosis-related bone fractures, vitamin B12 deficiency, and low magnesium levels hypomagnesemia. Frequency is not based on data from a head-to-head trial.
This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more. Protonix and Nexium, like other PPIs, interact with many of the same medications. These PPIs should be monitored or avoided with other drugs that are dependent on stomach acidity for absorption. Drugs that are dependent on stomach acidity for absorption include iron salts, erlotinib, ketoconazole, and mycophenolate mofetil.
Protonix and Nexium can also interact with antiretroviral drugs, or drugs that are often used to treat HIV. PPIs can increase or decrease blood levels of antiretroviral drugs, which can lead to an increased risk of toxicity or decreased effectiveness with antiretroviral drugs.
Nexium should be monitored or avoided with diazepam since it can increase blood levels of diazepam and lead to an increased risk of adverse effects. The use of Nexium and clopidogrel together should also be avoided. Nexium can decrease how well clopidogrel works in the body, which can increase the risk of blood clots. The long-term use of PPIs may lead to an increased risk of bone fractures, especially in people who have already been diagnosed with osteoporosis.
Bone mineral density may need to be monitored during long-term treatment with PPIs. Some patients have experienced acute tubulointerstitial nephritis TIN while taking Protonix or Nexium. Nephritis is the inflammation of the kidneys, which can lead to decreased kidney function.
The use of PPIs may be linked to an increased risk of Clostridium difficile-associated diarrhea. Those who experience persistent diarrhea may need to be monitored, especially in a hospital setting.
Heartburn is the lay term for a burning sensation in the general area of the heart, often due to gastroesophageal reflux disease GERD. When the person swallows, the LES relaxes so that ingestants can enter the stomach. The LES is usually closed, and food remains in the stomach. However, in certain situations, stomach contents push upward reflux into the esophagus. Stomach contents are acidic and contain damaging materials e. Other alarm symptoms include sweating; bleeding from any other area not previously mentioned; hoarseness; fever in conjunction with abdominal pain; anorexia; abdominal pain in a nonepigastric area; unexplained weight loss; chest pain; pain in the lower belly, on the side, or in the back; and pain that radiates to the jaw, neck, or arm.
These alarming referral symptoms could also be indicative of myocardial infarction, gastric cancer, appendicitis, peptic ulcer, gallstones, bowel problems, or other morbid conditions.
Nonprescription antacids carry FDA-approved labeling for heartburn. For patient safety, the pharmacist should urge the patient to closely observe these instructions.
Antacid labels also warn patients not to use the product for longer than 2 weeks. Magnesium hydroxide e. The product is usually safe when used as directed, but it can cause constipation.
However, they also share one major drawback—they cannot reduce the amount of acid produced. H 2 blockers, otherwise known as H 2 receptor antagonists H 2 RAs , have an inherent superiority over antacids in their ability to reduce the amount of acid produced, although they do not provide immediate relief.
Patients are cautioned against self-use if they are allergic to the ingredient or to other acid reducers, have trouble or pain when swallowing, or are using other acid reducers. All five product labels also advise against unsupervised self-use if the patient has vomiting with blood or has bloody or black stools, as those may be signs of a serious condition for which the patient should see a physician. The label of Maximum Strength Pepcid AC also carries an FDA-mandated warning against self-use if the patient has kidney disease, unless directed by a physician.
Labels of all five products warn patients to speak to a physician before use if they have any of the following: 1 heartburn for more than 3 months; 2 lightheadedness, sweating, or dizziness with their heartburn; 3 chest pain or shoulder pain with shortness of breath, sweating, pain spreading to arms, neck, or shoulders, or lightheadedness; 4 frequent chest pain; 5 frequent wheezing, particularly with heartburn; 6 unexplained weight loss; 7 nausea or vomiting; and 8 stomach pain.
Patients are cautioned on all H 2 -blocker labels to stop using the product and speak to a physician if their heartburn continues or worsens and if they need to take the product for more than 14 days. Patients are directed on all product labels to take one tablet with a glass of water to relieve symptoms. If they wish to prevent symptoms, they should take one tablet with a glass of water before eating or drinking anything that causes heartburn.
The products vary in the timing of dosing for prevention. PPIs lessen stomach acid production more effectively than the H 2 blockers. The indications for PPIs differ from those for antacids and H 2 blockers.
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