Is Nexium the Best Medication for My Stomach Issues?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Nexium (esomeprazole) certainly wins when it comes to marketing. While it is still available by prescription as Nexium 40 mg daily, there is now a generic esomeprazole and an over the counter form (Nexium 24HR) which is 22.3 mg. Yet somehow, Nexium is still the fourth best selling brand name prescription drug in the United States. Why is that? Well, purple does well with audiences which is why drug companies market their drugs in purple packaging . . . so the purple pill Nexium has made its way into people’s hearts.

While I’m not trying to be a Nexium hater and certainly appreciate the benefit of proton pump inhibitors (PPIs), I’m astounded that doctors continue to allow their patients to pay for brand name Nexium when the generic options are just as good. Let’s take a look at what we know to be true.

Take home message: when Nexium (esomeprazole) 40 mg is compared to omeprazole 40 mg there is no better esophagitis healing rate in patients with GERD and no difference in H. pylori healing rates. The only reason to pay for a brand name PPI is if you’ve tried the cheaper generic options, they haven’t worked for you, and Nexium has. Thoughts?

Dr O.

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