Nexium, Prilosec, Zegerid: Which Non-Prescription Heartburn Med Is Best?

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 24HR is now over the counter, joining the other proton pump inhibitors (PPIs) available without a prescription. This class of medications work well for the treatment of heartburn, gastroesophageal reflux disease (GERD), and gastric ulcers. Nexium as a brand name drug made over 6 billion dollars in one year so does that mean that it’s better than the others? Um, no.

Several PPIs are available over the counter: Zegerid OTC (omeprazole with sodium bicarbonate), Prilosec OTC (omeprazole OTC) and Prevacid 24HR (lansoprazole 24HR) and now Nexium 24HR (esomeprazole). Nexium has never been shown to be superior to any of the other PPIs, with some small exceptions. In a few studies paid for by the drug company that made Nexium, they found that for “maintenance of healing of erosive esophagitis” Nexium 20 mg edged out lansoprazole 15 mg a day.

For the most part, all PPIs are created equally. Of the over-the-counter PPI options listed above, there is no proof there is any significant difference between them. Interesting right?

Dr O.

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