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Overprescribed and overpriced: Just say ‘No’ to Nexium

How much money do you really need to spend to treat frequent heartburn or even acid reflux? $250 a month? $120 a month? Try as little as $24.

Last year, U.S. consumers and their insurance companies spent an astonishing $4.8 billion on Nexium, one of several prescription Proton-Pump Inhibitors (PPIs) that treats heartburn and acid reflux. It’s no wonder “the purple pill” was the second highest-selling branded drug in 2008, behind Lipitor.

The problem, though, is that Nexium is no better at treating heartburn or GERD than cheaper generics or similar drugs available without a prescription, according to a new  Consumer Reports Best Buy Drugs report.  

More than 15 million Americans suffer from heartburn everyday. If you suffer from occasional heartburn and have not been diagnosed with gastroesophageal reflux disease (GERD), your first and best bet is to try an inexpensive over-the-counter antacid like Maalox, Mylanta, Rolaids, Tums, or generic or drugs like Pepcid AC or Zantac 150, or generic (known as H2 blockers).  

But if you suffer from heartburn twice a week or more for weeks or months on end, you may have GERD often known as acid reflux. GERD is serious and can inflame or erode the lining of the esophagus. Doctors often treat GERD with a PPI drug, which is effective and generally safe, but beware: The price tag could drain your budget. 

If you take a PPI drug, talk to your doctor about one of several alternatives to Nexium, such as our Best Buy, Prilosec OTC or its generic omeprazole OTC. Switching could save you about $200 a month. Also, a new PPI, called Prevacid 24HR is available without a prescription and is comparable in price to Prilosec OTC.

But, before you reach for medicine to help ease your symptoms, there are some small changes you can make to your diet and other habits that can go a long way to reduce the likelihood of heartburn and could possibly eliminate it all together, such as:

• Avoid spicy, acidic, and fatty foods
• Reduce how much alcohol you drink
• Reduce caffeinated or carbonated drinks
• Limit chocolate, garlic, onions, and peppermint.
• Don’t lie down until at least three hours after a meal
• If you experience acid reflux while sleeping, keep your head elevated at least four to six inches, and try to sleep on your left side
• Try to add more fiber to your diet; some research shows this could help.
• Quit smoking: Nicotine relaxes the esophageal sphincter and increases acid production.
• Lose weight if you need to. Being even slightly overweight puts pressure on the lower esophageal sphincter, causing reflux. Even losing a few pounds can help.
• Consider chewing gum after a meal. One small study found that people who chewed gum after a high-fat meal had reduced acid levels; another study showed that people who chewed gum for an hour after breakfast had reduced symptoms for up to three hours.

Bottom line:Nexium is an expensive drug and it’s no more effective or safer than other PPI drugs for treating GERD or frequent or severe heartburn. If you find that you need treatment, ask your doctor first for a generic or an over-the-counter drug. Prilosec OTC and its generic, omeprazole, are our Best Buy picks because they are as generally safe, effective, and considerably less expensive than Nexium.


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