Those with Heartburn Paying Too Much Green for
Nexium ‘Purple Pill’ Says Consumer Reports
Report finds no one drug works better than another
and all are relatively safe but some far more costly
Nov. 11, 2009 - Just in time for the holidays, when
many senior citizens may suffer from occasional heartburn, a new Best
Buy Drugs report from Consumer Reports Health finds that you
probably don’t need an expensive drug like Nexium, the “purple pill,”
for relief.
The new report uses comparative effectiveness
research to identify “Best Buys” based on safety, effectiveness, and
price for Proton Pump Inhibitors, a class of drugs to treat heartburn
and stomach acid reflux (see more about these problems below news
report).
The report found that no one drug works better than
another and that all are relatively safe. However, some PPIs are far
more expensive than others.
Last year, U.S. consumers and their insurance
companies spent $4.8 billion on Nexium, one of six PPIs currently
available, making “the purple pill” the second highest-selling drug in
2008, behind Lipitor.
“It’s no wonder: a month’s supply of Nexium has a
retail price tag of up to $240 a month, compared to just $24 a month for
an over-the-counter PPI,” says Consumer Reports.
“For most consumers, over-the-counter, generic
drugs will treat their frequent heartburn and acid reflux just as well
as more expensive prescription drugs, and save them money too,” said
Lisa Gill, editor, prescription drugs, Consumer Reports Health.
“We think doctors have been too quick to prescribe
expensive, prescription medications when a generic or an
over-the-counter would work just as well.”
The first and best bet to settle your stomach is to
try an inexpensive, over-the-counter antacid (such as Maalox, Mylanta,
Rolaids, Tums, or their generic versions) or an H2 blocker (Pepcid AC,
Zantac 150, or their generic versions), according to CR.
People who suffer from heartburn twice a week or
more for weeks or months on end may have GERD, short for
gastroesophageal reflux disease, a condition that makes you prone to
acid reflux. Those people should see their doctor. They may need a PPI.
Consumer Reports Health notes that people who do
need PPIs could save about $200 a month by asking their doctor for an
alternative to Nexium such as Prilosec OTC or its generic version,
omeprazole OTC, which costs less than $1 a day. Preavacid24HR, an
over-the-counter version of Prevacid, could arrive as early as
mid-November, providing another good option for consumers.
Consumer Reports Best Buy Drugs, which rates more
than 200 prescription drugs to treat more than 20 common conditions, is
part of a larger initiative by the new Consumer Reports Health Ratings Centerto provide consumers with health ratings based on independent and
unbiased review of the best scientific evidence available, also known as
Comparative Effectiveness Research. Consumer Reports Best Buy Drugs
reports are available for free at
www.ConsumerReportsHealth.org.
Help for Heartburn
● Track how often you get heartburn, so you can
tell your doctor.
● Eat smaller meals, lose weight, and avoid
alcohol.
● Try over-the-counter antacids such as Maalox,
Mylanta, Rolaids, or Tums, or one of many acid-reducing drugs known as
an H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC),
nizatidine (Axid AR) or ranitidine (Zantac 150). These are available as
low-cost generics as well.
● See a doctor if symptoms persist.
● Compare cost and effectiveness of different PPIs
if your doctor recommends one; check to see if your insurance covers
over-the-counter PPIs.
About Heartburn
Also called: Acid indigestion, Pyrosis
Almost everyone has heartburn sometimes. Heartburn
is a painful burning feeling in your chest or throat. It happens when
stomach acid backs up into your esophagus, the tube that carries food
from your mouth to your stomach. If you have heartburn more than twice a
week, you may have
gastroesophageal reflux disease (GERD). With GERD, the muscles at
the end of your esophagus do not close tightly enough. This allows
contents of the stomach to back up, or reflux, into the esophagus and
irritate it.
Pregnancy, certain foods, alcohol and some
medications can bring on heartburn. Treating heartburn is important
because over time reflux can damage the esophagus. Over-the-counter
medicines may help. If the heartburn continues, you may need
prescription medicines or surgery.
If you have other symptoms such as crushing chest
pain, it could be a
heart attack. Get help immediately.
More information:
●
Heartburn(American Academy of Family Physicians) Also available in
Spanish
●
Heartburn(American Gastroenterological Association) Also available
in
Spanish
Your esophagus is the tube that carries food from
your mouth to your stomach. Gastroesophageal reflux disease (GERD)
happens when a muscle at the end of your esophagus does not close
properly. This allows stomach contents to leak back, or reflux, into the
esophagus and irritate it.
You may feel a burning in the chest or throat
called
heartburn. Sometimes, you can taste stomach fluid in the back of the
mouth. This is acid
indigestion. If you have these symptoms more than twice a week, you
may have GERD.
Anyone, including infants and children, can have
GERD. If not treated, it can lead to more serious health problems. In
some cases, you might need medicines or surgery. However, many people
can improve their symptoms by
● Avoiding alcohol and spicy, fatty or acidic
foods that trigger heartburn
● Eating smaller meals
● Not eating close to bedtime
● Losing weight if needed
● Wearing loose-fitting clothes
Medications
Your health care provider may recommend
over-the-counter antacids or medications that stop acid production or
help the muscles that empty your stomach. You can buy many of these
medications without a prescription. However, see your health care
provider before starting or adding a medication.
Antacids, such as Alka-Seltzer, Maalox,
Mylanta, Rolaids, and Riopan, are usually the first drugs recommended to
relieve heartburn and other mild GERD symptoms. Many brands on the
market use different combinations of three basic salts—magnesium,
calcium, and aluminum—with hydroxide or bicarbonate ions to neutralize
the acid in your stomach. Antacids, however, can have side effects.
Magnesium salt can lead to diarrhea, and aluminum salt may cause
constipation. Aluminum and magnesium salts are often combined in a
single product to balance these effects.
Calcium carbonate antacids, such as Tums,
Titralac, and Alka-2, can also be a supplemental source of calcium. They
can cause constipation as well.
Foaming agents, such as Gaviscon, work by
covering your stomach contents with foam to prevent reflux.
H2 blockers, such as cimetidine (Tagamet HB),
famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac
75), decrease acid production. They are available in prescription
strength and over-the-counter strength. These drugs provide short-term
relief and are effective for about half of those who have GERD symptoms.
Proton pump inhibitors include omeprazole (Prilosec,
Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole
(Aciphex), and esomeprazole (Nexium), which are available by
prescription. Prilosec is also available in over-the-counter strength.
Proton pump inhibitors are more effective than H2 blockers and can
relieve symptoms and heal the esophageal lining in almost everyone who
has GERD.
Prokinetics help strengthen the LES and make
the stomach empty faster. This group includes bethanechol (Urecholine)
and metoclopramide (Reglan). Metoclopramide also improves muscle action
in the digestive tract. Prokinetics have frequent side effects that
limit their usefulness—fatigue, sleepiness, depression, anxiety, and
problems with physical movement.
Because drugs work in different ways, combinations
of medications may help control symptoms. People who get heartburn after
eating may take both antacids and H2 blockers. The antacids work first
to neutralize the acid in the stomach, and then the H2 blockers act on
acid production. By the time the antacid stops working, the H2 blocker
will have stopped acid production. Your health care provider is the best
source of information about how to use medications for GERD.
Nov. 11, 2009 - Just in time for the holidays, when
many senior citizens may suffer from occasional heartburn, a new Best
Buy Drugs report from Consumer Reports Health finds that you
probably don’t need an expensive drug like Nexium, the “purple pill,”
for relief.