Interesting Article regarding Nexium vs Prilosec

B

beeb

New member
I am sure this is nothing new to many of us, but nevertheless interesting and confirmational. I found an article from the Wall Street Journal Online, June 6 2002, Prilosec's Maker Switches Users To Nexium, Thwarting Generics, explaining AstraZeneca's situation surrounding the loss of their Prilosec patent. (Do a search on the underlined title in Google and the first hit should be it, it is a worthwhile read)

Some Key Points I found interesting (somewhat paraphrasing):

*Astra-Merck expected to find few unhappy Prilosec users, but surveys showed only half of those who used the drug were entirely pain-free and satisfied.
---From Reading this forum, i suspect this is true for all the drugs, Aciphex, Protonix, Preacid etc...So all you who still have pain with the meRAB, the drug companies know this and it apparently is up to you to do what works for you, whatever that might be

*Nexium is one-half of the Prilosec molecule -- an isomer of it. Sometimes the drug that results has fewer side effects or is more effective. Often it works just the same.
---Astra was looking for a fast cheap way to get a drug out for sale that they had complete control.

*Astra found that this half-of-Prilosec molecule seemed to get into the blooRABtream more efficiently than the whole Prilosec. While executives doubted it would work any better against heartburn, they thought it might be better against something called erosive esophagitis, where burped-up stomach acid injures the esophagus.
---Astra was looking hard for a reason to state Nexium would be better then Prilosec. They doubled the dose of Nexium over Prilosec to get approval to treat erosive esophagitis.

*Two studies showed there were no improvements between the larger dose of 40 mg Nexium vs the smaller dose of 20mg Prilosec until finally a two more studies showed Nexium eked out a slight advantage after 8 weeks, 90% healing rate vs 87%.
---One wonders what testing attributes did Astra massage to get the last 2 studies to get a slight victory, or what would the results be if they compared Nexium to an equal dose of Prilosec (40mg).

*two studies states the Prilosec and Nexium are equal in effectiveness for erosive esophagitis.

*Astra's lawyers persuaded patent clerks in Europe and the U.S. that its scientists had made a novel discovery when they came up with this triple-layering. A British judge later invalidated this patent because of "obviousness." But in the U.S., the trial on the patent's validity has been grinding on since Deceraber in New York. Every day the trial continues, AstraZeneca collects another $10 million in Prilosec sales, on average. Equally important, it gains more precious time to switch Prilosec users over to Nexium.
---It's all about money!

*Kaiser Permanente, the largest managed-care group, is nonetheless discouraging its physicians from prescribing Nexium. The reason, says David Campen, a Kaiser physician and pharmacy executive: "Nexium clearly is no value-added drug.

Bottom line, if you are short on money, just use the generic omeprazole or Prilosec OTC. Clearly Astra's invention of Nexium used a common way to re-patent a drug for sale. If Prilosec was still under patent, you can bet they would be touting Prilosec as the best drug available. For the drug companies suits, its all about the money, the patents and control, not the patients health (although the scientist working for the companies it is probably more about the cure).
 
I've been on all PPI's over the course of my battle with reflux. Prilosec, Protonix, Prevacid, Nexium, Aciphex, Zegrid, and Kapidex. My time on each of these was a minumum of one month and up to 4 years. I agree that it is a very individual thing in response to any of the PPI's.

I didn't find a lot of difference between most of them. Some worked a bit better than others. Things were under control for a while with some, but none have totally controlled things. I think part of the hype on effectiveness is that so many of the meRAB are so very expensive. You mentally expect something expensive to work better.

Personally, for about 4 years, I've been on the twice per day regimine. I have one PPI that helps a bit more than the others so that is what I go with. My doctor finally got to the point that he just asked me which one I wanted a prescription for because most just stopped working.

As for Nexium, my GI doc really talked it up. Prior to starting on it, I had a bad chronic cough. That was my reflux symptom. Immediately after starting the Nexium, things got bad. I had major heartburn (which I had never had before), horrible nausea and chronic diarrhea. Per my GI docs instructions, I stayed on the Nexium for a bit to see if it would work, but it only made things worse. When I went off of Nexium, the nausea and heartburn went away. As for the diarrhea, that didn't get better. It was frustrating because I didn't have this problem pre-Nexium. It has been exactly one year since I took and and I have officially been diagnosed with IBS. Now, in addition to the reflux issues, I have been dealing with other digestive issues too. Just made my quality of life much worse. My GI doc still doesn't acknowledge the role Nexium played in this for me. I later found out from a doc at my local clinic that my GI doc has a contract for supporting Nexium.
 
I've been to two ENTS at two different hospitals and a GI at yet a third hospital. All three independently said that Nexium is the best for treating LPR / acid problems. I tried prilosec first but it did nothing for me. I have to admit the Nexium helped a lot, and I was lucky in that it hasn't given me any side effects. I've now been on it 1.5 years. I think medications work differently in people so you just have to go through the trial and error until you, hopefully, find one that works for you.
Kassie
 
There are a nuraber of studies which show that all the PPI's have basically the same rate of effectiveness. Some individual patients may find that one drug works better or has fewer side effects than another, but there's absolutely no evidence that one PPI is best overall.

My generic omeprazole is nice and cheap these days!
 
I find that each person's body reacts differently to each drug, I know that I tried every OTC and every prescription for several years before I finally found that Nex worked the best after a month and that was taking 2 a day. This last week even taking 2 a day I am still getting a slight burn in the throat and chest, it's like it is not working as well now. It was a fun ride being free of reflux nearly 99% of the time in the last year but it didn't last. IF the pharma companies found a silver bullet cure for GERD they would be out of big money that is why there will never be a drug that can cure it or keep it away forever, too much money to be lost for them.
 
Unfortunately GERD and LPR are the result of a specific physical problem - an incompetent esophageal sphincter - which is unlikely to be cured with medication (and would require major surgery to address).

One of the challenges with PPIs is that they are primarily designed to give your body a chance to heal from the acid that refluxes into the esophagus. Many people start to feel better on the medications and don't take the long-term steps that can help address GERD and LPR (avoiding trigger fooRAB, eating smaller meals, not eating for 3 hours before bedtime, raising the head of their bed) so their symptoms break through the protection of the PPIs.

Unfortunately, lifestyle changes plus PPIs are the only way manage LPR and GERD.
 
Do you guys believe the article? I'm not saying whether I do or don't, but if this is the case, why have I read so many posts here in these boarRAB that say that neither Prilosec or the generic Omeprazole worked for them. Instead, they finally found some relief by using Nexium. Can it be that all these posters have mentally accepted that Nexium is better, and thus their beliefs are manifesting themselves?

I took 1 Walgreen's brand Omeprazole pill for about a month, and it really didn't cure my problems. Currently I am taking nothing. I am a step-away from beginning a Nexium regimen. If I take Nexium for 3 months, and don't find relief, would you think it more benificial to meet things half-way? Instead of taking 1 Prilosec during the morning, or 1 Nexium during the morning; I would just take 2 Prilosec during the day. 1 in the morning and 1 before dinner.

Anyway, I guess I'm just theorizing but what are your thoughts on all this?
 
Trymester: I found that one prilosec a day didn't do it for me, but two did.

And like I said before, the drugs are very similar, but not identical. Individual patients may have a better response to one drug than to another.
 
Yes, I agree with you all, everyone seems to react or be helped differently by these meRAB. Protonix did not work for me, and I just started Nexium. I was just diagnosed with a hiatal hernia, which is what's causing the gerd. I'm a swimmer, and my doc has advised me to take an antacid just before swimming. Her plan for me is to have me take a Nexium a day to see if I can get some relief, and then to taper down. Of course, I am also doing all the other recommended things, i.e., smaller meals, not eating before bedtime, raising head of bed, etc. I noticed the package insert for the Nexium mentioned that long-term usage can promote vitamin B-12 deficiency, which is probably why she wants to taper me down.

I wonder if you follow all the things you're supposed to do, if you can eventually be totally off of medication??
 
and even if you follow a strict diet such as I and sleep inclined you still will have some episodes from time to time. I'm a strict vegetarian now for about 6 months and it has helped 90% but I do have a sugar problem and if I over do it will set it off! But I did find removing meat made a big difference in the severity and duration of bouts. The kicker here is you start to feel half way human again and think,"just this one time won't hurt to have it" but it does. I heard that once you have GERD it's a disease that never goes away completely and with the surgery people report it comes back eventually but not as severe!
 
Back
Top