Nexium and Prilosec for reflux - interchangeable?

[garyo]

I have reflux issues and had been taking Nexium 40mg once daily in the morning for the past 9-12 months. To save money, about a month ago I switched to Prilosec generic 40mg, and it works just as well for me. I have a few months supply of Nexium left over, and was wondering if it would be OK to switch back to the Nexium until it is used up, and then restart the Prilosec again after that. Side note: I also take Zantac 150mg in the evening.

[Dr. Safaa Mahmoud]

Hello,

Both drugs (Nexium and Prilosec) act by inhibiting the secretion of gastric acids, so basically they should be equally effective and shift between them is generally allowed. The fact that your symptoms were controlled on the generic form (Prilosec) is more reassuring to do so.

However, it is better to always follow up with your doctor before doing any change in your current therapies. He is more aware by your condition and the available medications for treating your specific problem, so he can provide you the most convenient therapy.

What seems not explained is the fact that you receive at the same time the medication ranitidine (Zantac), although there are no reported interaction between these drugs, this combination is not a standard of care and is not usually recommended. Ranitidine acts by antagonizing the effect of the gastric acid on its receptors, so if you take another drug that already abolished acid secretion, it is not convenient to use ranitidine. Moreover, patients are advised to receive either of the drug alone to treat conditions like yours and not both of them.

I would advise you to follow up with your doctor and please keep us updated.
Best regards.

[NBrazil]

Hi. I just saw this and wanted to note that there ARE some circumstances when an H2 Histamine blocker and PPI are taken.

Laryngopharyngeal Reflux (which differs from GERD in that the Upper Esophagheal Sphincter is not working versus the Lower Esophageal Sphincter) allows acid aspirate into the pharynx which has zero tolerance for acid. In this case as much acid suppression is needed and so the treatment is more aggressive. About 6 percent of the population has it, with the symptoms varying from annoying to socially debilitating.

The standard of care is two (2) Nexium 40 mg a day PLUS an H2 acid inhibition drug at bedtime like Zantac, Pepcid or Axid. This is a lifetime treatment for most and effective for most. Of course with such suppression of acid digestive enzymes are important and possibly even bone scans, but I just wanted to note that there are medical reasons for combining these two classes of medications with this lesser known condition.