What is a Proton Pump Inhibitor (like Dexilant)?

PROTON PUMP INHIBITORS

So...you have a prescription for a proton pump inhibitor (PPI) do you? Well, you are not alone! In fact, Nexium (a PPI) was the #11 drug sold (based on # of prescriptions) in 2011! So what are they? What do they do? They sound like something from a Star Wars movie. "Quick, Luke, aim that Proton Pump Inhibitor at the Storm Troopers!" But Proton Pump Inhibitors have nothing to do with intergalactic wars, and are unlikely to aid us against alien attacks.

A Proton Pump Inhibitor (also know as a "PPI") is a medication which can reduce the amount of acid secreted into the stomach. In this article I am going to:

  • Briefly explain how PPI's work
  • List all the currently available PPI's
  • Explain how you can pick the most cost-effective PPI for you!


HOW THEY WORK

How do Proton Pump Inhibitors work?

First, we need to understand a little about how acid is secreted into the stomach. The lining of the stomach has a variety of cells which do different things. Some of these cells secrete mucus. Some cells secrete acid. These "acid cells" are known as "Parietal Cells." Stomach acid, generally speaking, is a GOOD thing. We need it for proper digestion and absorption of nutrients. The low pH created by the acid helps other digestive enzymes to work also. However, it may be helpful to reduce the amount of acid we manufacture if that acid is causing problems like heartburn, reflux, or ulcers.

The Parietal cell comes to us fully equipped with a cool enzyme system capable of moving a Hydrogen Ion (AKA a Proton) into the stomach, in a slick trade for a potassium ion. This enzyme system is known to the science geeks as the H+/K+ ATPase Enzyme System. You have my permission to forget that. To you and I this enzyme system is affectionately known as The Proton Pump. Once these hydrogen ions (protons) are in the stomach, they combine with chloride ions to form hydrochloric acid! Yep, you remember this stuff from the science lab, the bottle with the big "DANGER" sign on it. Very corrosive!

Proton Pump Inhibitors work by disabling the proton pump in the parietal cell of your stomach. No proton pump = no proton moved into the stomach. No proton moved into the stomach = no formation of hydrochloric acid! If that isn't cool, I don't know what is! Almost makes ya want to be a scientist doesn't it???

Aciphex Tablets
Aciphex Tablets
Kapidex Granules
Kapidex Granules
Nexium Capsules
Nexium Capsules
Prevacid Capsules
Prevacid Capsules

AVAILABLE PROTON PUMP INHIBITORS (PPI's)

Today, Proton Pump Inhibitors are available both by prescription and also without a prescription (ie over the counter). Are the prescription PPI's necessarily better than those available without a prescription? No. In fact, both PPI's now available over the counter used to be only available by prescription, and still are available by prescription, in higher strengths. You should, however, never switch to an over the counter proton pump inhibitor without consulting with your doctor.

PRESCRIPTION ONLY PROTON PUMP INHIBITORS:

Aciphex Tablets (rabeprazole sodium): Aciphex comes in a 20mg tablet and is taken once daily for treatment and symptoms associated with GERD (Gastro Esophageal Reflux Disease). Aciphex does NOT have a generic available at this time.

Dexilant (formerly known as Kapidex) Capsules (dexlansoprazole): Dexilant is the newest PPI to emerge onto the prescription market. It is basically the same ingredient found in Prevacid, now available without a prescription (see OTC below). However, Dexilant has improved the product to some degree by adding a "dual release" mechanism which allows some medication to be released quickly, and the rest to be released several hours later for sustained relief. See picture to the right. Dexilant comes in 30mg and 60mg capsules and is NOT available as a generic. Dexilant is manufactured by Takeda Pharmaceuticals.  By the way, this company changed the name of their product from Kapidex to Dexilant because of numerous accounts of confusion with other similarly named products...specifically Casodex (for cancer) and Kadian (a morphine product for pain). 

Nexium Capsules (esomeprazole magnesium): Nexium capsules are yet another prescription PPI for the treatment of GERD. Also known as "the purple pill" Nexium and is available as a 20mg and 40mg capsule taken once daily. Like some other PPI's, Nexium is also approved to treat an ulcer-causing infection by a bacteria known as H. Pylori. Treatment for this condition requires the addition of two antibiotics (usually amoxicillin and clarithromycin). Nexium is NOT available generically.

Prevacid (lansoprazole): Prevacid is available both as a capsule (to be swallowed whole) and also as a "solutab" which can be placed on the tongue and dissolves usually within 1 minute. It should not be chewed or cut. Alternatively, the solutab can be mixed with a small amount of water, dissolved, and then swallowed. Both tablets and capsules are avaiable in 15mg and 30mg dosages. Prevacid is taken once daily, usually from 4 to 12 weeks, depending on the condition being treated. Prevacid IS now available over-the-counter (OTC) as a 15mg capsule marketed as "Prevacid 24 HR." The prescription version of Prevacid capsules recently became available generically as well.

Prilosec (omeprazole): Prilosec was the first prescription PPI (introduced in 1989) and comes in 10mg, 20mg, and 40mg capsules. Prilosec is also available without a prescription as Prilosec OTC in a 20mg tablet (more on this below). Depending on your prescription plan and coverage, you may discover it is less expensive to use the OTC version. Talk with your doctor or pharmacist to find out.

Protonix (pantoprazole sodium): Protonix was originally a product of Wyeth pharmaceuticals, which then was acquired by Pfizer pharmaceuticals who now holds the rights to this product. Protonix comes in 20mg and 40mg tablets and IS avaiable as a generic. Generics are generally less expensive and will typically be the lowest tier on your insurance copay.

Zegerid (omeprazole with sodium bicarbonate): Zegerid is the unique proton pump inhibitor manufactured by Santarus pharmaceuticals Inc. What is unique about it? Zegeris is the only PPI that immediately releases medication into your system. All other PPI's have a delayed-release mechanism, taking several hours for the drug to get into your blood stream. Does this make Zegerid better? Well...not really. The fact is that no matter how fast it gets into your blood stream, proton pump inhibitors take several days before they are most effective. Nice try anyway Santurus. Zegerid comes in 20mg and 40mg capsules, as well as powder for suspension. Zegerid does NOT have a generic.

Prevacid 24 Hour OTC Product Label
Prevacid 24 Hour OTC Product Label

OTC PROTON PUMP INHIBITORS

There are presently 2 Proton Pump Inhibitors available over the counter, without a prescription.

Prilosec OTC:  Prilosec OTC is available for patients who suffer from heartburn symptoms 2 or more days per week and are at least 18 years old.  It should generally not be used beyond 2 weeks without consulting a physician.  Why?  Well, it is not because it is dangerous to use for more than 2 weeks.  But it COULD be dangerous if you in fact have a more serious condition and you delay or avoid getting treated while taking Prilosec OTC.  Take my advice:  If you have symptoms that persist after a 2 week trial of Prilosec OTC...please...see your doctor! 

Prevacid 24 HR:  Prevacid 24 HR is also available without a prescription for symptoms of heartburn.  Like Prilosec, it should only be used by those 18 years or older, and not for more than 14 days continuously.  The packaging does permit the use of another 14 day course of therapy in 4 months if needed.  As I said before, if your symptoms persist beyond 14 days...see your doctor!

A note about these OTC Products:  If you have been prescribed prescription strength Prilosec or Prevacid, you may want to compare the cost of buying it yourself OTC.  If this would save you money (remember that you have to compare the strengths to your prescription product) then you should ask your doctor about using the OTC version instead.  They are the same medication and should work exactly the same way. 

SAVE MONEY ON YOUR NEXT PPI!

Do you have a prescription for a Proton Pump Inhibitor? Has the cost given you worse stomach pains than you had BEFORE the visit to the doctor? There are a few things you can do to reduce the cost of your prescription proton pump inhibitor.

1) If the prescription is for Prevacid or Prilosec, check the price of the OTC versions mentioned above. Your pharmacist can help you compare the cost and see if this will save you money.

2) Remember that Prilosec, Protonix and Prevacid are all available generically by prescription. Make sure you try the generic product if you can.

3) Know your insurance. Do you know what tier your Proton Pump Inhibitor is? You can look it up on your insurance formulary. Most formularies can be found online, or you can call your insurance company and ask them. A lower tier means a lower cost to you! For an example of what an insurance formulary for Proton Pump Inhibitors looks like, see the picture below!

4) Take advantage of Prescription Manufacturer Website Coupons! If you are on a prescription OR OTC Proton Pump Inhibitor, the manufacturer might have discount coupons you can print right from their website! Here are some links to coupons for the following products:

5) Finally, check out my other articles on how to save money on prescription drugs for more tips!

AN INSURANCE FORMULARY FOR PPI'S

Notice that in this example the generics are tier 1, which is the lowest cost on your plan.  Prevacid is tier 2 and Zegerid is the highest at tier 3.  This is just an example of 1 formulary.  Your formulary will be different.
Notice that in this example the generics are tier 1, which is the lowest cost on your plan. Prevacid is tier 2 and Zegerid is the highest at tier 3. This is just an example of 1 formulary. Your formulary will be different.

HOPE THAT HELPS!

As a pharmacist I get questions about medication all the time. I hope this article has answer your question "What are Proton Pump Inhibitors?" I also hope I have provided some useful information about the PPI's currently available and how to make some cost effective decisions about them with your doctor. Feel free to leave me a question if there is anything else about Proton Pump Inhibitors you would like to know!

Sincerely,

Your Pharmacist



More by this Author


Comments 149 comments

sharon Levander 6 years ago

I liked your explanation of the different proton pump meds

I would like to know why you stated that these meds should only be used for 2 weeks. I was diagnosed with Gerd many years ago & was on it form several months. Now it has returned & I am concerned about staying on it for very long because I have read that it can cause many side effects. I would appreciate any information that you might be able to give me

thanks

sharon


pharmacist profile image

pharmacist 6 years ago from Whitinsville, MA Author

Hi Sharon,

The 2 week limit is only for patients who have not had their condition properly evaluated. The concern is that we might "self-treat" for heartburn...when the condition is actually something far worse and requires more serious medical attention. There is no problem, however, using these meds for longer periods if we know that the diagnosis is GERD or a related acid condition.

Good question!


Jason  5 years ago

Hi Jason,

I was curious what your thoughts are on Dexilant. I have been on Prevacid 30mg for about 5 years (the generic for the last year or so). I have GERD that has been breaking through lately. I have heard some pharmacists say that you develop tolerance to PPI's and others say that you don't. My doctor says it happens all the time. My problem is that I have tried all the other PPI's except dexilant. I had side effects like headache or extreme drowsiness on a lot of them probably because I am on Luvox and Xanax and I know Prilosec and some of the others may have a problem with luvox inhibiting the CY P450 enzyme system.

Have you heard if the side effects of dexilant or comparible to prevacid which I do well on side effect wise. Is the isomer different enough from regular lansoprazole to give it a shot?


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Jason,

Tolerance, per se, is difficult to prove. In the case of GERD, it could simply be a matter of disease progression, or other factors. Ultimately, though, it doesn't really matter if the symptoms are due to tolerance or some other factor. The question is how to respond and treat it.

I think a trial of Dexilant, if insurance wil allow it, is a reasonable step. Some may say that it "should" work exactly like Prevacid. But I have been in this field for too long to rely simply on what "seems" logical and right. What works...works. Profound, huh? LOL. Also, do not forget all the non-pharmacological approaches, as well as OTC products for breakthrough like antacids, etc. Best wishes!


Pia 5 years ago

Hi Jason i would like to know what's the difference between a generic and a brand name pill, is one more effective than the other and if it is, why? thanks.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Pia,

Generics have exactly the same ingredients and have been shown to have the same effectiveness as the respective brand name products. When a generic becomes available, it is a good idea to give them a try. There are rare times when a person will not get the same results with a generic. It is hard to understand from a medical/scientific perspective. But this is pretty rare.

Best wishes!


Meredith_A_Iager profile image

Meredith_A_Iager 5 years ago from Maryland

PPIs are DANGEROUS (for being on them for NO REASON) - I think you all need to read what happened to me......


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Meredith,

So sorry about your experience. NO medication should ever be taken for NO reason. Many patients, including myself, have taken PPI's safely and effectively.

Best wishes,

Jason


Steven 5 years ago

I have been diagnosed with gastritis and have been dealing with the symptoms for about 2 months now. I was prescribed dexilant but it cost too much money so I've been taking otc omeprazole but it doesn't seem to be working as well as I had hoped. Should I just save up and buy the dexilant instead?

Also one more question, do these medications cause diahhrea as a side effect?

Thanks

Steven


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Steven,

Ask your doctor about using 40mg (2 tablets) of omeprazole instead of the 20mg (1 tablet) recommended usually. Also, yes, they can cause diahhrea. But so can other things, so if it continues, let your doctor know. Best wishes.


Brian 5 years ago

I have a question regarding Dexilant vs Prevacid... it appears they are the same drug and as you stated in your writeup that Dexilant has the time-delayed release feature. Is this really the only difference?

I'm currently taking Dexilant now and have had great results with it (after trying Prilsec OTC and Zantac), however it is rather expensive and am considering alternatives to save money. I see that Prevacid is also available as a generic, which also helps.

Do you have any thoughts on this?

Thanks.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Brian,

Yes, except for the "dual release" feature, there is no clinical difference in the way Dexilant and Prevacid work. If cost is a concern, OTC Prevacid might be worth talking to your MD about.


Cheryl 5 years ago

I was just diagnosed with GERD and some other stomach problems leading to my taking Dexilant. I can tell you from a patient perspective that Dexilant works where anything over the counter that i have taken in the past does not work! I have taken prilosec, nexium, protonix, etc., all to no avail. I know it is expensive and now my insurance company is refusing to pay for it even tho my doctor has told them that i have tried everything else. Shame that insurance companies can dictate what they are willing to pay for when i pay premiums of over $500.00 a month. For me, Dexilant has been a wonder drug and i don't mind paying if insurance wont pay. My doctor keeps giving me coupons from the manufacture for a cost savings so anything helps.


Mony 5 years ago

Hello Brian,

Is it safe to take Dexilant and Ratinidine? Your advice is greatly appreciative.

Thanks!


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Mony,

There is no harm in doing so, but there is also really no reason to do so. Dexilant is much stronger than ranitidine, and so ranitidine would really not be doing anything.

Best wishes,

Jason


Deanna Newton 5 years ago

I have GERD and have been prescribed Omeprazole for the morning and Dexilant for the evening. Yes, the Dexilant is expensive but if you go to their website, you can get an instant savings card that can save you up to $55 per prescription! It's definitely a help to me. I look forward to the day their patent expires so we can get generic but that won't be until 2020.


Tony 5 years ago

My doctor is switching me from aciphex 20 twice a day to dexilant 60 twice a day. He is a GI specialist but I'm concerned that the packaging says once a day and he prescribed it twice a day. Should I be worried about this?

Thanks


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Tony,

Just verify that dose with the MD. It is above normal, and has some risks associated with it. Your condition may require it, but I would certainly want to verify that with the specialist.

Jason


vhristian 5 years ago

I just started taking dexilant it has been giving me chest and throat pain, shortness of breath and I can't sleep at night are those normal side effects. Please let me know thank you


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi vhristian,

Those sound like pretty severe symptoms and probably a reaction to the dexilant. On the other hand, very bad reflux could cause that too. You should contact your MD. My guess is they will try something else. Hope it improves for you.


David 5 years ago

I am writing this because I am a little concerned about some of the medications I am taking. I visited a gastroenterologist and he did not find anything wrong in my digestive system. According to my symptoms he said I might be suffering from acid reflux and prescribed me to take Dexilant in the morning and Ranitidine at night. I have noticed some relief but I always wake up throwing up some green stuff, real bitter. Any ideas on what this might be or if the medicine I am taking is affecting my system.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi David,

Well, first of all your doctor should be made aware of this daily symptom. That is important. It may improve as the Dexilant and ranitidine go to work. Dexilant is stronger. Maybe ask the doctor if you can switch and take the Dexilant at night instead. Just a thought.

Best wishes!

Jason


stacy 5 years ago

I was recently diagnosed with gastritis and esophagitits, both mild...but I am having some serious gastric discomfort. My doctor prescribed Dexilant for me but I am scared to start it because I am worried about the side effects. Some of my symptoms seem very cardiac in nature as I have back and shoulder pain and pain down my arms. I have had several EKG's and an echo stress test.... all came back good, but I read about potential cardiac side effects (I know they are rare) with Dexilant. If my symptoms would be cardiac in nature, could I be more at risk for the rarer cardiac side effects with Dexilant? I have taken Prevacid otc though without any trouble but a lesser doe that the 60 mg prescrition. And then I saw the above post and am now even more concerned. Any info would be appreciated.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Stacy,

As you know, I'm not a doctor, and not pretending to be. I can tell you from personal experience that acid reflux often feels very cardiac in nature, and can cause severe chest pain. Dexilant is as safe as Prevacid, at any normal dose. Ultimately you have to decide for yourself if you wish to take it. I can tell you a good friend of mine, a pharmacist, was recently prescribed Dexilant. She took it and feels better. Best wishes!


Joe 5 years ago

Hi Jason,

I have a non-diagnosed hiatal hernia. I say non-diagnosed because the doc said so without an upper GI. Symptoms were classic enough I suppose. I had some cardiac symptoms that went away IMMEDIATELY when I was put on Dexilant. After a month, I suddenly got the most epic diarhea in the history of the world. We are talking biblical here. So, I told him about it and he said to keep taking it. Well...that wasn't going to work for me so I started taking 150MG of Zantac twice a day and it worked for about 5 months. Last week, the reflux began to break through pretty badly. I hesitantly went back on Dexilant and whammo...back to huge amounts of gas and the D word. My question is this: Is there enough difference in Prevacid and Dexilant for me to give it a try? I can feel the knot around the hernia coming back (it healed completely while on Dexilant the first time around) and I don't want to do damage to my esophagus but I also cannot live with the side effects.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Joe,

If it were me, I would give the Prevacid a try. If you get the same symptoms you may want to talk about other options with the MD. For example, increasing the dose of Zantac, or possibly consider taking an anti-diarrheal medication to combat the Big "D."

Best wishes. Definitely keep your MD informed about any changes from what he/she prescribes. Take care.


sophia humphrey I. 5 years ago

will the nexium 40 g provide the same as the new Dexilant 60 i also take naritidine at night comments?


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Sophia,

Nexium 40 and Dexilant 60 are very similar in their acid blocking power. They belong to the same family and work in the same way. Some patients, however, do find that one will work better for them, than another. But the basic side effects and mechanism of action are the same. Best wishes.


Malford 5 years ago

I also suffer from GERD, and experience discomfort in my chest. After several trips to emergency and my cardiologist (cath showed a 50% blockage), my GI dr. suggested trying Dexalint or Zegerid along with Elavil to help the relaxtion when anxiety sets in due to chest pain. Do you feel this form of treatment will be effective? Also, can a second dose (20 mg) of Zegerid be harmful? I have been taking PPI's for several years, with the past few years being Omeprazole.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Malford,

As for Dexilant or Zegerid, either one may be helpful at preventing your symptoms. Take them daily as directed. As for the Elavil, if it helps, then that is okay. Mostly it would just be providing a little sedation. You actually shouln't take a second Zegerid dose. It is better to get a prescripition for the 40mg if 20mg isn't enough. In this particular case, 2 of the 20mg are not actually the same as 1 40mg capsule. This is due to the amounts of sodium bicarbonate in them. Another option would be to ask the doctor about using omeprazole for the 2nd dose instead. Best wishes!


Nik 5 years ago

I have been on Dexilant 60 mg once a day and no relief. When should I get results??


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Nik,

Generally it takes a few days (3-4) before a Proton Pump inhibitor is working to the fullest. In the mean time, antacid tablets like Tums can be used for relief.

Good question.


tracy ann diamant 5 years ago

hiys jason im on omeprazole dispersible 20 mg just had them changed after been on lansoprazole twice aday 30mg 2 in morning 2 at nite befor bed did work after 3 years...rite the omprazole doc didn't tell how meant hours apart should i take ? it iv been taking it 11am on monring an 11pm at nite is that ok


tracy 5 years ago

opps *DIDN'T


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Tracy,

That is a pretty high dose if I understand you (120mg per day). Yes, 12 hours apart is fine.


tracy 5 years ago

good an when you you omprazole can you eat soon after you take or you have to wait 30 mins to 1 hour?


tracy 5 years ago

sorry missed this am also very limited to wat i can eat an getting dipressed of this plane stuff i really don't know wat i can eat


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Tracy,

I usually tell people to try taking in 15-30 minutes before eating. Take it at the same time daily. As for food, I know it is tough, but try these suggestions to help improve symptoms:

• Decrease fat intake - High fat meals & fried foods tend to slow down and delay stomach emptying

• Go with smaller meals more oftern, rather than large meals

• Decrease your caloric intake if weight loss is needed- • Watch out for chocolate - Chocolate contains methylxanthine, which has been shown to contribute to GERD

• Consider backing off of coffee, depending on individual tolerance - Coffee, with or without caffeine, may cause reflux. Coffee may be consumed if it is well tolerated.

• Avoid other problem foods and items: Alcohol, mint, carbonated beverages, citrus juices, and tomato products

all may aggravate GERD.


tracy 5 years ago

ok an i don't eat fatty stuff never have don't drink alcohol coffee ect spicey food don't like...very healthy lady i have a lot of intake in vegys an fruit i oven everythink i drink loads of bottle water an decaff teamine has come because of stress at home as i have 3 specail needed children...iv been eating boiled fish an chicken an cabbage an spinaish an wholemeal bread an rice crispys with semmy sinked milk an gluten free and wheat free stuff at the mo i have food coming back ur my food pipe on tablets for it ect just with i could eat like a normal person so to speak


Rhonda 5 years ago

I was on OTC Prevacid as recommended by my Dr for 2 months. Symptoms kept returning. Dr gave me samples of Dexilant and ordered a scope. GI dr did scope and gave me script of Prevacid 60mg, said my insurance probably wouldn't cover Dexilant. I wanted to try so my Dr (not GI) called in Dexilant and it was covered. Took Dexilant for 6 weeks and symptoms returned. Any reason to think the Prevacid 60 would work better? I could switch but stopped taking everything because I am so frustrated.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Rhonda,

Typical first step would be to increase Dexilant to the max dose. If that doesn't work, then yes, I would try an alternative like Prevacid, Nexium, protonix, etc. Switching to any of these may provide more relief. It is really hard to predict which one will work better for a particular patient. Thus...we "practice" medicine...

Best wishes


Shelly 5 years ago

I have ben taking Dexilant for the last 6 months and it is my "miracle pill"! No other medicine I took was fighting all my symptoms. I have a Hiatal Hernia. We had to change insurance companies and they do not cover Dexilant. So, now I am trying to find a new drug that does not cost so much money. I think I am going to try Prevacid 30mg twice daily. Spoke with my Pharmacist and she informed me this should do for me what Dexilant was doing. I really hope it works!


Mary 5 years ago

I am taking 60 mg Dexilant daily. I am having muscle spasms in my stomach, esophagus and chest. I was having them before I starting the PPI. Can these spasms be caused by stress or by the heartburn? What's the best way to take the Dexilant if I have breakthru nighttime GERD. Actually, I've been having breakthru more often than that. could that be due to the spasms?


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Mary,

Yes...and yes. Try taking Dexilant in the evening if overnight is getting worse. Also, be sure to watch for all the food triggers and consider proping up the bed a bit. Have a bottle of Maalox or Mylanta handy for breakthrough, and definitely speak to your MD about it. Hope it improves.


Mary 5 years ago

Hi, Mary again. I have been taking the Dexilant around 5:00 PM--a half hour before dinner. I've been on the Dexilant for over a month. I am thinking about switching over to 40 mg Nexium. My doctor gave me samples. He wants me to take bentyl for the spasms, so I tried it last night, but I just noticed on the product info that it can be a problem for people who have GERD! It did seem to get worse. So frustrating. Any insights/suggestions?


Joseph Rivers 5 years ago

I've been dignosed with Hiatal Hernia. Can Dexiland heal it? Or it just control the amount a acid we produce in the stomach?

Thank you.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Mary,

You may have to give both the Nexium and Bentyl a few days to begin to work. Bentyl is okay with GERD, since you are also on a PPI (Nexium).


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Joseph,

Dexilant may help control the symptoms, but not actually heal a hernia.


Valerie Purcell profile image

Valerie Purcell 5 years ago

Dexilant is the newest PPI ... is basically the same ingredient found in Prevacid. So if the Dr. prescribes Dexilant 60 mg to replace Nexium 40 mg -taken because prevacid or prilosec weren't working-, and the only advantage is that it delayed release mechanism, then why not just take a 20 mg Prevacid in the am plus a 20 or 40 mg in the evening before bed when PPI's do the most good?


IRENE 5 years ago

I was just switched from Protonix to Dexilant 60 an Bentyl 20. How do protonix and dexilant differ. i am having a lot of diarrhea at present (10 days post-op thoracotomy). Is this drug likely to make the diarrhea worse? I have taken Prevacid, Prilosec, and others in the past but had been taking Protonix for several years.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Irene,

They belong to the same family, though some people have had better results with Dexilant. It is not likely to make the diarrhea worse. Best wishes.


Concerned 5 years ago

I have been on dexilant now approximately one year now. I have lost weight, and my appetite is not like it used to be. Also I feel very nervous slot and have palpitations. I also read that depression, loss of appetite, anxiety, and palpitations are a few of the side effects. I'm very concerned. Could you please shed some insight on these concerns?

Thanks

Concerned


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Concerned,

All your symptoms could simply be from the anxiety. But "diagnosis" per se is the job of your physician. I recommend you make another appointment. Best wishes.


Lynda 5 years ago

My dr wanted me to try dexilant instead of nexium (which I have taken for last 8 years) and the first day I felt a little revved up and the 2nd day I felt like I had drank about 10 cups of coffee! I guess I am not going to be able to tolerate it. I also tried prevacid one day and felt a little bit the same but not nearly as bad (but it was a lower dose, the OTC prevacid). Dr. thinks the nexium is not working anymore and that is the reason for the change.

Do you think if I stick with either the dexilant or prevacid, my body will adjust and that feeling will go away? Maybe start out taking it every other day and work into everyday?

Thanks!


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Lynda,

What you are describing is pretty unusual, so it is hard to predict, but I think your suggestion about every other day is worth trying.


Brian 5 years ago

You mention which foods to avoid for gastritis. What about medications? Besidse NSAIDs, aspirin, and cortisone what other medications are culprits? Thank you.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Brian,

So many things can cause acid reflux. OTC supplements like iron. Prescription drugs, aside from those mentioned above, like antibiotics and some blood pressure medications. Spicy foods, alcohol, obesity...the list goes on. :) Great question. Thanks!


Mary 5 years ago

Is it ok to take Beano or other digestive (plant) enzymes while I am on a PPI?


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Mary,

Yes, those enzyme products are safe to use with PPIs.


Freddy 5 years ago

Hi i am 17 years old and for the past month i have no appitite whice is not normal and i haven't been eating anything for weeks i feel really weak and nauseous all the time. My doctor prescribed me with nexium 40mg and so far ive takken 6 pills and it didn't help so he gave me dexilant 60mg for 1 month do you think this will get my appitite back thanks.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Freddy,

It will help - if the doctor has correctly diagnosed you and you have GERD. Your symptoms could be many things, but GERD is a good guess to start with. Give it a week or two though. Best wishes.


Mary 5 years ago

Do I need to space digestive plant enzymes from PPI's? If so, how much time between?


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Mary - can you name a specific one you are wondering about?


Mary 5 years ago

One product is Beano. The other is called Plant Enzymes. It's made by "Now" It contains protease, amylase, lipase, cellulase, lactase, papain and bromelain.


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Hi Mary,

No special spacing needed with the enzyme in Beano, or the plant enzyme product and the PPI products.


Sylvia 5 years ago

Among the PPIs offered, which one is the safest for long term use?


pharmacist profile image

pharmacist 5 years ago from Whitinsville, MA Author

Sylvia,

There have been no studies comparing the PPI's with respect to long term use safety. I recommend they be used no longer than needed to control symptoms, and at the lowest effective dose.


Lee 4 years ago

I have been on a PPI for 16 days. The gastro dr tells me to stop taking it. I did that one time with a bad attack of battery acid burning in my stomach. Quickly went back on PPI. Do I wean off or follow dr's orders and just stop and use Zantac?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Lee,

PPI's do not require tapering, though there is no guarentee the symptoms won't return. Switching to something like Zantac may help prevent symptom return.

I wrote an article on heartburn here: http://hubpages.com/health/constantheartburn...


colin aherne 4 years ago

Hey there I was on protium for about 2 years and then it stopped working for some reason I got real bad gerd again got the camera down had touch of gasteritus and tube badly inflamed my questions are can the tabs stop working, I got zoton now today was first day should they work right away or a few days? Thanks


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Hi Colin,

As with all PPI's, Zoton with take several days to begin working. Hope it helps!


colin aherne 4 years ago

Do some ppis work right away some people say they work right away I tried nexium few days ago felt relief right away but side effects were bad was weak and light headed,, do all ppis work just the best to suit the person? I found protium brillent no probs on them just stopped working thanks again


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

They all take several days to be working at their best. Some may feel results more quickly. Yes, some PPI's work better for some patients, and switching is often necessary.


colin aherne 4 years ago

What are the best ppi, I was on protium for 2 years nexium I got side effects came off the gertac and razole never worked on zoton day 4 and my chest is still on fire same with yesterday like. Its so hard to find another one to work like,


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Colin,

When one stops working, switching often helps. They are really all about equally effective. But some people find one to work better than another for them.


Natdaddy 4 years ago

I was diagnosed with LPR reflux last December. I've never had heartburn in my life. With my reflux I have excessive throat mucous, hoarseness, and it feels at times like a spasm in my throat. I have been on 60 mg Dexilant for one year. Is this dose equivalent to two nexium? And, is there anything I could possibly implement with the dexilant to help with the throat clearing, mucous and occasional spasms? Its very uncomfortable when this flares up!!

Thanks,

Nathan


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Natdaddy,

All PPIs are equivalent when taken at standard dosages, but some people will find one to work better than others. Try Mucinex and lots of water for the mucous.


Colin Aherne 4 years ago

is there a chance my protium work again if i tried them again? i was told in chemist that the cheaper brand of protium may not work the same as the original protium is this true?? they wanna try me on pariet now, zoton day 6 today and still burning not as bad but acid still breaking true like


shar 4 years ago

I was on dexilant 60 mg for 5 days. On the 5th day I had a severe case of uncontrollable diarreah and severe upper abdominal cramps. I stopped taking and diarrea and cramping continued along with burning stomach. Is this a side effect? I have tried all the ppi listed and they have all given me similar side effects. Any suggestions? Aciphex was the only one that didn't give me the runs but I had severe cramping in my calfs at night. I am at a loss.Will my body adjust to the aciphex over time?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Shar,

Yes, it is possible these symptoms are side effects from the PPI's. You will have to discuss options with your physician. One might be a reduced dosage. Another might be switching to an H2 antagonist (e.g. Pepcid, Zantac). Leg cramps are an unusual side effect for PPI's. You might try Aciphex again and make sure you drink plenty of water. I have written a separate article on leg cramps too. Best wishes!


Brittany51908 4 years ago

Hi, I have recently been to the doctor and she had started to have me on dexilant 60mg for a month because it seemed everything I was eating was causing extremely painful heartburn. I went back for a follow-up 1 month later with better results but the pain was still there just not as severe only when I had eaten certain things. She then referred me to a specialist which i see on the 13th but she had placed me on the cheaper Pantoprazole Sod 40mg to save me money, however it seems to have no effect. I'm now getting a refill of the dexilant 60mg so i can at least eat until the appointment. But why would the pantoprazole not have the same effect as the dexilant? She had said they were very similar but I was just curious as to why. Any information would be greatly appreciated! I'm only 21 and just curious, I like information especially if it's something that I am taking health wise. Thank You! :)


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

HI Brittany,

Good question. Honestly...if scientists could figure out that answer...they would solve a great mystery and make a ton of money. Why "similar" meds don't work "similarly" is a puzzle. Thus we are left with a "trial and error" approach often. Thankfully you have something that works, but I'm sorry it is so expensive. Hope your appointment goes well.


suzie 4 years ago

thanks for taking the time to answer these questions; information is power!


john mason 4 years ago

Hello there, would taken 20 mg of protium twice and day be weaker than taken 40mg twice a day? And would cheaper brands of ppis not work the say way? Heart by chemist no? Thanks


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Hi John,

Well, yes, in theory. But there is a maximum benefit that you get to with PPI's. A higher dose doesn't necessarily translate into better efficacy. If prescribed as such, it is worth trying. And the cheaper PPI's are not less effective. Best wishes.


Pam 4 years ago

4 years ago I was diagnosed with Barrett's Esophagus. Having previously tried OTC meds along with prilosec, prevacid, protonex it was determined that Nexium was my answer to all my symptoms. Having just changed insurance to Fallon I am now being denied authorization for this medication. I am told I have to switch to Dexilant. I am in near panic worrying about what this will to my stomach and esophagus especially in that you state that Dexilant is the same compound as a drug that failed for me. How long before I know if Dexilant is causing harm? What symptoms will occur again? Sure would like to avoid cancer. Thanks for any recommendations.


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Pam,

Sorry about your discomfort. Dexilant is a good drug and may work just as well as Nexium would have. Follow your doctor's order for this. Give it several days to see if it is going to help. If not, see if your doctor has Nexium samples that you could try before paying more for it. Best wishes.


Al 4 years ago

I went to my doctor a few days ago. I had one day where I had heartburn and an acid feeling in my throat. How ever after that incident I haven't had any of the symptoms since but kept waking up with chest pains and would have them a after every single meal for about 45min- 1 hour. I sleep fine and don't wake up with any kind of heartburn. I do have the feeling of air stuck in my chest and keep burping a lot throught the day. They are small burps and dont really make me feel too much better. The doctor told me he thinks I have GERD and gave me a 5 week supply of Dexilant. I have taken it for three days and although the chest pains are almost not there i still have the feeling of air in my chest and keep wanting to burp. Do you think that Dexilant is the proper thing I should be taking? or is it possible that maybe i was misdiagnosed. The doctor did listen to my heart and ran an EKG to rule out any heart problems. What my main concern is... Can GERD be just chest pains after eating and the feeling of being filled with air?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Hi Al,

Your symptoms are consistent with GERD, and I can tell you from personal experience that the chest pain may accompany GERD. My advice would be to continue with the Dexilant for the full 5 weeks. However, stay in touch with your doctor, especially if the symptoms get worse. Best wishes.


vijayaraghavan krishnaswamy 4 years ago

sir,

extremely well written being a surgeon myself and a neurosurgeon with 30 years of experience i had great difficulty in explain g the mechanism "YOU HAVE MADE IT A CHILD'S PLAY,

REGARD

Dr.vijayaraghavan krishnaswamy


Julie 4 years ago

Hi,

I am wondering about the cancer risk with long term use of all the PPI's. Is one less risky than another?

Thanks!


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Julie,

They are all equally safe and effective in appropriate doses. The cancer risk is not clear. Plenty of studies show no relationship between PPI's and cancer. Best wishes!


Kevin 4 years ago

Hi there: I have been taking omeprazole for months, but it really only worked for the 1st 6 weeks, then its effectiveness kind of wore off. A friend suggested I try 5 or more days without it, then start taking it again to try and "reset" its effect. But all the info here is really useful. My next step would be to try Prevacid. I thought it was more or less the same as omeprazole (Prilosec), but you give me hope that it might have a different effectivity for me. Thanks !! :-)


Dean 4 years ago

Hi,

I have been diagnosed with GERD. I tried Nexium 40mg but it did not seem to help enough. I was on Pantoloc 40mg for 6 weeks, all my GERD related symptoms went away but my legs became very stiff and I developed runners knee. Within a week of coming off Pantoloc and returning to Nexium my legs got better and even my knee tracking problems went away, but my GERD symptoms returned. I am looking for a PPI that will work like the Pantoloc did but without the side effects. Do you know of any people with muscle cramps or other muscle related side effects on Dexiliant. I have even tried Pepcid, but it also made my legs stiff and did not work on my GERD sysmptoms very well.

Thanks!


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Dean,

Sounds like you will need to try some other products. Talk with your MD. My advice would be to start with a low dose of Omeprazole. Take it at bedtime and get plenty of fluids during the day. Then increase the dose after 1 week. See if that helps. As I mentioned, talk this over with your MD first. Best wishes.


Lynn 4 years ago

Hi, i would to get your opinion on which PPI would be best for someone who already suffers from bile acid diarrhea I take colestid at night which has helped me immensely, but know I have gastritis and GERD. I have taken Zantac twice a day. It helped, but seemed to make the the chest pressure and throat tightness worse. I tried aciphex for two weeks and actually helped with the diarrhea, but not much help with the Gerd. Should I try taking the aciphex twice a day or would you suggest trying a different PPI? I am concerned with the based ones such as Prilosec, nexium , and Dexillant because of the diarrhea. It seems after reading reviews on Aciphex- that it is the only one that does not cause diarrhea. Is this because it is "rabeprazole sodium" as opposed to Magnessium based? Any input you could offer would be greatly appreciated. Thank you!


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Lynn,

The good news is that you have tried most of the available PPI's so there are not too many more to attempt. Protonix caused less diarrhea than others in studies. But Aciphex is one of the best for low incidents of diarrhea. Either talk to the MD about increasing the Aciphex dose or switching to Protonix. Best wishes.


Rick 4 years ago

Hello,

I'm a 34 year old male who was given 30mg samples of Dexilant this past summer by an ENT after having the sensation of having something caught in my throat, and some minor chest tenderness. A month or two later, my PCP wrote me a script for Dexilant, but the script was written for 60mg. I talked to my PCP, and I guess there was just a miscommunication between us, but he said 60mg should be fine. The 30mg did improve the situation to an extent, but obviously, 60mg does work even better. I'm wondering, though if 60 might be too much if one doesn't necessarily need it? I'm also wondering if there is a risk of weight gain involved with Dexilant, as I've read of complaints about other PPIs and weight issues?

Thank you,

Rick


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Rick,

60mg is a reasonable dose, though we always like to go with the "lowest effective dose" for sure. Most PPI's have a VERY small reported weight gain (less than 2%). But think about it - many people are not eating due to GERD. So some weight gain is just because they are working...so people can eat again. They do not cause obesity. Best wishes!


Jo 4 years ago

I am a 45 year-old female with a small hiatal hernia, LPR and angioedema (several allergies). I take 60 MG Dexilant in the morning at least 30 min. before eating, and take Zyrtec 25 (histamine #1) mg and Ranitidine 150 (histamine #2) both at morning and night (sometimes with the Dexilant). I am allergic to sulphites, sodium nitrate, and borderline on Carageen gum (in Dexilant capsule) and yellow #5. The head of my bed is raised which helps tremenously. However, in addition to still feeling a small "lump" in my throat, I have stomach upset after taking Dexilant for at least a few hours. If I forget to take it, little to no upset stomach. Should I remove the capsule and swallow it with applesauce as I have read to avoid the carageen gum in the capsule that may be the issue? Or is there something else with this combination of meds making me sick to my stomach? Dexilant was the pill with the least symptoms - maybe because of the dual release formula. I'd been on Zegerid (gave me a sore throat), and Protonix previously. I also get a LOT of gas...is there an alternative? I think I also had some other prescriptions, but had bad reactions (one changed my vision). I have been on Dexilant for about a year and was told I'd be on this or similar meds rest of my life due to the hernia. It's getting old to feel ill every day. Thoughts?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Jo,

Yes, the best thing to do in this case would be to empty the contents of the capsule into a spoonful of applesauce. Then you would have very little left to bother your stomach. The pellets are enteric coated, so they will not dissolve in the stomach and thus cannot irritate. Best wishes!


KL 4 years ago

I have been taking it for a month now and my mouth is constantly dry,my stomach seems to have gotten worst, and seems that it stops mucus production, which I need.


Leslie 4 years ago

My doctor wrote a prescription for 20 MG of Omperazole once a day 30 minutes before a meal for a month. I have not seen a gastro doctor AND have not been diagnosed. He simply prescribed me the medicine for the symptoms I was having. Is this safe? My symptoms are non-traditional, such as back pain, chest, and stomach pain. I've already been tested for cardiac issues, and it's been ruled out. I just don't know how safe it is for me to be in the medication if I don't have a problem with acid in my stomach. My doctor told me there's no problems with using it for a short-term time, to rule out acid reflux...but I am leery. I took my first dose of the medicine today.


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Leslie,

The symptoms of GERD are pretty broad, and can include all those things which you mention. The process of diagnosis is often a process of ruling out one thing at a time...moving from the most common...to the more rare. I believe your doctor is taking a reasonable approach. On a personal note...I had the same symptoms you describe. It was GERD. Prilosec worked. Give it a week though, and do not skip any days. Best wishes.


Leslie 4 years ago

Thank you for your prompt response. This is day two of the medicine and I don't currently feel my back/chest pain feeling any better. My stomach issues have been less noticeable. I'm wondering how many days this medicine takes into effect. I take it with applesauce, since I have a hard time swallowing pills. I'm really hoping this works...


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Leslie,

You are welcome. I usually tell people to give it a week. Some healing has to occur before you can feel better, even though it will begin working sooner.


Abby 4 years ago

How many days into Omeprazole should I stop, if it does not work?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Abby,

I generally tell people to give it 2 weeks before calling your doctor about requesting an alternative.


omeprazole user 4 years ago

How many days into an omeprazole trial do you start to get side effects? I've been on it for 6 days and am just noticing some stomach discomfort (stomach issues) ect...I'm not sure if it's the drug causing it or just a stomach bug, but still would like to know when side effects can take into effect.


Laura 4 years ago

I know you're not a doctor, but maybe you could give some insight. Do gallbladder problems and esophagus issues, like GERD, often get mistaken for each other? My doctor put me on medication for GERD, but I'm not sure I have it. I haven't been officially diagnosed for it and I think I may have a gallbladder issue instead. Could the PPI be harmful to my body if I do not have a need for it?


Megan 4 years ago

why cant the time release capsules be taken in yogurt. why just apple sauce??


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

omeprazole user,

Side effects would typically be seen in the first week or two. But "stomach discomfort" is such a general symptom it is hard to nail down the cause without a more complete exam. I would contact your physician for a consult. Best wishes.


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Laura,

I can tell you that the symptoms of GERD are often confused with other conditions, as similar types of pain and discomfort are typical of other conditions too. That said,in medicine, we start with the most likely and least intrusive (and least expensive) approach. Thus, GERD is probably reasonable, and a PPI is very safe (even if you don't have GERD). If symptoms don't improve in a couple weeks...then they will go on to "diagnosis B" (whatever that is). Hope that helps.


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Megan,

Dexilant mentions applesauce. Probably that is what they used in their studies. However, any cool, soft food is just fine.


Sandi 4 years ago

Doctor prescribed Dexilant for GERD and Cymbalta yesterday. Took the first pills together last night and approximately one hour later I was hurting so bad in my chest I thought I was having a heart attack. Cold sweat, dizzy, chest pain through to back,and nauseau. Went to ER and blood work showed no heart attack but not sure what caused this symptoms. Have you heard of any serious reactions with either drug similar to this? or could it be because I took them together?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Sandi,

Would need lots more space for questions, etc. to really advise you well. Starting both those drugs at the same time is unusual, as they are entirely unrelated. But maybe you have been on 1 or both before. I would talk to your doctor, and consider getting the GERD under control first - if possible - before trying to treat something else. But again, I can really only advise you to seek a medical evaluation again. Best wishes.


Lisa 4 years ago

I have a small hiatal hernia and barett's esphogas (both recently diagnosed). I have tried Prilosec 24 and Prevacid in the past and had pretty severe allergic reactions to both medications. My doctor would like me to try Nexium next and then Dexilant if the Nexium doesn't work. I'm concerned about both of these drugs because my understanding is that Nexium has the same ingredient as Prilosec and Dexilant the same ingredient as Prevacid. I have a wonderful doctor who I am very happy with but I don't think he has the time to figure out which of these drugs is safest for me to try. He wants me to try and rule them out as I have symptoms. Because the previous symptoms were so severe I'm very nervous about going through the side effects again. Is it possible that Nexium and/or Dexilant may not cause an allergic reaction even though some of the ingredients are the same as Prilosec or Prevacid? Are there any other PPI's or acid reducing medicines that I can be sure won't cause a similar reaction? Any advice you could give would be greatly appreciated. I need to treat the reflux as soon as possible. Thanks in advance!


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Lisa,

By "allergic" reaction do you mean hives/rash? I ask because we try to distinguish between an "allergic" reaction and a "side effect." An allergic reaction is more serious and dangerous. If the reaction was a side effect, then Nexium is an option. If that doesn't work, I would try a different type of medicine - like Pepcid AC or Zantac. Sadly there is no guarentee a side effect won't occur again. Hope this gives you some options.


Dottie 4 years ago

I am an 81 y.o. woman with osteoporosis and would like to take Prilosec for the shortest possible time, so as to not compromise my bones. I took the first pill this morning and have had complete relief of heartburn. Is it unreasonable to take it for just a couple more days and then quit, and see if that might be all I need?

Reading all your previous comments has been very helpful -- thank you!


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Dottie,

I would give it at least 30 days to allow for healing. There will be no risk to your bones during this time frame. Then talk to your doctor about your symptoms and your concerns for fractures. Best wishes.


davegluck2000 4 years ago

Hi Jason - are you ready play Dr. House?

I am a 29 y/o male who had gained a little extra weight and started a diet called the Paleo Diet - No Grains, Wheat or Dairy - low sugars low carb and lots of meat - red meat, fatty cuts etc as well as all the veggies i could eat and dark chocolate fruit and nuts for sweets.

Things were great I dropped 15lbs in the first month of strict paleo eating. i reintroduced some carbs to the diet (bread) and my troubles began.

I started to get a knot in my stomach after eating almonds, so i thought this was the key although it was only sometimes as i really enjoy them and took the risk of continuing to eat them. Then it would be burping uncontrollably all night, all day really anytime i ate anything with normal heartburn that i had experienced for years. I took pepcid and zantac to control this but went from zantac 75 to 150 bc of the new pain.

I Went to see a GI after about 3 weeks of pain - now 20lbs down from the starting weight, still trying to stick to this diet with adding in of Rice because i was getting so sick. The GI suggested an Endoscopy (Ulcer) and sonogram (gallbladder) both came back negative as did my blood test - meanwhile he started me on DEXILANT!!! I love IT - but my insurance wont cover it.

2 things - thoughts on the diet contributing to the heartburn and stomach issues?

thoughts on the next best thing other than 60mg dexilant which has slowed the issues altogether, I can eat without fear of disgusting uncontrolable burping and having to leave work or not sleep :)


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

davegluck,

Hi. The shift toward more fatty foods caused the GERD to kick in, but you were probably borderline before this. With your doctor's permission, start with Prilosec OTC or try one of the other OTC products like Prevacid. These are similar to Dexilant (and much stronger than Zantac)


davegluck2000 4 years ago

Thanks!


pam9 4 years ago

I have been taking omeprazole or something like it for over 30 years for GERD. Several months ago, there was an increase in severe pain, and I was prescribed the prescription strength omeprozole delayed release 40mg 2x day. It did not help for long. An Upper Endoscopy, diagnosed esphogitis, healing bleeding stomach ulcers, stomach polyps, and duodentitis. I was then prescribed Dexilant 60 2x per day, as well as something to take before meals, and a simethicone prescription to take one hour after meals 3x day. Of course doing the very strict GERD diet. Have been on this regimen for one month. Still very weak, have lost 10 pounds, and pain is almost constant now with some back pain. Doctor said to give it two months! Can I add an omeprazole mid day?


pam9 4 years ago

Forgot to add I was negative with both blood and biopsy testing for H. pylori, so it is all due to excess acid.


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Pam9, I'm not a doctor. It sounds as though you have some very severe GERD symptoms. You may want to try a see another specialist just to confirm this diagnosis. I do not know of any study that suggests adding Omeprazole is likely to help. You may need to talk with your MD about switching to another PPI. Best wishes.


nhagerty 4 years ago

I recently had an endoscopy and was diagnosed with a small stomach ulcer that appeared to be trying to heal. I had already taken protonix for 3 months with no relief. I am now on dexilant 60mg once a day. I have only been taking it for 5 days but im still having the ulcer pain. what is a good amount of time to know if the medicine is working on an ulcer?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

nhagerty,

Usually 3-4 days is enough to begin seeing improvement in symptoms with a PPI. You may need to supplement it with another med temporarily (like a liquid antacid). I would talk to your MD if it doesn't improve in a week.


nhagerty 4 years ago

Does it mean it's not helping to heal the ulcer if you still have the burning pain occasionally after being on it for 2 weeks? I was told Dexilant 60mg is the strongest PPI there is. Is it possible some people need to take them alot longer than others before healing begins?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

nhagerty,

In 2 weeks you should have significant improvent in symptoms, but not complete healing. So as long as it has improved, keep going. Yes, some people may take longer than others.


Scott 4 years ago

I have had gastritis for 4 or 5 months now and I haven't been using medication. I'm trying a all natural way to cure my gastritis to stay away from side effects and what not. If you had to say, which PPI is the best medication that helps with the lowest amount of side effects?


ksr 4 years ago

IF "disabling the proton pump in the parietal cell of your stomach...= no formation of hydrochloric acid" is true, how the heck is a person supposed to absorb/digest the nutrients from the food we eat? I've read online about these GERD drugs that doctors prescribe year after year, and then end up treating us for osteoporosis, and osteoarthritis and all the other kinds of conditions later on. I know doctors and pharmacists need to make a living too but.. they write these drugs which are not good long term without telling us about our situation or educating us about the dangers and long term solutions that we need to implement or else. Google, experiment with leafy greens, and eat less fat, less sugar, until your stomach acid is normal - educate yourself on "How To Stop Gerd Drugs". Another thing: Get knowledge on Gluten. It's no fad. Gluten is 4 times stronger than when we were kids because of the changes to wheat. 12 years ago I started out having heartburn, then realized later I had a dairy intolerance (diarrhea), then ten plus years later realized my problem was gluten (heartburn, sleep sitting up, hard to focus memory, constipation/diarrhea, skin problems, toe fungus, thinning hair, knees hurt, odd pains). I have given up many foods, and am now working on giving up the gerd drugs because my blood tests now show I have a lack of nutrients, vitamins and minerals... coincidence? How can a person get enough nutrition if they take drugs that cut down on their nutrition? That person needs to stop the drugs and learn to eat better. Eat leafy greens-learn about healthy food-cure yourself.


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

ksr, I understand your condern. The error in your reasoning is this: hydrochloric acid is only minimally involved in the absorption and digestion of foods. Our stomach and intestines have other enzymes that do this. Taking PPI's do not generally have any impact on nutrition. Thus people like myself, and millions of others, take them with no malnutrition problems.


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Scott - avoiding dietary triggers may help. But if treating the problem naturally means a slower healing - you have to factor in the loss in quality of life you are giving up. Using a 20mg dose of omeprazole for a few weeks (if recommended by your MD) is a safe and effective approach to promote more rapid healing and resume your quality of life. Best wishes.


susantyner 4 years ago

I was wondering if taking one Prevacid 30mg in the morning and another Prevacid 30mg in the evening would be equivilant to taking one Dexilant 60 mg.

Thank you


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

susantyner,

Well, the way to look at these is like this. They are generally equally effective at their individual recommended dosages. 30mg of Prevacid and 60mg of Dexilant are therefore about equiavlent in effectiveness. That is NOT to say that an individual might not find 1 to work better for them. However, doubling up on the Prevacid just to make it = 60mg isn't really correct. Hope that makes sense.


Dolly 4 years ago

I have been on Dexilant now for approximately 2 years and it has helped me tremendously. Until recently, I had only been paying $20/month with the manufacturer's saving card. Now it is $92/month. I have no insurance and cannot afford to spend that much on one prescription (because I have 7 others to buy) but I have used others in the past that have not worked for me. I have been out for 4 days and have very bad acid "episodes" at night. My doctor suggested trying omeprazole but the box says only 1 a day and that isn't working. Is it ok to take 2 a day?


pharmacist profile image

pharmacist 4 years ago from Whitinsville, MA Author

Dolly - the OTC strength is 20mg. By prescription you can get 40mg. I'm not telling you to double your OTC tablet...only that 40mg is a dose that sometime people use. Check with your MD about doing that first. Best wishes.


Zohaib Khan 3 years ago

Hi I have Acid reflux problem for more than a year. I have been using Dexilant 60mg which works for me very nicely. Unfortunately, my health insurance has stopped coverage for dexilant and i am forced to use other medications. I have used Prilosec OTI, Lansoprazole 30mg and Pantoprazole 40mg. Nothing seems to work for me. Please let me know which medication is close to Dexilant ingredient-wise. Thanks for your help in advance.


Dark Myst 3 years ago

Hi, I was prescribed to take pantoprazole 40mg twice a day at my visit to the GI doctor a few days ago. I didn't realize the possible side effects of PPI's until after filling the prescription. Previous to the visit to the GI doctor I went to an ENT who prescribed me dexilant 60mg once a day for 6 months due to a feeling of a constant lump in my throat, occasional chest pain, occasional stomach pain and hoarseness. CAT scan of the neck came back negative. The ENT scoped me and found streaking at the back of my throat and inflammed voice box as well as post nasal drip. I am scheduled for an endoscopy May 4th. I tolerated the dexilant 60mg once a day fine, no side effects (didn't know about possible side effects at the time). I am nervous about taking the pantoprazole 40mg twice a day. Do dexilant and pantoprazole contain similar ingredients? If dexilant didn't give me any side effects will pantoprazole? Will the higher dosage make a difference in the possibility of side effects? Wish I would have known the possible risks at my doctors appointment so I could have asked him. I would be grateful for any information you can offer. Thank-You in advance.


pharmacist profile image

pharmacist 3 years ago from Whitinsville, MA Author

Zohaib, Thanks for the question. Dexilant is basically the same ingredient as Prevacid...but with a special time-release formulation. Ask your MD about increasing your Prevacid dose. That should help. Best wishes.


pharmacist profile image

pharmacist 3 years ago from Whitinsville, MA Author

Dark Myst,

Sorry for the delayed reply. You would be moving from the maximum recommended dose of Dexilant to the maximum recommended dose of Pantoprazole. So we would expect similar effects, side-effects, etc. Although they are different ingredients, they work the same way, so you can expect similar results. Is that always the case? No. But most people would tolerate such a switch with no problems. Best wishes!


dylan 3 years ago

I was prescribed dexilant but I've heard that it was bad for your bones I hv a years perscription should I be worried taking it every day for a year?


pharmacist profile image

pharmacist 3 years ago from Whitinsville, MA Author

Hi dylan,

The latest evidence does not show a strong correlation between PPI use and loss of BMD (bone mineral density). I continute to recommend people use their PPI as directed and only in recommended dosages.


Barb 3 years ago

I have phlegm in my throat and was given dexilant 60. How long does it take to work. Very thick mucus.


pharmacist profile image

pharmacist 3 years ago from Whitinsville, MA Author

I would definitely give it a month of daily use and then assess from there.


Virginia Ward 3 years ago

Thanks for all your help, Pharmacist, but I'm afraid it's not true that Dexilant can't cause weight gain. Quite a few official web sites say it can, and I've noticed that myself. Same thing happened on Prilosec. With no change at all in diet or exercise, I gained some weight. I'm quite unhappy about this. It's not because I was eating less before, I'm sure.


Tina Sanderson 2 years ago

I was given samples of Dexilant from my doctor. I am almost out of the samples and am awaiting approval from the company that sponsers Dexilant. Will Dexilant still give me the same great results if I am without it for several weeks? There has never been a medicine that helps my condition like Dexilant. I have no insurance and I can't afford to pay for the prescription.


pharmacist profile image

pharmacist 2 years ago from Whitinsville, MA Author

Hi Tina,

Your symptoms may return while you are off of Dexilant. Ask your doctor about samples or check the website for coupons. Hopefully you can start it again soon.

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.


    Click to Rate This Article
    working