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???
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.
PPI's and Bone Fracture Risk
- Proton pump inhibitors (PPIs) class labeling change to include fracture risk - MPR
The FDA has notified healthcare professionals and patients of labeling changes for prescription and over-the-counter (OTC) proton pump inhibitors (PPIs) to include new safety information about a possible increased risk of fractures with the use of th
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
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
Comments
AUTHORHi 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.
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.
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.
- AUTHOR
I would definitely give it a month of daily use and then assess from there.
I have phlegm in my throat and was given dexilant 60. How long does it take to work. Very thick mucus.
- 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.
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?
- 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!
- 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.
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.
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.
- 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.
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?
- 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.
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
- 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.
- 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.
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.
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?
- 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.
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?
- 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.
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?
- 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.
Forgot to add I was negative with both blood and biopsy testing for H. pylori, so it is all due to excess acid.
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?
Thanks!
- 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)
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 :)
- 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.
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!
- 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.
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!
- 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.
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?
- AUTHOR
Megan,
Dexilant mentions applesauce. Probably that is what they used in their studies. However, any cool, soft food is just fine.
- 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.
- 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.
why cant the time release capsules be taken in yogurt. why just apple sauce??
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?
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.
- AUTHOR
Abby,
I generally tell people to give it 2 weeks before calling your doctor about requesting an alternative.
How many days into Omeprazole should I stop, if it does not work?
- 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.
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...
- 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.
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.
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.
- 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!
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?
- 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!
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
- 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.
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!
- 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.
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!
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 !! :-)
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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!
Hi,
I am wondering about the cancer risk with long term use of all the PPI's. Is one less risky than another?
Thanks!
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
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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.
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?
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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.
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.
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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.
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
thanks for taking the time to answer these questions; information is power!
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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.
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! :)
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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!
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?
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
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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.
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
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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.
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,
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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.
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
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Hi Colin,
As with all PPI's, Zoton with take several days to begin working. Hope it helps!
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
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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: https://hubpages.com/health/constantheartburn...
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?
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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.
Among the PPIs offered, which one is the safest for long term use?
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Hi Mary,
No special spacing needed with the enzyme in Beano, or the plant enzyme product and the PPI products.
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.
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Mary - can you name a specific one you are wondering about?
Do I need to space digestive plant enzymes from PPI's? If so, how much time between?
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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.
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.
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Mary,
Yes, those enzyme products are safe to use with PPIs.
Is it ok to take Beano or other digestive (plant) enzymes while I am on a PPI?
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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!
You mention which foods to avoid for gastritis. What about medications? Besidse NSAIDs, aspirin, and cortisone what other medications are culprits? Thank you.
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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.
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!
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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.
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
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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.
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.
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