Follow-Ups to Answer from Expert Michael Anisfeld

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Patte wrote at 2006-08-25 17:04:24
Hi - I was diagnosed with Acid reflux about six years ago.  I was originally n previcid, but it failed,  I then started Protonix and this has been working great for more than four years.  However, my drug plan will not pay for Protonix - they say it cost more than Nexium and switched me to nexium.  I have been experiencing bouts of unexplained diarrhea since starting nexium two months ago and most recently sever acid reflux has re-occurred.  I had some protonix on hand and switched back.  I am now in a battle to have my drug company (Medco) change me back.  They even argue with my doctor!!!

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Dan Woodard, MD wrote at 2007-01-25 22:41:46
As a physician I was in complete agreement that Nexium was a fraud and should be no more effective than other proton pump inhibitors - until my wife, who has a severe hiatal hernia and was on the maximum dose of Prilosec (the racemic form of the same drug) developed gastroscopy-proven espophagitis so severe that after gastroscopy surgery was recommended. As a last resort she tried Nexium and I was astounded to see that it was actually much more effective, in fact her espohagitis was gone on a subsequent gastroscopy. Symptomatically she tried other PPIs twice with the return of symptoms. I have to conclude that the "inactive" isomer in omeprazole must competitively inhibit the active isomer. I still think the price is unfair, but I have no choice but to conclude that Nexium really is more effective. I absolutely would not have believed it if I hadn't seen it with my own eyes. No, this isn't a testimonial. The manufacturer's pricing policy makes me sick; we can't get it anymore. But in at least this case, documented by repeat gastroscopy, Nexium really was so much more effective than Prilosec that the gastroenterologist changed his mind and hiatal hernia surgery was not recommended. As a result of changed insurance we will have to try Protonix instead. Wish us luck.

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Helen Giss wrote at 2007-05-04 15:05:28
Hi. I have been diagnosed with a large hiatal hernia which causes severe heartburn. I had been taking Protonix which was working very well although it was more expensive. Now Medco reports that my benefit plan will not include this medication. Of course, I can pay the full price like anyone else which is prohibitive. Medco says I can use Prilosec or Nexium which they say are the same thing.

However, I have been experiencing more and more bouts of painful heartburn. My doctor says the Protonix is what I should be taking but I can't afford to buy it without co-operation from Medco.

Interestingly, Protonix is not approved for treatment of GERD by the FDA.

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