Reflux Medications - when to take?

By Dr. Fred Raleigh
Plus Magazine
Date 10/04


Question.

Yesterday while at the doctor's I received some samples of Nexium, a brand of esomeprazole. I tried reading the brochure, that came with these samples, to find out how to properly take this medication. If that information was in the brochure, I couldn't find it. And the print was so small! So...how do I take this product? Is it one in the morning or at one at night? Should this product be taken with or without food? I would surely appreciate your advice.

PM Santa Margarita, CA via email

Answer.

Nexium is a product that is in the family of medications called proton pump inhibitors. In a nutshell this means that these chemicals are designed to stop the chemical cycle that produces stomach acid. Members of this family are very effective at accomplishing the goal of reducing stomach acid. Generally within 3-4 days after beginning these products your stomach's acid content will be reduced by 95%. Yet, there will be sufficient stomach acid to help with the breakdown of proteins, but hopefully not enough stomach acid to cause symptoms of gastroesophageal reflux disease (GERD).

Nexium is a once a day product and I would advise taking it within one-half hour of a meal or with a meal. The agent itself requires the presence of food in the stomach. Food starts the chemical cycle necessary for the production of stomach acid. It is this chemical cycle that must be running for the proton pump inhibitors to be activated in your system so that the stomach's acid production can be significantly curtailed.

Our body tends to produce more stomach acid after meals. As dinner is generally the largest meal I would suggest taking the product as close to dinner or or during dinner, if possible. It is the late day production of stomach acid that causes more problems of reflux later in the evening or at night while we sleep.

Somewhere down the road say....3-4 weeks and once your system becomes adjusted to this chemical, you might want to discuss with your physician and consider taking the product 5 out of 7 days to see if it is as effective. As I mentioned in the opening paragraph, these products are long acting. I have seen many patients who can do with just taking agents in this class of products, every other day.

Nexium is a prescription medication. Briefly stated the parent compound that Nexium is derived from is omeprazole which is now available in an over-the-counter tablet known as Prilosec OTC. The average purchase price of this product is around $0.57-$0.80 per dose. If you compare this cost to the prescription cost of Nexium you may find you can save a significant sum of money and obtain the same relief.

Of course you will have to consider your insurance co-pay and other insurance factors such as is this product, Nexium, on your health insurance's formulary. If not, the co-pay and/or out of pocket expenses may be significantly higher. For now I would think quelling the acid beast would be you first goal if that is indeed you problem.


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