For millions of Americans, a pill or antacid is the only way to relieve heartburn. Though some control the fiery stomach acid through lifestyle changes, many face ongoing pain and discomfort without medication. The most potent acid reflux drugs available are proton pump inhibitors, or PPIs. These medications (including best-selling Nexium and Prilosec) once required a prescription. However, they’re now available in over-the-counter (OTC) formulations, despite studies warning against long-term use. These severe side effects and complications make many physicians wonder: Should Nexium OTC be pulled off store shelves?
Even Doctors Are Wary of Taking PPIs
In an article titled “8 Drugs Doctors Won’t Take,” the list includes Nexium OTC and Prilosec. Nexium’s active ingredient, esomeprazole, is commonly prescribed (1.5 million Medicare patients in 2013, total sales of $2.5 billion). However, the drug’s unsafe nature is making many doctors think twice before prescribing it for continuous use. And if physicians are worried, keeping Nexium OTC in every grocery store and pharmacy is even more cause for concern. But in order to understand why doctors wouldn’t take a drug they readily prescribe to patients, it’s important to understand their concerns.
How Heartburn Remedies Like Nexium OTC Work
When stomach acid backs up into the esophagus, it causes heartburn. Most heartburn medications reduce gastric acid production in the stomach to relieve pain and other symptoms, like gas or bloating. And gastroesophageal reflux disease (GERD) is a severe heartburn condition that frequently returns without taking medication indefinitely.
Many different heartburn remedies work, but they belong in three distinct categories. Antacids are the mildest option and include Tums, Mylanta, as well as Rolaids. Go one level up and you’ll find H2 blockers, which include brands such as Zantac and Pepcid. PPIs are the most potent drugs of all and frequently used to treat GERD, a disease that plagues over 7 million Americans. Among the more popular PPIs are Nexium OTC (esomeprazole), Prilosec (omeprazole) and Zegerid (omeprazole and sodium bicarbonate). Because Prilosec, Zegerid and Nexium OTC are all PPIs, they effectively halt gastric acid production in the stomach. The only problem is that they may be a little too good at doing their job.
Dangerous Side Effects of Prolonged PPI Use
“Dip into any physiology textbook,” says Harvard Health Publications, “and you’ll find that stomach acid serves several constructive purposes.” When you eliminate gastric acid completely, your stomach is unable to absorb nutrients, causing malnutrition and vitamin deficiencies. Eliminating stomach acid is shown to cause the following severe and possibly deadly complications:
- Pneumonia. Stomach acid kills incoming bacteria and viruses. Though excess acid hurts, having some protects you from harmful infections. Pneumonia occurs more frequently because there’s no stomach acid to destroy the viruses causing it.
- Bone fractures. Your body absorbs calcium during digestion, but PPIs impede that process, making bones brittle and easily broken. In fact, the FDA released a warning about increased bone fracture risks while taking PPIs. The hip, wrist, and spine are especially vulnerable.
- Dementia. A February 2016 JAMA Neurology study analyzed over 70,000 adults aged 75 and older for eight years. (No participants showed signs of dementia at the study’s onset.) Researchers found subjects taking a PPI for 18 months or longer had a 44% increased risk of developing dementia.
- Heart attacks. A 2015 study linked PPIs taken regularly for years to heart attacks. Researchers found the risk of heart attack “might extend to subjects without any prior history of cardiovascular disease.” They also found long-term PPI therapy patients had a 16%-21% increased heart attack risk compared to those not taking PPIs.
Are Nexium OTC & Prescription Formulations Too Profitable To Pull Off The Market?
In 2014, Nexium was the third-highest-selling prescription medication in the U.S. After launching Nexium OTC 24HR in May 2014, sales rose even more. Nexium became the second-highest-selling U.S. medication. Nexium, Nexium OTC and generic esomeprazole are growing more popular, not less, despite studies revealing the drug’s potential dangers.
Other Heartburn Remedies to Consider
Harvard Health Publications says to think twice before taking Nexium OTC for GERD symptoms. The publication asserts, “it may be a good time to step back and ask whether we’ve been reaching for that PPI bottle too often and too soon. Occasional reflux can be treated effectively with the old-fashioned antacids. Some people find that only certain foods (chocolate, coffee, fatty food) trigger GERD-related heartburn, so they learn to avoid them. A chewing gum habit increases the production of saliva that can soothe an irritated esophagus and wash stomach acid back down into the stomach. And if the problem’s nighttime heartburn, elevating the head of the bed can help.” They say if you really produce excessive acid, it’s okay to take PPIs — but only under your doctor’s supervision. Nexium OTC, Zegerid and generic Prilosec leave reflux patients without medical support to avoid long-term PPI complications.
What You Can Do
If you took Prilosec, Zegerid or Nexium OTC and developed any side effects listed here, you may have a claim. Because drug manufacturers failed to warn consumers and physicians about dangers of long-term PPI use, patients are filing lawsuits. Get your free Nexium claim evaluation today to see if you may qualify for financial compensation. After submitting your information, a Nexium lawyer will contact you to discuss your case and how to get the justice you deserve.
Related: Alternatives to Nexium and Prilosec for Acid Reflux
Mandy Voisin is a freelance writer, blogger, and author of Girls of the Ocean and Star of Deliverance. As an accomplished content marketing consultant, mom of four and doctor's wife, Mandy has written hundreds of articles about dangerous drugs and medical devices, medical issues that impact disabled Americans, veterans' healthcare and workers' compensation issues since 2016.