Proton pump inhibitors ppis are a class of very effective and generally safe medicines used to treat heartburn, gastroesophageal reflux disease gerd , and gastric ulcers.but not everyone who experiences heartburn needs one. Several of the ppis have been widely advertised to consumers and heavily promoted to physicians, and this has led to an overuse of the drugs in the treatment of garden variety heartburn. With $9.5 billion in sales last year, and one of them, nexium, was the top selling of all drugs, earning nearly $6 billion in 2012, according to ims health, which tracks drug sales and marketing. If you suffer from occasional heartburn and have not been diagnosed with gerd, nonprescription antacids such as maalox, mylanta, rolaids, and tums, or acid reducing drugs known as h2 blockers, such as cimetidine tagamet , famotidine pepcid , nizatidine axid , and ranitidine zantac will very likely provide relief. Talk with your doctor about the role that dietary and lifestyle changes can play in alleviating heartburn, too, such as eating smaller meals and not lying down for at least three hours after eating, losing weight if you need to, and avoiding alcohol.

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If, however, you experience heartburn twice a week or more for weeks or months on end, have frequent regurgitation of food into your throat or mouth with or without heartburn , or if your heartburn is not relieved by the drugs mentioned above, you may have gerd and may need a ppi. Gerd is a condition that makes you prone to acid reflux and, over time, can cause damage to your esophagus. The seven available ppi medicines are roughly equal in effectiveness and safety but differ in cost.

Three omeprazole prilosec, prilosec otc , lansoprazole prevacid, prevacid 24hr , and omeprazole/sodium bicarbonate zegerid, zegerid otc are available as both prescription and nonprescription drugs. Four lansoprazole, omeprazole, omeprazole/sodium bicarbonate, and pantoprazole protonix are available as both brand name drugs and generics that contain the same active ingredient but cost significantly less. Taking the evidence for effectiveness, safety, cost, and other factors into account, if you need a ppi, we have chosen the following as consumer reports best buy drugs: generic omeprazole otc generic lansoprazole otc proton pump inhibitors ppis are a class of very effective and generally safe medicines used to treat heartburn, gastroesophageal reflux disease gerd , and gastric ulcers.

Three omeprazole prilosec, prilosec otc , lansoprazole prevacid, prevacid 24hr , and omeprazole/sodium bicarbonate zegerid, zegerid otc are available as both prescription and nonprescription drugs. Taking the evidence for effectiveness, safety, cost, and other factors into account, if you need a ppi, we have chosen the following as consumer reports best buy drugs: generic omeprazole otc generic lansoprazole otc both of these drugs are available without a prescription. You could save $200 a month or more by choosing one of these medicines over more expensive prescription ppis. If you have health insurance, find out if your plan will help pay for generic omeprazole otc or generic lansoprazole otc. If not, talk with your doctor about taking the ppi with the lowest out of pocket cost for you. If you have esophagitis inflammation of the esophagus , you might want to consider esomeprazole nexium , pantoprazole protonix and generic , or rabeprazole aciphex.

Some research suggests those drugs could provide better healing from esophagitis. safety note: several studies have now linked ppis to a higher risk of pneumonia and infection with a bacterium called clostridium difficile, and other studies have found that long term use of ppis may be associated with an increased risk of fractures. Talk with your doctor about those risks, especially if you must take a ppi over a long period of time. People who are 65 and older and those with chronic medical conditions should be vaccinated against pneumonia and get a flu shot every year.

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And we emphasize this recommendation for people in those categories who are also taking a ppi. In addition, anyone taking clopidogrel plavix and generic , a blood thinner used to prevent clots after heart attacks and stent placement, should be especially cautious with ppis, particularly omeprazole and esomeprazole because they can reduce clopidogrel's effectiveness, which could increase the risk of another heart attack. Our medical advisers recommend that people taking clopidogrel should not take ppis unless other treatments have not been adequate. why you shouldn't rely on otc nexium for heartburn consumer reports saturday, january 30, 2016 if you suffer from regular heartburn you may be tempted to pick up an over the counter ppi proton pump inhibitor.