PPIs all the same?

I recently went to a new ENT doctor.  My last ENT prescribed Nexium 40mg twice a day.  Since there is no generic and I am going to fall into the gap where I will have to pay $350/month for this, I asked for another suggestion.  I was thinking of taking Nexium 40mg once a day and some other PPI another time during the day.  However, this new ENT just said to take one of the other over the counter PPIs twice a day, since one is not really better than the other.  This bothers me because my previous ENT was very specific about the Nexium 40 mg twice a day.  He has now left the area, and is no longer my doctor.

Anyone have any opinions or experience with this???

I am over 65, so I am on the wonderful prescription plan the government did for me.  My insurance will pay for the Nexium until I reach a certain limit.  Then I fall in the gap section and have to pay for all medications myself.  Nexium 40 mg twice a day runs $350 a month.  I am trying to determine if it is worth it or if another PPI would be just as good.  My current doctor has been no help, but I don't have the confidence in him that I had in the doctor who said I should take Nexium 40mg twice a day FOREVER.

If the Nexium was working for you I would try the Prilosec. Nexium came out only when they were going to lose their patent on Prilosec. They added one ingrediant(so to speak) so they would have a new cash cow since they were losing the other. The new ingredient was supposed to heal the esophagous. Does it? I don't know but Prevacid, Protonix and Aciphex are basically the same thing with a molecule apart. I would try the Prilosec and see how you do or you Doctor can give you a prescription for the generic version and your insurance will cover it. It comes in only 20mg so you would have to take 4 a day obviously but it is cheap with prescription. I get 100 for $7.00 The other PPI's  are almost as expensive as Nexium. The other thought is to buy from Canada or India and save a lot of money that way if you are determined to use the Nexium. Most Doctors don't feel one is that much better than the other and like someone said each one has its own problems. Protonix made me worse. That is a very high dosage you are on. I hope you are making sure that you get enough Calcium and Vit D as studies are showing that the PPI's may cause osteoporosis. As soon as this patent runs out they will be coming up with a newer version to get your money. My Doctor calls acid relux the disease of the decade. Everyone seems to have it.

It seems this is the difference (besides cost) between Nexium and Prilosec:

The active compound in Prilosec is omeprazol, which comes in two forms, R-omeprazol and S-omeprazol. The R and the S come from the Latin for right and left - just like the hands - and indicate that this is a pair of identical mirror images. Both R-omeprazol and S-omeprazol are effective in reducing heartburn, but S-omeprazol is about 4 times as effective as the R form. Prilosec contains a 50/50 mixture of the R and S forms, Nexium is pure S. So 20 mg of Prilosec is equivalent to 12.5 mg of Nexium (10 mg of S + 10 mg of R/4). The prescribing literature on Nexium obscures this fact, giving a new name to S-omeprazol: esomeprazol. Get it? "es"omeprazole.....

My problem is that I don't have the obvious symptoms for GERD or LPR that most do. I am on Nexium 40mg twice a day because I have idiopathic trachea stenosis. That is what many doctors prescribe. I was told my throat looked like I had severe GERD even though I have no symptoms.

I have no problem taking the Nexium 40mg twice a day, other than the cost which is going to catch up with me when I reach the gap on my insurance. I could try Prilosec, but if it doesn't work the only way I will know is that the stenosis will return and that is not a pleasant way to find out. Doctors seem to disagree on whether the Nexium is necessary, but I'm not sure I want to 'try' something different in this case. I guess I am stuck with the cost. I wonder when Nexium will go generic?

Ugh.

Does Canada have a generic? There seems to be one on the internet, but I don't see how that can be.