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Swapping PPIs and side effects

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Posted 10/31/2011 5:16 PM (GMT 0)
I have been on Nexium almost 10 years.  My dr. suggested I swap from nexium to dexilant.  I have never had any side effects on the nexium.  Does that mean I should be able to tolerate the dexilant ok as well?  I am med sensitive so am alway nervous about swapping meds or starting new ones. 

Thanks for any advice!

Gingin

Posted 10/31/2011 6:21 PM (GMT 0)
I dont see the point in switching if the nexium is working for you. I started getting lower abdominal pains after starting Dexilant, and still have them even though I stopped taking the medicine.
Posted 10/31/2011 7:24 PM (GMT 0)
Hi Chuck. When I was first diagnosed I was diagnosed with GERD. Had the scope and had strictures so had to have my esophagus stretched. I never had heartburn then but was waking up at night with burning in my throat. I was put on 40 mgs nexium and symptoms went away. After a year or so I was able to just take nexium every other day and still did fine. Last spring I started having hoarseness and lump in throat so went to ENT and was scoped. Said it was LPR. Left me on nexium every day and added 20 mgs prilosec in afternoon. Was scoped again last week and said I went from moderate to mild but I still have symptoms that come and go. Like the hoarseness/throat clearning is always there but the lump is better on most days. I asked about being on 2 PPIs and the chance of loss of bone because I am petite and don't want to have to deal with bone loss one day from taking a med. She suggested that I change to dexilant and see if I get better, and if so, I can probably cut back to every other day again like I did on the nexium.

Maybe I will not have side effects and maybe it will help me get back to where I was before this LPR thing started.

Gingin
Posted 10/31/2011 7:40 PM (GMT 0)
i would ask my doctor why?

from some reading and what ive been told by people who know way more than me....

arent both of these PPIs still under patent? (expense?)

i believe both nexium and dexilent are enantiomers of previous PPI medications that are off patent

enantiomers are chemicals that have a right hand or a left hand twist to part of a molecule...but otherwise the drugs are chemically the same

sometimes enantiomers have been shown to have different chemical - biological action and sometimes not

most of the studies ive read fail to show that any PPI is more effective than any other, on average..... but...BUT, this may vary from individual to individual

sometimes a drug may become ineffective after years of use and a change of medication helps

this is a person by person trial and error kind of thing with of course the advice of your doctor

if you are doing ok on your current meds i would ask the doctor why the change is recommended

btw dexilent is the enantiomer of lansoprazole (one of lansoprazole's common brand names is prevacid)

nexium is the enantiomer of omeprazole ( one of omeprazole's common brand names prilosec)

i wish you well as you make your decision...these choices are not easy

mock turtle
Posted 10/31/2011 8:03 PM (GMT 0)
I actually (from reading this board) asked if changing meds would make a difference. I had one ENT tell me that generally we do not become tolerant to PPIs, that something else may have triggered the symptoms to start again. The ENT I am seeing now said that if I wanted to change, it couldn't hurt to try it. She gave me about 20 days worth of samples to try before I fill the RX.

When I found this board, I kept reading many saying their PPIs pooped out on them and they had to change. I had never even thought of that happenening since I have been on the nexium 10 years and it has worked wonders. Not even any breakthru acid.

Do you think I would be better off just trying the prevacid? Right now, I am taking nexium and prilosec and I don't like taking two meds for the same problem if I can get by with one med. The bone issue really worries me since I am petite and small boned anyway.

I wonder if prevacid 2 times a day (morning and evening) would work as well as the dexilant or what I am doing now?

Thanks for all the comments and help!
Gingin
Posted 11/1/2011 1:10 AM (GMT 0)
Gingin

im not a medical professional and im not smart enough to know which PPI at what dose might be best for you

ive taken two different PPIs (pantoprazole and omeprazole) and both worked well

and ive taken 2 different H2s, ranitidine and famotidine and both worked well

the side effects were problems for me

can your doctor, PA or nurse help you decide?

best wishes
mt
Posted 11/1/2011 4:25 AM (GMT 0)
Hi Gingin,

Some people seem sensitive to certain PPIs...personally I never had any noticable side effects when taking any of them.  I went from Prilosec to Nexium to Protonix.  At first Protonix was not available in a generic version, but now it is, so it's much cheaper.  Depending on your insurance plan, you might want to opt for different a generic version first.

When I started taking Protonix it was the "gold standard" PPI.  I believe that Delixant has taken it's place as being the top of the line PPI.  I'm not sure that any one will work better than any other, but it appears that your doctor wants to see if it might do a better job and alleviate some of the problems that are persisting.

I doubt you'd have a problem taking the Delixant if you haven't had trouble with the others you've been on. 

Good luck making your decision!

Denise

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