Dear Dr. Garner,

I have been on Nexium, better known as the “little purple pill,” for about two years now.

My original symptoms – bad pain after I would eat and acid in my esophagus – are no longer present.

I want to know what you think about this pill and if I should be getting off of it.

Thank you for your help.

Stomach Acid in Astoria

 

 

Dear Stomach Acid,

You have asked a popular question. It is one you should discuss with your doctor. Nexium should only be taken as long as your doctor prescribes. Taking it longer can lead to harmful side effects.

The side effects of Nexium include stomach pain, back pain, bloating, burping, difficulty swallowing and even heartburn. Other side effects, not related to the stomach, include vertigo, sneezing, runny nose, wheezing, chest tightness and diarrhea.

The treatment for stomach pain many times involves the use of Nexium. Antacids like Maalox or Mylanta are often chosen as an initial treatment. Maalox and Mylanta work by neutralizing excess stomach acid to relieve heartburn, acid indigestion and upset stomach. They are sometimes prescribed to help relieve the pain of ulcers. Some antacids also contain simethicone, which reduces gas. Antacids work the quickest to relieve occasional heartburn.

A second category of drugs is called histamine II blockers, or H2 blockers. An example of this is Pepcid AC. These drugs reduce production of stomach acid. They can be purchased without a prescription.

A newer type of heartburn medication that is available without a prescription is known as Prilosec. It belongs to a group of drugs known as proton-pump inhibitors. This type of drug is usually used when antacids or H2 blockers fail. They basically block the pumping of acid into the stomach. Prilosec can also be bought over the counter.

Nexium is another example of a proton-pump inhibitor but is available only by prescription. Proton-pump inhibitors may cause harmful interaction with Warfarin, Plavix and Valium. There are alternative proton-pump inhibitors such as Protonix, which may be useful for patients taking Plavix. Always discuss all of the medications you are taking with your doctor to determine possible harmful adverse drug interactions.

Almost $5 billion was spent on Nexium last year. The “little purple pill” has been the highest prescribed drug in recent years. This has been a result of a successful marketing campaign. Patients who have seen the commercial often demand it from their doctors.

There are simple things you can do to reduce the need for these medications: avoiding spicy or fatty foods, reducing alcohol intake, losing weight, quitting smoking and adding more fiber to your diet.

You should sleep with your head elevated at least four-to-six inches and try to sleep on your left side. Limit the amount of chocolate, onions and peppermint that you eat. Reduce caffeinated or carbonated drinks. Avoid large meals close to bedtime. If medication is necessary, always ask for generic pills, which are as effective and much less expensive.

Nexium-type drugs interfere with the absorption of minerals like calcium and magnesium, which may lead to broken bones. They can also disrupt the normal bacteria in your stomach and intestines. This can cause serious infections. Many physicians feel that people are taking these pills needlessly or longer than necessary.

In the past few years, scientists have raised concerns about long-term side effects such as bone fractures and pneumonia. One study even found that the drugs, when stopped abruptly, can cause severe acid problems.

The bottom line is that it is important to see a doctor regularly while you are taking this medication. This can minimize side effects and unnecessary intake of medication. When taken correctly, it can be a very useful medication.