Nexium reduces acid formation in the stomach and treats symptoms of GERD or gastroesophageal reflux disease as well as a variety of other stomach disorders.  Once available by prescription only, this popular over-the-counter pill contains the same active ingredient as Prilosec.

Although many believe Nexium functions as an antacid, it actually belongs in the category of proton pump inhibitors.  Also included in this group are Prilosec, Aciphex, Protonix, Prevacid and Dexilant.  These drugs require several days of regular use to shut down the acid producing cells.  Consequently they fail to provide immediate relief from indigestion or heartburn.

In spite of advertising that champions the benefits of one drug over another, medical evidence suggests only minor differences exist between members of the class.  Contrary to popular expectation, none of the drugs completely eliminate acid production.  As a result symptoms may not disappear.  And for some, acid exposure may not even cause their GERD.

In order to obtain optimal benefit from Nexium, it must be taken either 30-60 minutes before breakfast or about an hour before dinner.  Absorption decreases by about half when taken with meals.

Interestingly although Nexium gained marketing approval almost 20 years ago, an array of newly described adverse reactions demands attention.  Recent associations with kidney disease, pneumonia, diarrhea and kidney disease suggest Nexium should be used for the shortest period of time appropriate.  Additionally Nexium seems best restricted to those instances when other therapy such as antacids fails to provide relief.

Other worrisome side effects may include low levels of vitamin B12 and loss of bone mass or a predisposition to develop osteoporosis and fractures from reduced levels of magnesium and calcium.  A study from the Danish Heart Association linked this class of drugs with an increased incidence of stroke.  German investigations associated chronic use of PPIs with an increase in dementia.

Whether these represent cause and effect remains to be determined.  However the American Gastroenterological Association reminds us these drugs should not be taken when not absolutely necessary.  Other reports indicate more than 70% of people take these drugs inappropriately.

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