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Best Buy Drugs for heartburn

Last reviewed: February 2011
Nexium ad of a man in a jacked up bed
Nexium
Generics work as well as the purple pill for most people with heartburn.

When heartburn flares up, many people turn too quickly to powerful drugs called proton pump inhibitors when lifestyle changes or antacids might do the trick. Studies show that up to 69 percent of people who are prescribed a PPI don’t actually need it. Not only can that be a waste of money, but it can also expose you to potentially serious side effects, including an increased risk of pneumonia and hip and other bone fractures.

For relief of mild or infrequent heartburn, cut back on alcohol and caffeine, quit smoking, eat smaller meals, don’t lie down for 2 hours after eating, and lose weight (if needed). If those changes don’t bring relief, try an inexpensive over-the-counter antacid, such as Maalox, Mylanta, Rolaids, Tums, or their generic equivalents, or other drugs called H2 blockers, such as Pepcid AC, Zantac 150, or their generic equivalents.

If heartburn strikes twice a week or more for several weeks, see a physician. You might have a serious condition called GERD (gastroesophageal reflux disease), and you might need a PPI.

CR Best Buys

  • Generic omeprazole
  • Prevacid 24HR
  • Prilosec OTC

All are available without a prescription for $19 to $24 for a month’s supply and work as well as the more expensive medications.

Less impressive

  • Dexilant (dexlansoprazole). It was approved in 2009, so it has a limited track record. We recommend waiting until more is known about its effectiveness and safety.
  • Zegerid OTC (omeprazole/sodium bicarbonate). It costs about the same as the other over-the-counter PPIs, but it has not been well established how the bicarbonate ingredient affects it, so skip it for now.
  • Nexium (esomeprazole), Prilosec (omeprazole), Prevacid (lansoprazole), AcipHex (rabeprazole). These branded prescription medications are much more expensive and not much more effective than generics in this class. Aciphex and Nexium are not available as generics.

Nexium vs. Omeprazole

Make sure you really need a prescription medication; many people don’t. If you do, pick the least expensive option because no one drug is clearly better than another.

Brand-name or top-selling drug CR Best Buy Drug Monthly savings
Nexium One 20-mg pill per day $203/month
Omeprazole (generic) One 20-mg pill per day $19/month
$184
 
 
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