Tier 2 alternatives to Protonix - which do you prefer, why?

[DreamDiver]

I haven't said earlier, but one of the things that has crimped my experience with Protonix is that I don't really get on well with my Gastro MD. He and I probably have very similar personalities. A doctor's visit tends to be like a verbal fencing match, both of us trying to get points across. I'm probably going to change to a different MD in the same group that seems more approachable. In the mean time, I went to talk with an internist about the various meds and the reasons why I'm taking them. This is what I learned that my Gastro didn't tell me:

The idea behind taking these meds is so that you heal your esophagus. The idea is to take them for a while, then get to the point where your esophagus is healed and you no longer need them. Most people are supposed to be on them for a few months, then graduate to less potent things like ranitidine or cimetidine, or even something less systemic like gaviscon or mylanta. I didn't really get that. I thought this was supposed to be something I was going to take for a long while. The internist further said that omeprazole 20mg is very similar in potency to Protonix 20mg. Nexium is a little more potent, so a dose for the same treatment as 20mg of omeprazole is actually less than 20mg. He didn't know the exact amount. Prevacid is somewhere between Nexium and omeprazole (Prilosec) in potency.

So I'm going to try a few days without anything to get a baseline. During that time, I'll try ranitidine and generic mylanta with simethicone to try to heal my throat and stop the gas. If I start feeling chest pain, I'll start some OTC omeprazole because its a heck of a lot cheaper than Protonix.

Thanks everyone for your feedback about what you're taking and what your experience has been. If anyone else wants to chime in, I know I'm not the only other person here who'll be interested.

[CorgiGirl]

The idea behind taking these meds is so that you heal your esophagus. The idea is to take them for a while, then get to the point where your esophagus is healed and you no longer need them. Most people are supposed to be on them for a few months, then graduate to less potent things like ranitidine or cimetidine, or even something less systemic like gaviscon or mylanta. I didn't really get that. I thought this was supposed to be something I was going to take for a long while. The internist further said that omeprazole 20mg is very similar in potency to Protonix 20mg. Nexium is a little more potent, so a dose for the same treatment as 20mg of omeprazole is actually less than 20mg. He didn't know the exact amount. Prevacid is somewhere between Nexium and omeprazole (Prilosec) in potency.

So I'm going to try a few days without anything to get a baseline. During that time, I'll try ranitidine and generic mylanta with simethicone to try to heal my throat and stop the gas. If I start feeling chest pain, I'll start some OTC omeprazole because its a heck of a lot cheaper than Protonix.

The info your internist gave you is only one part of the therapy. If you still have reflux after your esophagus has healed, it doesn't do any good to stop the meds because you will just damage it again. Some people have "silent" reflux where they don't have heartburn, but they are still having reflux affecting their throat and vocal cords. One of my friends never had heartburn but was diagnosed with silent reflux because she kept losing her voice. My asthma is due in part to reflux, so I can't stop taking the PPI.

I know that the drug companies and the insurance companies say people should only be taking PPI's for a few months, but I don't actually know anyone who has started on them who has successfully gotten off of them. My GI doc said that if you need an anti-acid every day, you should be taking a PPI because they are more effective.

[Steviemain]

Hi Dreamdiver - I too am on Tricare and recently changed from Protonix to Nexium for no other reason than the decreaesed cost because Protonix was working fine. However, once I started Nexium I realized I was actually doing better than the Protonix because I actually had stopped the "flaming burps" all together.

And now that I'm one month into my CPAP regiment I haven't had any signs or indications of GERD...I'm still not comfortable enough to stop the Nexium yet, but in due time....

I originally was subscribed Prevacid and got a big rash on my chest....stopped Prevacid...rash gone! Haven't had any rash issues with either Protonix or Nexium.

So the moral of the story is.....it's whatever works for you, but I do like the Nexium better than the Protonix (I was on them for 5 years). Oh yeah, they were all 40mg doses.

Good luck,
Steve

[The Texan]

I agree that your Internest is not telling the whole truth. I know that those of us that have had Gall Bladder surgery must stay on them for life, as do those that have the silent type.

[howkim]

Dreamdiver,

Are you aware that there's a generic for Protonix that's available? I take it, and it costs much less than the branded. It also works. Would this be an acceptable alternative for this insurance?