... years and it worked great, but it was so expensive. So, I recently started taking 2-20mg over the counter pills a day instead of the 1-40mg tablet …my pharmacist said this should be the same thing. It isn't working! I have had acid reflux and heartburn worse than I've had in 2 years. Can the over the counter pills really be THAT different, or is it a coincidence that my symptoms have flared up at the same time I switched over? I haven't changed my diet or anything else in my lifestyle recently and I have been under no stress recently. Has anyone else shared this type of complaint?
I have been taking over the counter Nexium for 1 month now. I have taken Rx nexium for several?
Question posted by dboling on 10 July 2014
Last updated on 6 May 2023
The information on this page reflects personal experiences shared by our community members. It is not reviewed for medical accuracy and should not replace professional medical advice.
41 Answers
torxx
2 Oct 2020
I’m sorry to hear so many having these issues with the meds and insurance, sounds very frustrating. I think it’s obvious the otc is not the same, and plenty of sources state that Nexium 24 Does not treat GERD and prescription grade does. When I started on heart burn relief years ago and had an Endoscopy it turned out that nexium was the only ppi I could tolerate, other brands would give me tightening in the chest types of symptoms that Put me in the emergency room two days in a row. Prilosec otc started it all. insurance made me try all the other brands first because Nexium was the most expensive but Nexium was the only one I can tolerate. Anyway I never bought into the taking the pill daily like the doctors recommended.
I just didn’t want to take that much medicine because I knew it was a powerful medicine That lingers in your system so I always took it as needed and it slowly got better over time and now I only take it maybe once a month or less sometimes . I probably did take it daily at first for sometime, but not for too long. Nexium will heal The esophagus. if insurance doesn’t pay one option Is to get from online in Canada at a reasonable cost if you have the prescription. Im sure some of you or most of you have more severe symptoms than I do but I thought I’d share My experience. I’m out of Nexium prescription and I was considering the 24 hour version which I don’t think is worth tying after reading this post and other research I’ve done.
Curious Penny 17
6 May 2023
Thank you for your comment your experience is very similar to mine as to not being able to take any other PPI except next to you. I started with Prilosec and I had a bad reaction to it causing heart symptoms and the same with all of the others I used to be able to take Zantac and I had waiting myself off of the Nexium and was just taking the Zantac but then they took it off of the market and I tried hard not to have to get back on the Nexium which I hated, but I had to have something as my GERD is really severe and other meds didn't help. I was given Dexilant and Carafate among others and I also had bad reactions to those. I changed my eating habits many years ago, but still it's very bad and I have developed Gastritis and other GI problems added. It's been so awful.
An important helpful thing I found for natural acid reduction is drinking pure plain organic Aloe Vera juice and also organic carrot juice. If you can tolerate
oxalates for the carrot juice because it is high in oxalates, too much of which can increase arthritis type pains and not good for those with kidney problems.
Drink only 4-5 ounces a day of carrot juice. I hope that this is helpful for you and others.
Abba777
27 Oct 2018
Dear dboiling,Just recently,my 98 year old mother who had been prescribed rx Nexium 40 mg for at least 15 years due to acid reflux and a history of aspiration pneumonia in the past.The only effective treatment was specifically Rxnexium.recently, she wanted to try reducing her dose to 20mg since she had no symptoms for several years.after taking the over the counter type for about 7 months,she became very i'll with aspiration pneumonia when she was hospitalized I asked the Dr that question if switching her to the otc type could have triggered her illness,he dismissed my concern and soon after, my mother passed away due to aspiration pneumonia. I am not a health care professional but I am convinced that had she remained on her RX 40 mg Nexium she may still be with me.so my answer to you is they are NOT the same.I hope you were able to get back on the prescription also,i found out the over the counter kind is made by a different company.Hope this helps you
Mirf
6 Feb 2018
You're not crazy. I thought I was because the same happened to me. They kept saying it was identical active ingredients, but it didn2work identical. My insurance had me try 4 other options before they would approve nexium rx. After doing that with a variety of problems from headaches, to stomachaches to just not working, they approved it for one year. When i was to lower the dose from 40 to 20, they said I'd have to go through the approval process again because it was a different dose. I said I'd use otc nexium 24 instead. I did successfully for a long while, but then the terrible reflux came back. My insurance won't approve the nexium 40 rx without me going through the same ones i already did, because it had been over 180 days since i tried them, and they added 2 new ones!! I tried one of the new ones and woke repeatedly during the night coughing acidy phlegm. I finally gave up and pay out of pocket.
Astrazeneca has a savings card to help with cost, but it isn't accepted in Massachusetts because a generic is offered. It's terrible how insurance has this much say. I pay thousands of dollars for a ppo insurance and they wont even pay what they would pay for the generic to help me with the cost for name brand. Bottom line is I suffer same as you, and otc nexium isn't same. Maybe the binders that are different has something to do with it.
bschill
21 Jan 2018
I have made the change from prescription Nexium to OTC with satisfactory results, though I have to take 2 pills to make up the daily 40 mg dosage. Costco has them for around $24 for a pack of 42 pills (similar to most retailers), and sometimes discounts them to about $19, so I stock up on them at that price. But they also sell a generic version, Kirkland esomeprazole magnesium dihydrate, for about $14, same quantity of 42 pills, about 22 mg. But I see in the fine print that Nexium brand name is esomeprazole magnesium trihydrate. How clinically significant is this difference? A patient does not necessarily notice any symptoms after a change, until significant damage is done and a medical crisis emerges, as happened in my case.
PamPell
12 Jan 2018
Insurance co notified me they would no longer cover prescription; tried other similar drugs-none worked-tried over the counter nexium doubled dose-didn't work-there is a difference between the two. Dr sent in paperwork to ins co stating the prescription was medically necessary they finally approved it at a higher copay. The interesting thing is if they claim that the over the counter/prescription products are the same why is there such a price different full cost chrged to ins was over $300 compared to $40 for over the counter! Same Drug-yeh I don't think so.
fisher834
19 Sep 2017
Your story sounds Like mine ! I too have been on Prescription Nexium for 8 years . 3 months ago I started taking 2 OTC Nexium and as of 2 months ago I have had increased pain and burning. My GI said that i cannot possibly have any issues but would scope me. The results of the Upper Endoscopy : I now have gastritis and esophagitis, and have lost weight bringing me down to 105 pounds, because I cannot eat regular food. I am very angry and want to know how we can all get this addressed. Especially since the insurance companies are refusing to pay for the prescription name brand. The generic is not as effective either.
Tmcleod0623
5 Sep 2017
OTC NEXIUM is for heartburn Prescription is for GERD... my pharmacist said they are different
Queeksdraw
2 Sep 2017
I have been taking Nexium 40mg for over 25 years. Like many others, my insurance limited me to 30 pills every 90 days which has forced me to use Nexium OTC. Within two months all my original problems returned. I tried Omeprazole prescription in the past with poor results. I am now starting a 40mg of prescription Omeprazole and so far it has appeared to be working and my insurance will give me a full 90 day supply. It appears these OTC drugs are a waste of money as they are far from the prescription version and are still a drain on your money. I think the OTC versions are more for people who have an occasional problem not those of us with GERD or other acid reflux issues.
bschill
20 Sep 2017
I think you mean Esomeprazole, which is the chemical name for Nexium. Omeprazole I believe is the stuff in most of the OTC meds like Prevacid. Also, you state first that the prescription Omeprazole worked poorly, but in the next sentence it seems to be doing good.
Queeksdraw
20 Sep 2017
I tried prescription Omeprazole several years ago and it did not work. I had to fight it out with my insurance to get Nexium, which is what I was prescribed after my esophagus surgery . Beginning this year my insurance would only allow 30 capsules for a 90 day period. When the Nexium OTC came out I started using it and within three weeks my heartburn and GERD returned with a vengeance. I was taking the maximum daily dose of Tums and still having problems. Went to the doctor and decided to try Omeprazole again and was surprised how well it is working. I am happy, my insurance is happy so I hope this continues to work. As for OTC Nexium, it is pure garbage as far as I am concerned. Considering the price of prescription Nexium verses OTC Nexium there is no doubt in my mind they are not the same.
bschill
21 Sep 2017
Were you taking just one pill a day of the OTC Nexium? Because I was for several weeks, no probs, but then I came down with gastritis, bleeding ulcer, blood in vomit and stool, 3 days in hospital. The OTC is half the strength of the Rx Nexium, but I was only following directions on the package. Now I am taking 2 a day for the 3 or 4 years since then, and doing OK, no symptoms. You can get the OTC for a little under $24 for a 3 week supply taking 2 a day. I don't like taking anything as a maintenance drug, but I am afraid to make any changes after that crisis.
luckysparks
3 May 2017
I just started taking Nexium 40mg today because for the last few months, I keep feeling like food stuck in my throat and bad acid that I need to throw up or burp in the morning. How long would I need to take this medication or it is something that I need to keep taking even though it's getting better?
Rich19
22 March 2017
Do not talk to me about reflux, i am the poster child, i have been studied by international doctors,
Rich19
22 March 2017
I have no idea what you guys are takling about i have been on otc for 4 yrs or so, and it works perfectly, i drink a lot of wine every night, and never have a problem. I had the worst reflux you could speak of, i needed surgery to correct, and each time i go for an endoscopy , my doc says everything is perfect, keep going . Actually the otc is stronger than rx . I was diagnossed with barrets, and now its cured.
Maryjaye
22 March 2017
OTC is not stronger than prescription strength. Many of us are unable to metabolize the ferrous oxide that is an inactive ingredient in both the generic and the OTC that is not in the brand name. Glad you were able to have the surgery to strengthen your spinchter and eliminate your barrettes.
teech62
23 Jan 2017
I have taken the generic version of Nexium, Esomeprazole. I take 40 mg, twice a day. My insurance covers it but only after my $2000 deductible is met. I need a refill but the cheapest I can get it is over $400 dollars. I am considering the OTC because I can't sleep from the acid reflux and the situations in my life are causing a lot of stress. Has anyone found any combination of antacids and or OTC pills that work. Thanks for listening.
Maryjaye
25 Jan 2017
If the generic works for you, you should be ok with the over the counter Nexium. You will need to take 2 OTC for every 1 RX due to the strength difference. Good Luck.
shelene777
14 Oct 2017
I have been doing one OTC Nexium, and two Zegerid OTC split up morning and afternoon, then Zantac for break thru acid. So far this is helping. I have found Zegerid made by Bayer to be pretty good. I feel that if I needed to take two at once this would work also, along with the Nexium. I have pancreas issues that are causing my acid problems, so It's a bit different for me, but I was miserable until this past week when I added the Zegerid to the Nexium.
djbrooks1966
22 Nov 2016
I had the same problem and I started taking Probiotics with my 20mg Nexium and that worked great been doing going on 4 months now I have even started taking my Nexium every other day now still doing fine.
jyjr
1 Nov 2016
The Nexium OTC does not work for me either-check out the Nexium FAQ s page and it says the Nexium prescription contains the healing part of the pill-the OTC does not- most of us are suffering from erosive esophagus which can lead to Barrets syndrome and then colon/stomach cancer-the otc does not fight this-I cannot believe the insurance co [mine also] will not cover this pill-try and have your Dr call the ins co
Maryjaye
3 Nov 2016
The difference between two OTC or a 40 mg generic and a 40 mg brand name is ferric oxide. It is not in the brand name but is in the others. read through this entire post.
ozze_dollar
5 Oct 2016
I am not aware of an OTC Nexium. What country are you in. I am in Australia.
Maryjaye
3 Nov 2016
OTC is available in US.
Related topics
Further information
- Nexium uses and safety info
- Nexium prescribing info & package insert (for Health Professionals)
- Side effects of Nexium (detailed)
Similar questions
Search for questions
Still looking for answers? Try searching for what you seek or ask your own question.