Cee asked
I see that Nexium 20mg. is now available as a generic prescription. is there a difference in the generic Nexium vs the over-the-counter version? When I have had my prescription filled for Nexium, the pharmacy placed a prescription label on the box of the over-the-counter version. I am trying to reduce costs by trying the generic.
Answer
The only difference between the over the counter Nexium (esomeprazole) and the prescription Nexium are the doses available. The OTC dose only comes as a 20 mg capsule, whereas the prescription products are available in 20 mg capsules and 40 mg capsules. Additionally, the OTC product is technically only FDA approved for a 14-day course. However, a physician may recommend taking the OTC product for longer periods of time, depending on the situation. Currently, all Nexium products, both brand and generic, are only available as a Delayed-Release (24 hour) capsule.
Brand Nexium Vs. Generic Nexium Vs. Over The Counter Nexium
Even though Nexium is now available as a generic, sometimes the brand may be cheaper than the generic in the first year or two depending on insurance coverage. Additionally, it is important to compare the price of the prescription with the price of the OTC product. Depending on insurance coverage, the OTC generic may be your best option. The generic form of Nexium was approved by the FDA in early 2015.
Other ways to reduce cost would include making sure that Nexium is the product that is right for your situation.
Other proton pump inhibitors (PPIs), such as omeprazole (Prilosec), have been on the market longer and are likely a cheaper alternative. Typically, treatment can be initiated with omeprazole and progressed to Nexium if it doesn’t seem to work. Nexium is actually the S-isomer of omeprazole, meaning that omeprazole is actually made up of a significant amount of esomeprazole. Controversy exists about whether Nexium is truly more beneficial than omeprazole, especially considering the increased cost. One study shows mixed results, if not marginal benefit.
In regard to the pharmacy putting a label on the over the counter product, that is relatively common. As odd as it sounds, there is a specific prescription product and over the counter product for Nexium 20mg (even though, as stated above, they contain the same active ingredient). The prescription version of Nexium 20 mg is going to have a much higher cost associated with it when compared to the over the counter product. Your insurance company most likely prefers to pay for the over the counter product to dispense as a prescription.
Finally, make sure to discuss with your physician how long you should take this medication. Sometimes patient continue medications like this unnecessarily. For example, patients may start the medication in the hospital when they are at high risk of developing an ulcer or bleed. However, they may continue the treatment even when they leave the hospital without having a reason to continue therapy.
Source: Nexium
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