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Prilosec OTC Question

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  • Prilosec OTC Question

    I had been on Nexium 2 times 40 mg per day, but last week switched to 2 Prilosec OTC (20 mg) per day. If I understand it correctly, these are equivalent doses. So far I've not really noticed any differnce between the two.

    I am interested in trying to "step down" my doseage. Is there any reason I can't just cut a Prilosec OTC in half? I'd like to cut down to 20 mg in am, and 10 in the pm, at least at first. (Based on my reading of the nexium literature, plus the fact that it comes in capsule, doing this with nexium doesn't seem practical, and I didn't want to ask for a different prescription from my doc. But Prilosec OTC comes in tablet form).


  • #2
    I may be mistaken, but, I believe that it would take (2) 20 mg Prilosec to equal (1) 40 mg Nexiom. These two drugs are very similar in chemical make up. By switching from (2) 40 mg Nexiom to (2) 20 mg Prilosec, you have cut your dosage in half already.


    • #3
      That's correct. I was taking Prilosec for awhile. The doctor said taking two of those was the same as taking one Nexium. Each Prilosec tablet is 20 mg I believe. I'm not on Prevacid.


      • #4

        Hi Randy , There is a debate over whether 1 prilosec 20 mg is equal to 1 nexium 40mg .

        When nexium first came out , Astra Zeneca did all of their studies comparing 40 mg of nexium to 20 mg of prilosec, claiming that they were equal in dosage and nexium was just a better version of PPI.

        Nexium has one less isomer than Prilosec. . Removing one isomer from a drug sometimes reduces side effects or makes a drug work better. The Patent Office recognizes something with one isomer as a separate invention from something with two.

        Many Critics claim that prilosec is merely a weaker version of nexium, and i remember a lawsuit filed about 2 years ago against Astra Zeneca to that effect .

        You'd have to be a chemist to know for sure , there is no consensus , and i don't know what Astra Zeneca is saying now.....probably sticking to their original story that 20mg of prilosec is equal to 40 mg of nexium.

        .....Don't know of any reason why you couldn't cut a prilosec tablet in half ?

        Have been enjoying my junket trememdously


        • #5
          Prilosec vs Prilosec OTC

          I guess it depends if Randy is taking the Prescription Prilosec or the Prilosec OTC. Here is what it says on a web site.

          Prilosec and Prilosec OTC contain omeprazole, which stops acid production. Prescription Prilosec treats various diseases, Prilosec OTC is only for symptoms of frequent heartburn.


          • #6

            I see on their website LSAT posted they say ...... Do not crush, break, or chew the tablet. This decreases how well Prilosec OTC works in the body. So i guess that answers the breaking the pill question.

            I wonder if you could take half a capsule of nexium, seeing they say you can mix the contents of the capsule with applesauce?.... or would that affect the chemisty too ? I guess you could call the 1 800 number to see.

            Or if you want to cut down, you could try taking it every other day .


            • #7
              Thanks for the feedback.

              Based on what I read, I figured 1 Priolosec otc 20 mg = 40 mg nexium (i.e. Aztra Zenaca's original theory). If, however, the two drugs are really eqaul, then I guess I have already cut my dose in half w/o any (as yet) ill effects. If not, then I'm on about the same dosage as before. In any case, I tried Prilosec OTC a long time ago but gave up on it after a week. Now (so far - dont' want to jinx myself) its ok. If I have to stay on PPIs for the long haul, I would rather it was Prilosec OTC since I wouldn't need a Rx to get it, even though the cost is about the same as Nexium under my insurance drug plan. (It is so much better being able to buy Claritan w/o a prescription!)

              Sounds like cutting the pill in half may not be the way to go. I might try the every other day method for a while. Or perhaps replacing one of my Prilosecs with a pepcid for a while.

              (I am reluctant to reduce doseage too fast, since in the past this caused me problems.)



              • #8
                Priolosec vs. Nexium

                This thread raised some interesting questions about Nexium and Prilosec. I decided to look into it some more, based on the "Product Information" provided on the websites for each drug.

                First, there seems to be no answer to the question of whether nexium is just 2 times the dose of prilosec. (i.e. is 40 mg nexium a comparable dose to 20 mg prilosec.) The drug studies showed that nexium 20 mg was really not any better (statisically) than prilosec. However, the 40 mg N vs. 20 mg P, studies shows a small (but statistically significant) difference. In other words, perhaps 70% of people got relief from Prilosec, but 75% did from Nexium. Not much of a difference, unless you are one of thepg eeps who was in the extra 5%. (Since this forum is populated by hard to treat cases, then maybe Nexium is better for us.)

                The interesting thing is that doubling the dose of these drug does not make them twice as good. Going from 10 mG of Prilosec to 20 mg does almost double its effectiveness. Going from 20 mg of Prilosec to 40 mg of Prilosec does almost nothing, however. Perhaps nexium and prilosec really are equal, except that you can increase the does of Nexium and still get some added benefit while you don't with Prilosec.

                I am no chemist or medical expert, however, the molecular diagrams of the 2 drugs look almost identical.

                So is Nexium just a fraud, designed to get around the expiring drug patent laws? Or is it really better? I don't know.

                I tried Prilosec OTC in the past when I ran out of achiphex, and within a week I felt it had failed to provide adequate relief. Eventually I went to nexium cause I felt it was more effective. Under my drug plan Nexium costs no more than Prilosec OTC, so I don't particularly care. I'm trying Prilosec again, however, and have to admit I would rather use a Non Rx drug if possible. So far its been ok. But I'll drop it in a minute if I think it doesn't work as well as my nexium did.