13 replies to this topic

[HeatherLS]

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Hello. I'm new here. I was diagnosed with GERD, a hiatial hernia, and Barett's Esophagus (sp) a little over 3 yrs ago and have been on Nexium ever since. My heartburn has gone away and my last EGD came back with no signs of Barett's anymore. Good news. My doctor told me that I'd probably have to stay on Nexium long term. In January, I sent in my new prescription. This year our insurance is making us do mail order for long term medication. The pharmacy sent me a notice with my first delivery that my one year prescription had only been OK'd for 6 months, I called and they said that they had contacted my Dr because of potential risks associated with using Nexium long term. The pharmasist actually said that it could increase the risk of Esophageal cancer and stomach polyps. I found this a bit disturbing, seeing as though my Dr never mentioned those risks and I can't find much online about it.Has anyone else ever been told this or been warned of this? Why haven't any other pharmasists or doctors said anything...if it's even true?

[Kathleen M.]

Odd, because untreated acid reflux disease also increases the risk of esophageal cancer so I'm not sure how much worse it would be. Especially since you've been diagnosed with Barrett's which really does increase the risk compared to GERD without it and they can't want that to come back.I'd call your doctor and see what he says. Internet info can be particularly unreliable. Also since Prilosec, a similar drug, is now over the counter I think most insurance companies (mine anyway) will come up with any excuse to not cover any drug in that class.I don't know how your company is, but mine works very hard to get as many drugs as possible on the we don't cover that, or won't cover it the way doctors prescribe it. Usually a doctor can write a protest letter and get it covered but it is a pain.

[faze action]

There has been some research done on long-term PPI use that seems to indicate that you can be predisposed to cancer. It may have something to do with the constant suppression of HCl. I can't remember where I read that though. Long term suppression of stomach acid can also promote bacterial overgrowth, h pylori, and other things. My guess is your doctor figured that the risk of those was less than the risk of cancer due to the Barrett's/GERD...

[HeatherLS]

Thanks for both your replies. I kind of thought the same thing. I'm guessing the insurance is trying to get me off of it so that they don't have to pay. With the GERD and the previous diagnosed Barett's, I would think the Esophogeal cancer risk from that would be greater than anything the Nexium might cause. My dr told me I could try going down to Prilosec OTC and see if that still works for me or just stay with the Nexium. Thanks again. I was really curious as to what others have been told and if it was just something I hadn't heard of. I agree that if they sell PPI's OTC, then there must not be much risk or they wouldn't be able to sell them without a prescription.

[hannahb]

Hi, I'm an IBS sufferer and also a pharmacy technician. Mail-order pharmacies tend to do weird stuff like that. Most insurance companies are eliminating PPI's from their formularies because of the availability of Prilosec and Prevacid OTC. Your RX should still be good for 1 year as the MD intended, the mail-order pharmacy is probably being overly cautious.

[HeatherLS]

Thanks for the reply.Ahhhhhh...kind of like when they decided to stop approving Zyrtec-D (preOTC), because Claritin was available OTC. That sucked because Claritin didn't work as well for my allergies as Zyrtec. My gastroenterologist is telling me that I should have my primary physician write my Nexium prescription now, because she sees me more often. He says he doesn't need to see me again unless something changes, which means the Barrett's is fine still and he's not worried anymore. Love getting the run around, even if it's for something good this time.

[aflellemap]

Actually Nexium is not the only medicine of the class that can give you chances of cancer or other problems with prolonged usage. But the thing is, if you learn anything about any such prescribed medicine in future, you should check the composition of the medicine, and then it's total drug history and experimental results on internet. Doctors are not always right, and many a times prescribe faultily. I had such an experience, when my doctor prescribed me Unicontin for cough and cold, and I don't know what struck my mind about the drug, that I studied about it, and I was lucky to find out that it was used for only asthma patients. I did not have asthma, and I discontinued it immediately. Since then, I do my part of research on drugs right after I get home with a prescription.

[onyx]

I don't know about Nexium specifically, but I was under the impression that at this point PPIs generally seem safe for long term use. I've been on Prilosec for over 10 years and my docs think that's fine. I have no plans to ever get off the stuff unless they stop working (which unfortunately seems to be happening to me, but that's another story). I did read somewhere that there's some increased risk for osteoporosis for women due to decreased calcium absorption. As far as cancer I'm not sure but I know for sure that Barrett's puts one at risk for esophogeal cancer (although I think the actual percentage there is low) so if they won't give you Nexium maybe you can try another PPI that's on their formulary.

[pukka]

I don't know about Nexium specifically, but I was under the impression that at this point PPIs generally seem safe for long term use. I've been on Prilosec for over 10 years and my docs think that's fine. I have no plans to ever get off the stuff unless they stop working (which unfortunately seems to be happening to me, but that's another story). I did read somewhere that there's some increased risk for osteoporosis for women due to decreased calcium absorption. As far as cancer I'm not sure but I know for sure that Barrett's puts one at risk for esophogeal cancer (although I think the actual percentage there is low) so if they won't give you Nexium maybe you can try another PPI that's on their formulary.

I have been on and off PPIs for 6 years. I dont take them every day (about once a week) because I am afraid of getting osteoporosis. Long term PPI use is also linked to stomach cancer, but this occurs in the elderly.

[madge]

I have been on and off PPIs for 6 years. I dont take them every day (about once a week) because I am afraid of getting osteoporosis. Long term PPI use is also linked to stomach cancer, but this occurs in the elderly.

pukka, does using a PPI once a week work for you? I've weaned myself from 40 mg a day of Nexium to 20 mg. every other day, but haven't tried taking it less often than that because sometimes I do get reflux if I cut back anymore. (And occasionally I need to take just one cherry-flavored Mylanta on the days when I don't take Mylanta. I'm quite careful about my diet. Otherwise I'd probably have to be on Nexium daily. Just wondering what you do...how you are able to take Nexium just once a week.I'm also dealing with back pain on a regular basis and can use only limited amounts of Tylenol. Is there any way I can take aspirin or ibuprofen when I have GERD? What do some of you do for pain if you have reflux from aspirin or ibuprofen (Advil, Motrin, etc.)? Sure could use some help here.

[pukka]

pukka, does using a PPI once a week work for you? I've weaned myself from 40 mg a day of Nexium to 20 mg. every other day, but haven't tried taking it less often than that because sometimes I do get reflux if I cut back anymore. (And occasionally I need to take just one cherry-flavored Mylanta on the days when I don't take Mylanta. I'm quite careful about my diet. Otherwise I'd probably have to be on Nexium daily. Just wondering what you do...how you are able to take Nexium just once a week.I'm also dealing with back pain on a regular basis and can use only limited amounts of Tylenol. Is there any way I can take aspirin or ibuprofen when I have GERD? What do some of you do for pain if you have reflux from aspirin or ibuprofen (Advil, Motrin, etc.)? Sure could use some help here.

Madge,I have good months and bad months. One time I was off the Zegrid for almost three months. Then I got a bad case of IBS/bloating/GERD and I was on it for three weeks straight. Right now I just got back from 2 week vacation and my IBS flared, so I had to be on it for the entire two weeks and this week. The only thing I do to help IBS/GERD is make sure I have a BM everyday. I know you think that it has nothing to do with GERD, but it does. When you are contipated your body has to work harder to digest food and can cause more problems with GERD. Do you have IBS? Regarding the Asprin or ibuprofen, I take it when needed but not in excess. I took one Asprin today instead of 2 and I have not taken more today.

[madge]

Madge,I have good months and bad months. One time I was off the Zegrid for almost three months. Then I got a bad case of IBS/bloating/GERD and I was on it for three weeks straight. Right now I just got back from 2 week vacation and my IBS flared, so I had to be on it for the entire two weeks and this week. The only thing I do to help IBS/GERD is make sure I have a BM everyday. I know you think that it has nothing to do with GERD, but it does. When you are contipated your body has to work harder to digest food and can cause more problems with GERD. Do you have IBS? Regarding the Asprin or ibuprofen, I take it when needed but not in excess. I took one Asprin today instead of 2 and I have not taken more today.

[madge]

I also have mild IBS-c, but aside from bloating/cramping I do okay on a regimen of a Fibercon tablet(or a less expensive pharmacy equivalent) along with one Culturelle capsule per day with dinner. So I'm able to have a daily BM most days now, sometimes several a day (that's the IBS thing in action), sometimes normal BMs and sometimes not, but they're at least more regular. The Culturelle has increased my comfort level and enables me to eat a small salad or broccoli, or a small serving of baked beans now and then. It's a special form of acidophilus, developed by two doctors at Tufts University, that survives stomach acid much better than yogurt, Activia or other probiotics and it colonizes well in the colon. It lasts there for up to 4 or 5 days; it really helps me. When I first began taking it (at the suggestion of my doctor) I had a few days of increased gas as the colon bacterial climate changed, and then I noticed that I was feeling quite a bit better than I had before. That's when I began having more regular BMs.As for ibuprofen, thanks for telling me what you do. I really would like to be able to take it occasionally (even in a small dose) when I have a flareup of back pain or arthritis. Wish I could taper the Nexium to just once or twice a week. Have been scared to try it, but you've made me think that I might be able to do it. It would help my bone density issues, that's for sure. How did you taper down to once a week? I'm at every other day now, at half my former dose of 40 mg.Thanks!

[Yarm]

I was on Nexium for a year and a half - my doctor highly encouraged me to get off it! He said it was for short-term use and that it could increase the risk of pneumonia and deplete certain vitamins and minerals. I went to a Naturopath for herbal remedies and have been off it for over a year now.Your system takes about 3 weeks to adjust when you go off it and you can get terrible acid reflux.I also read about the Alkaline Diet (google it), increased my green veggies and other alkaline foods. This really helped me.Good luck!