Why you shouldn't take Nexium


The sciencebloggers are abuzz after a WSJ editorial mentioned Nexium, a heartburn medication, repeatedly by name, implying that it is some kind of wonder drug. Nexium was developed by AstraZeneca because its flagship anti-heartburn med, omeprazole (sold under brand names like Prilosec or Losec) was going off-patent. I take omeprazole for reflux, and it works just fine. I've never tried Nexium, and now I'm glad I steered clear of it, as it is an absolute ripoff in every sense of the word: a compound that never should have been granted a new patent, whose "improvement" over omeprazole was demonstrated by cooking the research.

In clinical trials the only difference between Nexium and its off-patent parent drug are modest improvements in some symptoms at distant time points; however, it is standard in these trials to compare 20mg of Nexium to 20mg of Omeprazole. In other words, the trials that have justified the use of this drug compared to the generic only show that when two times the amount of the active compound is used (1 nexium = 2 omeprazole), a slight improvement in some symptoms (87% vs 90% for cure of gastroesophageal reflux disease at 8 weeks) is achieved.[1-2] This is a result that is certainly not worth 4-8 times the cost.

Based on patent law AstraZeneca should never have been able to patent esoomeprazole as a new drug since they had already patented the same active ingredient when they patented prilosec. They effectively patented the same drug twice, thus doubling the time their drug can avoid generic competition. However, in order for the scam to work they had to pull one over on the regulators (coincidentally they spent millions in lobbying congress the year before Nexium was approved), then advertise the hell out of Nexium to make it appear it was somehow superior to it's chemically identical sibling drug Prilosec.

Why no one should take Nexium and it should never have been approved

(Image: Nexium, a Creative Commons Attribution (2.0) image from tomsaint's photostream)