The benefits and risks of Nexium and Zantac
Both H2 blockers (Zantac) and proton pump inhibitors (Nexium) have been shown to be effective in the suppression of the secretion of basal gastric acid. While H2-blockers are known for their rapid onset of action (within 1 hour) and short relief duration (less than 12 hours), proton pump inhibitors have been shown to have a delayed onset of action with a prolonged symptom relief duration (up to 3 days). Thus before deciding on which therapeutic option best suits a patient, consider the both the advantages and disadvantages of selecting either treatment option.
The benefits and risks of Nexium therapy:
The major benefit of Nexium over Zantac is that proton pump inhibitors have been shown to have a superior symptom relief compared to H2 blockers. In fact, studies have shown that proton pump inhibitors significantly relieve symptoms compared to H2 blockers in the initial therapy of uninvestigated GERD (75 percent vs. 58 percent), heartburn relief at 4 weeks in endoscopically negative reflux disease patients (53 percent vs. 42 percent) and uninvestigated dyspepsia symptom relief at 4 weeks (23 percent vs. 11 percent).
Although proton pump inhibitors have been shown to have a relatively good safety profile, there is recent evidence suggesting that they are associated with an increased risk of hip fracture related to a decrease in calcium absorption with acid suppression. Secondly, the suppression of gastric acid has been associated with a decreased destruction of ingested pathogens and an association between proton pump inhibition and community acquired pneumonia has been identified. Furthermore, observational studies have claimed an association between in proton pump inhibitor use and Clostridium difficile associated diarrhea. However, No significant correlation has yet to be made.
The benefits and risks of Zantac therapy:
While studies have shown that proton pump inhibitors are more effective than H2 blockers, there are certain conditions or circumstances in which less intense acid suppression of H2 blockers would be considered a reasonable option, depending on the level of symptom severity. Moreover, they are also a less costly option for many patients compared to proton pump inhibitors and they have been shown to control symptoms in almost 60% of GERD patient. Additionally, its faster onset of action makes it a favorable by many patients.
Its major downfall of H2 blockers is its reduced effectiveness. In fact, a study demonstrated that H2 blockers rarely provide complete symptoms relief of chronic heartburn and dyspepsia and do not reduce physician visits for GERD-like complaints. Moreover, these agents provide no protection against Barrett's esophagus and their use may cause cancerous changes in the stomach in patients who are infected with H. pylori.