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Take Heartburn Medicines Before Breakfast

Too many patients unaware that timing is key to treatment, study finds

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

WEDNESDAY, June 11, 2014 (HealthDay News) -- Many people with heartburn aren't taking their acid-reducing medicine at the right time, which makes the drugs less effective and wastes money, according to new research.

Only about one-third of those buying these medications -- such as Nexium, Prevacid and Prilosec -- over-the-counter used them properly compared to just under half of those who were prescribed the drugs by their primary care doctor. Those who were given a prescription by a gastroenterologist were most likely to use the drugs as they're supposed to be used, with seven out of 10 taking the drugs properly, according to the study.

These drugs are activated once in the body, said the study's senior author, Dr. M. Michael Wolfe, a gastroenterologist and chair of the department of medicine at MetroHealth System. "In order to activate the medicine, you must eat. For that reason, you take it before breakfast. If you don't take the drug correctly, you don't do as well," Wolfe said.

Despite labels advising users to take the drugs before breakfast, people aren't following those directions, he said. Those who aren't taking the medicines properly "are wasting money, they're not feeling well and they aren't getting symptom relief," Wolfe added.

The study was published in the June issue of The American Journal of Gastroenterology.

Heartburn is a painful, burning feeling just below the breastbone, experienced at least once a month by about 44 percent of U.S. adults. About 7 percent have heartburn daily. Frequent heartburn may indicate a condition called gastroesophageal reflux disease, or GERD. Food and acid from the stomach backs up, or refluxes, into the esophagus. Reflux can damage the esophagus and cause serious issues over time.

Direct costs related to GERD, including acid-reducing medicines, top $10 billion each year in the United States, according to background information in the study.

The medications looked at in this study are a class of drugs known as proton pump inhibitors. They work by reducing the amount of stomach acid produced, according to the U.S. National Library of Medicine. Unlike antacids, such as Tums or Rolaids, proton pump inhibitors don't provide immediate relief of heartburn symptoms. It takes about 7 days of continuous use for the drugs to reach their maximum acid-suppressing potential, the study noted.

Wolfe and his colleagues surveyed 610 patients who used heartburn medicine for their GERD. Of that group, 190 got a prescription heartburn medicine from a gastroenterologist and 223 received a prescription from their primary care doctor. The other 197 bought over-the-counter heartburn medicines.

Those prescribed the medicines by their gastroenterologist did best, Wolfe noted, with 71 percent taking the medicines correctly. Only 47 percent of those who got prescriptions from their primary care doctors took them correctly. And just 39 percent of those who bought them over-the-counter used them right, the investigators found.

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