Codey Jackson, Pharmacist
Early this month I received a call from a customer asking if I had heard about a lawsuit that they’d seen on the news the night before. I hadn’t heard the news story, but I was intrigued. The customer went on to explain that the company that makes a medicine they take regularly, Nexium, was at the centre of a lawsuit regarding its safety. They asked me if it was safe for them to to continue to take their medication, I’ll explain my answer further in the article.
Nexium is a brand name for a medication called esomeprazole. There are multiple brands of esomeprazole available in Australia. Esomeprazole is available in multiple strengths on prescription. Smaller quantities of the lower strength are available without a prescription as pharmacist only supply. Esomeprazole is a proton pump inhibitor, or PPI. PPI’s have been in use since the 1990’s. PPI’s act to reduce the amount of acid the stomach makes. They are used to treat acid reflux, gastric ulcers and other conditions.
In 2022-2023 over 8 million prescriptions for esomeprazole were dispensed throughout Australia, making it the fourth most common prescription item dispensed. As many as 1 in 5 people suffer from acid reflux at some point in their life and the fact that these medications can be available without a prescription means it is likely that many of us will take esomeprazole or another PPI at some stage in our lives.
In its Consumer Medication Information summary Nexium (and all brands of esomeprazole) include the following as less serious side effects: nausea, diarrhoea, changes in sleep, mood changes, confusion, and many more. More serious side effects listed include shortness of breath or difficulty breathing, severe skin reactions which include rash, itching, blistering or peeling of the skin, and also liver inflammation. The lawsuits, which began as far back as 2016, also cite kidney damage and stomach cancer as being linked with PPI use. Long term use of PPIs is linked with lower bone density and increased risk of bone fractures in old age. PPI’s may also interact with other medications.
So, what did I tell my customer on the phone when they asked if it was safe for them to continue to take Nexium? My answer was, “It depends and if you are worried at all, please talk to your doctor”. The list of side effects and these lawsuits are definitely scary, but on the flip side living with acid reflux can be debilitating. Taking any medication needs to be done in consultation with an expert and the risks and benefits need to me made apparent to the patient in advance.
Furthermore the listed side effects for medications need to be taken with an educated grain of salt. As much as drug companies would love to test their medications on healthy people there wouldn’t be much point in doing that. When you read nausea or stomach cancer as a potential side effect remember that these have happened in people with preexisting health issues. You may experience all or none of the known side effects of any medication, this is why we have doctors to guide our treatment.
When a medication is made available in Australia the Therapeutic Goods Administration assesses the known safety data of a medication and weighs that against the benefits that medicine offers. Currently there are no product recalls or plans to discontinue esomeprazole in Australia.
