Biotech Values

[biomaven0]

Is the reason that patients don't double on the PPI dose because they aren't approved for that dosage?

This is actually an interesting story. Prilosec's original label was for 20mg once a day, although many people in fact need more. When AZN developed Nexium (the single isomer of Prilosec) they saw an opportunity, and instead of comparing the equivalent dose, they showed that 20mg of Nexium (equivalent to 40mg of Prilosec) was somewhat better than 20mg of Prilosec - so they essentially doubled-up the dose and hence were able to differentiate the switch.

Turns out though that not even 20mg of Nexium is enough for some folks, and increasingly the 40mg Nexium capsule has grown in popularity - that dosage is equal to 80mg of Prilosec.

So I think it is more of an education issue - some doctors just don't consider increasing the dose when the patients have breakthroughs.

(In my view 40mg of generic Prilosec BID is actually the best and cheapest dosage for the hard cases).

Peter