No transition needed: Prilosec is the parent compound for Nexium (esomeprazole). If you tolerate one you will likely tolerate the other. Maximum dosing for Nexium (esomeprazole) is 40mg BID (e.g. one 40mg pill before breakfast and one 40mg pill before dinner). Lack of response to that dose obligates further evaluation--in other words, your problems may be due to oversecretion of acid or not entirely due to acid.
Answered 8/20/2017
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