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Motilium and Nexium: Is There Any Difference between the Two?

Motilium and Nexium are drugs that are prescribed to treat digestive disorders but what is the difference between these two medications?

The rhythm of modern life is such that few people manage to allocate time to have regular meals. Usually, everyone snacks on the go and the quality of the products leave much to be desired. Naturally, such a diet leads to disruption of the normal functioning of the gastrointestinal tract. Flatulence, bubbling in the abdomen, bitterness in the mouth, constipation or diarrhea are some of the symptoms of digestive disorders. What drug should you use if you suffer from a disordered motor function? Both Nexium and Motilium are substances that improve the motor skills of the musculature of the stomach and intestines, however, they are different chemical compounds.

What Is Motilium?

Motilium is a prokinetic agent. This is the most commonly used group of drugs prescribed for gastrointestinal diseases. The goal is to restore the normal contractile function of the muscles of the stomach and esophagus. The main active ingredient of Motilium is domperidone.

Domperidone is a dopamine receptor antagonist that stimulates gastric motility and is an antiemetic. It is preferred, in comparison with the obsolete prokinetic metoclopramide, which has a large number of adverse reactions. It does not affect gastric secretion and penetrates poorly through the blood-brain barrier (BBB).

Domperidone’s indications include:

  • Gastric hypotension
  • Cytostatic therapy
  • GERD
  • Vomiting of various genesis
  • Radiotherapy

The side effects include:

  • Gynecomastia
  • Amenorrhea
  • Hyperprolactinaemia
  • Extrapyramidal disorders (in adults rarely, in children are reversible)
  • Gastrointestinal disorders (rare)
  • Passing intestinal spasms
  • Dry mouth
  • Allergies
  • Headaches

Contraindications include:

  • Sensitivity
  • Mechanical obstruction
  • Perforation and bleeding of the GIT
  • Tumor prolactinoma
  • Children under one year old
  • Pregnancy and lactation

During pregnancy, the Motilium medication is prescribed only if the intended benefit exceeds the risk. Caution should be taken in case of liver failure.

Motilium is available in the following forms:

  1. Coated tablets
  2. Tablets for resorption
  3. Suspension for oral administration

The effect of the drug comes in an hour and ends nine hours after the intake. Domperidone is taken three to four times a day. The dosage of the substance in tablets is 10 mg, the package contains from ten to thirty pills. The suspension contains 1 mg of domperidone per 1 ml. The vial has 100 ml. A precise dosing of the suspension is ensured by the syringe supplied in the kit. The maximum daily dose is 80 mg.

What Is Nexium?

Medications from the group of proton pump inhibitors, which include Nexium, are widely used for the therapy of many diseases caused by the excess release of hydrochloric acid (gastric or intestinal ulcer, reflux disease, etc.). These drugs have opened up new possibilities in the treatment of acid-dependent conditions as they inhibit the formation of hydrochloric acid at the level of the membranes of the lining cells in the stomach by inhibiting the transport of hydrogen ions and surpassing all previously used drugs that inhibit the secretion of the acid with regard to safety and efficacy.

One of the Nexium ingredients is esomeprazole (in the form of esomeprazole magnesium trihydrate).

The drug is produced in several forms:

  1. Extended pinkish tablets in a film shell in packages of 7, 14 or 28 pills. The content of esomeprazole is 20 or 40 mg in each dose.
  2. Capsules with the prolonged release (pellets in an enteric coating) containing 10 mg of the active ingredient. This form is used in children or patients who are not able to swallow the pill. In this case, the capsules are dissolved in water and used in the form of a suspension.
  3. Lyophilizate for the solution (for injection). It contains 40 mg of esomeprazole in one bottle. It is used when it is impossible to use the drug through the mouth.

Indications for the intake of Nexium include:

  • Gastroesophageal reflux disease
  • Treatment and prevention of stomach and duodenal ulcers (in complex treatment together with antibiotic therapy)
  • Various pathological conditions characterized by the excessive formation of hydrochloric acid (including idiopathic secretion)

Esomeprazole blocks a specific enzyme H+/K+/ATPase (otherwise, a proton pump) that works in the gastric lining cells. Its inhibition leads to the fact that the final stage of hydrochloric acid evolution is inhibited. As a result, the level of both basal and stimulated secretion (regardless of the type of stimulus) falls. The intensity of the action is determined by the dosage of the drug.

Main Advantages of Motilium and Nexium

Let’s look at the main advantages of Motilium (domperidone) and Nexium (esomeprazole).

Motilium is good at the following:

  • It effectively normalizes the motor function of the stomach and restores the natural rhythm of its work
  • It acts quickly
  • It has a favorable safety profile

The main advantages of Nexium include:

  • It promotes the healing of erosions in reflux-esophagitis faster and more efficiently than other drugs.
  • It provides a more rapid and persistent elimination of GERD symptoms in a larger number of patients with reflux esophagitis than domperidone.
  • The daily intake of Nexium is highly effective in preventing the recurrence of reflux esophagitis. Practically all patients achieve stable remission, they tolerate treatment well.
  • Nexium is highly effective as an initial therapy for the treatment of GERD without esophagitis.
  • The high efficiency of the Nexium drug opens the possibility of a new approach to the prolonged symptomatic treatment of patients with GERD without esophagitis. It is the only proton pump inhibitor that can be recommended for the on-demand reception, for the relief of recurring symptoms.
  • A triple therapy with Nexium as a basic agent for 1 week provides eradication of H. pylori and promotes healing of peptic ulcer of the duodenum without the need for subsequent antisecretory therapy.

Why Is Esomeprazole Better than Domperidone with GERD?

Domperidone and esomeprazole are almost equally effective in reducing acid production and increasing the pH of the stomach contents. However, with GERD, it is very important to maintain a steady pH at the same level throughout the day. Clinical studies have shown that with proper dosing (20 mg twice a day or 40 mg once a day for adults), esomeprazole better maintains the pH balance within 24 hours.

What to Choose: Nexium or Motilium

So, what drug should you choose when suffering from digestive disorders? Can you take Motilium and Nexium together?

  • Choosing between Nexium and Motilium, you need to consider what diseases in addition to the problems with the digestive tract you have and what other drugs you take to minimize the risk of drug interactions. If you take many various medications, then it’s best to choose Motilium since it reacts less with other substances than Nexium.
  • As for the price, Motilium is much cheaper than Nexium.
  • One of the main advantages of Motilium is the variety of dosage forms and the possibility of using it for children from the age of five.
  • Nexium is well-tolerated and has an optimal safety profile. Side effects during its application are rare, usually mild and transitory, and do not depend on the dose.