What’s the top-selling brand-name prescription drug in America? Nexium, “the purple pill.” We spend six billion dollars a year on it. It’s one of many proton pump inhibitors, or PPI’s, and it’s often prescribed for heartburn to keep your stomach from producing too much acid. But Consumer Reports says that unless you have gastroesphogeal reflux disease, when you have heartburn a couple times a week for several months, you actually may not need such a strong drug. Nexium and other PPIs have drawbacks. They can take days to start working. You must take them daily. And they have been linked to side effects, including pneumonia and bone fractures. For occasional heartburn, Consumer Reports recommends choosing an over-the-counter antacid like Tums or Rolaids. Or you might want to try a different kind of drug called an H2 blocker. These are drugs like Pepcid AC or Zantac. They generally cause fewer side effects and are less expensive than a PPI. If you’re going to eat something you know will irritate your stomach you should take an H2 blocker ahead of time. If you and your doctor do decide a PPI is really your best option, Consumer Reports says be aware there are alternatives that are much cheaper than Nexium. Consumer Reports’ analysis shows that these medications are equally effective, equally safe and you can shop by price. Nexium (20 milligrams) averages $240 a month. But over-the-counter PPI’s omeprazole, and lansoprazole, average just $17 a month. Some people mistake pain from gallstones or heart disease for heartburn. So Consumer Reports cautions, before starting any heartburn drug, see a doctor to rule out other health issues.

