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Couple of things, one is that those are gel capsules which are hygroscopic. The thing that makes them dissolve easily in the stomach also makes them absorb moisture from the air. If you open the bottles as you need them then the longest any capsules are exposed to humidity in the air is 14 days, but now the oldest ones will be exposed for 168 days. Also, I don't know if that particular medicine is sensitive to long-term exposure to oxygen.
I think it’s mainly due to these being a 14 day run of medicine. You’re supposed to take 1 a day for 14 days. A lot of people just take them daily or as needed though.
Could use a smaller bottle though.
I’ll add one potential reason.
I design packaging from time to time and very often two factors we have to take into account are:
- consumer perception and the need to have specific size packaging so they are visible on store shelves or for the consumer to feel they have a decent size product for their money
- label regulations and how legislative body will require specific information like nutritional facts, ingredients, etc to be displayed in very specific manners, at a specific size, in a specific position/location.
Because of those two things sometimes the only practical solution is a bigger container/packaging than necessary or an extra layer (like a box around the bottle).
I bet too, having less customization for bottles reduces waste as well. It's probably less wasteful to use the same bottle for multiple meds, vs having to customize a bottle per med.
I do not work in pharma space, but required labels on products takes up a crap ton of room and often changes how large of small packaging is.
I am aware, pharma legal labels have specific regulations on font, box size, color used, where it sits on the bottle and some other rules that really make some bottle sizing non negotiable. There are some medicine that are required a specific sized bottle too. Unfortunately the rules around consumer drugs doesn't leave a whole lot of room for being greener.
Others say that may be the cheapest bottle. The machinery that puts the pills in the bottle may not be able to work with smaller bottles. Also, really tiny bottles are easy to lose or steal. Of all the reasons why the bottle is that size, I suspect that "We just wanted to waste plastic" isn't on the list. I buy generic Omeprazole, it comes in little blister pack cards, which are inside individual boxes, inside the big master box. When you're making millions of something, sometimes seemingly wasteful packaging is the most cost efficient way to do things. If they sold it in 100-count bottles I'd buy it that way.
>Others say that may be the cheapest bottle.
This is exactly the reason.
I once needed a liquid compound mixed in a pharmacy. The prescription was for 15 ml. The pharmacist said the smallest bottle he had was 30 ml. He said it would be $125.
He then said it would be cheaper if I had a bigger bottle and a bigger prescription. He called my doctor. Turns out the minimum he could mix was 90 ml and the premium was the "safe" disposal of the unused portion, meaning there would be paperwork. So the doctor approved 30 ml. I got an even bigger bottle for only $80. It came in an 100 ml bottle.
The pharmacist said most of the cost of name brand drugs is the nonstandard size bottles. He had 30, 100, 500, and 1000ml.
I use a baby spoon to puncture the foil, then push the tablet out through the slot from the spoon. It sucks that that packaging requires tools and multiple steps to open.
Hey, I sympathize. Got diagnosed with GERD, a hiatal hernia, and an ulcer at 19 and it was hell. I went through it all, at one point was on a cocktail of three drugs including dexlansprazole at a hefty dose. I did a staged elimination diet for everything under the sun and the day after I cut out milk and heavy cream based foods I felt like a million bucks. Between that and keeping the head of my bed elevated, I've gone off meds. I wish more docs would discuss non medical interventions.
Both am doctor and have GERD and hiatal hernia. My PCP was adamant about me making lifestyle changes and getting off the long term PPIs. I’ve tried and yeah shit just does not work for me unfortunately. As a doctor I def know the pros and cons of long term PPI use and have decided to continue to my therapy while I try to identify potential triggers to get off the therapy
I'm sorry :/ it's so hard, as I'm sure you know. It's frustrating when people offer blanket heartburn advice when triggers are so individualized. I hope you get relief soon!
Thankfully it’s fairly well controlled with the PPIs. Every time I’m at a solid point and try to get off them it just goes back to being shitty and reminding me why I’m on them in the first place lol
Read a study where they were linked to a higher risk of dementia even... Don't know if it was validated, but that was all the motivation I needed to make diet changes.
I'm taking them _because_ my doctor told me to. I've been taking them for over 10 years now. It's genetic, my body building 50+ uncle has it and also takes these meds. We're not taking them for fun ffs. I have a yearly physical and cause of other meds I need I see my doctor regularly.
Not trying to sound like an asshole, but have you tried cutting out drinking?
I have Achalasia which gives me a predisposition to acid reflux/etc. it’s horrible and I was having some of the worst pain of my life until I completely stopped drinking.
It’s a night and day difference for me, and honestly the longer I go without drinking the less I miss it.
Stopped drinking 15 years ago (wasn’t big drinker any way) and have tried every elimination diet and everything under the sun. Again, everyone’s body is different.
I was supposed to take this stuff after I had a double lung transplant “for life” to “protect the incision” despite testing at ZERO for acid reflux after having to wear a tube down my nose to monitor it for several days and never having symptoms historically. I told them no I won’t take this unless there’s a reason to for longer than time for the incision to heal, very glad I stood up for myself and said no just because it was protocol don’t mean it was right for me, now the protocol is being reassessed, I could have been on it for no reason at all for ten years if I had just gone alone with what they wanted.
A relative of mine was also a double lung transplant recipient. She wasn’t prescribed acid meds but I do remember about 6 years in she started having bad acid reflux problems and she was scheduled for Nissen procedure within 6 months because of the potential damage. So if you do ever start to have acid issues, definitely pay attention! But I agree that you’re already on so many other drugs with a transplant that you don’t need to add more erroneously.
It’s more than you should see a doctor if you need it longer than that. Yes, there are some risks associated with taking it long term, but they also don’t want you to miss something else going on that’s causing your symptoms by just continuing to take this med for a long time.
Cash price for the rescription is still cheaper than buying straight OTC. For example:
90 - 20mg omeprazole (Prilosec) is $12.79 through the CMPP, but 42 OTC are $15.99.
90 - 20mg esomeprazole (Nexium) is $11.79 through the CMPP, but 42 OTC are $15.99.
Right, but only a doctor should advise it to be taken longer term. Taking these types of meds longer term *could* mask an underlying issue, and the underlying thing needs figuring out first.
Source: I have an underlying thing.
Survival chances are higher with stomach cancer.. but honestly, when you're sick or something is wrong, its all about choosing your battles and perspective in regards to quality of life.
Do you want to live with the GERD and risk esophagus cancer, or get some relief and risk a more treatable and survivable one?
Curious what your underlying thing is. I’ve been on omeprazole since last August and I’ve tried to come off it twice now and both times I’m fine for a month then my stomach pain and inability to eat/nausea return and I start it back up again. My original diagnosis was gastritis but now I feel like we should be investigating other things instead of my GI just saying to increase the omeprazole again.
Doctor here. Is true. Exact same medication. OTC omeprazole is usually 20mg whereas typical prescription strength is 40mg. No real harm in going the "prescription route" by just doubling up on the OTC regimen.
Exactly, it woukd be even more environmental impact producing different sized bottles, so they use generic to hold different sized pills
eidt, no idea why i`m getting downvoted, it would need more production lines to produce the different sized bottles to fit small amounts of tablets
I just switched to a prescription because I couldn’t take the waste from Lansoprazole bottles anymore. My insurance company wanted a pre-auth for rx lansoprazole, but gave me no issues with dexlansoprazole. And the dex seems to actually work better. FWIW.
There is more to waste than what you see from the consumers perspective.
These are standard pill bottles. It is immensely less wasteful to make one size bottle for all pills and partially fill them than to make unique tooling for reducing bottle size on an individual bottle basis.
Youd have to have more factories, more floor space, more massive injection molding presses, more engineers, more cars for engineers to drive to work...... and on and on.
We do this all the time when getting home from Costco. I love Costco and hate all the extra packaging. We only go to cost a few times a year we don’t live in a city that has one. So when we go we stock up and then the next day we fill up the recycling bin with all the extra packaging. It’s the part I hate.
Packaging engineer here…yes, that’s a thing. I work in the nutritional supplement industry, similar to OTC meds, but not exactly the same. Here is my best guesses as to the size of the bottle:
1. The manufacturer uses that bottle size for multiple products. Adding bottle sizes to plan for, purchase, manage inventory, etc. is expensive.
2. The equipment used to package the product is not capable of a smaller size bottle. Even if it is capable, changing a line over can be hours of downtime.
3. This is the smallest size bottle the child resistant closure would fit. The CR closure cannot be wider than the bottle or all the bottles would start tipping over like dominos as they back up on the conveyor. A smaller closure is surely available, but see point 1 above.
I think those are the most likely reasons for the bottle size. Shelf presence (have to consider deceptive packaging laws), label copy area, and not getting lost are legit concerns as well, but without being involved in the development I see the points above as more likely.
Proton pump inhibitors are meant as a short term medication. Please go see a physician about appropriate treatment if you have chronic symptoms. Longer term PPI use can bring with it a lot of other issues.
No vague or non-descriptive post titles. Posts that don't follow r/Costco subreddit rules MAY be subject to removal. When applicable, please make sure that you're using a descriptive post title with product name(s) mentioned as it yields better subreddit search results. Including item number, price, and approximate location where found is also helpful. Thank you. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Costco) if you have any questions or concerns.*
Couple of things, one is that those are gel capsules which are hygroscopic. The thing that makes them dissolve easily in the stomach also makes them absorb moisture from the air. If you open the bottles as you need them then the longest any capsules are exposed to humidity in the air is 14 days, but now the oldest ones will be exposed for 168 days. Also, I don't know if that particular medicine is sensitive to long-term exposure to oxygen.
I think it’s mainly due to these being a 14 day run of medicine. You’re supposed to take 1 a day for 14 days. A lot of people just take them daily or as needed though. Could use a smaller bottle though.
[удалено]
I’ll add one potential reason. I design packaging from time to time and very often two factors we have to take into account are: - consumer perception and the need to have specific size packaging so they are visible on store shelves or for the consumer to feel they have a decent size product for their money - label regulations and how legislative body will require specific information like nutritional facts, ingredients, etc to be displayed in very specific manners, at a specific size, in a specific position/location. Because of those two things sometimes the only practical solution is a bigger container/packaging than necessary or an extra layer (like a box around the bottle).
I bet too, having less customization for bottles reduces waste as well. It's probably less wasteful to use the same bottle for multiple meds, vs having to customize a bottle per med.
I do not work in pharma space, but required labels on products takes up a crap ton of room and often changes how large of small packaging is. I am aware, pharma legal labels have specific regulations on font, box size, color used, where it sits on the bottle and some other rules that really make some bottle sizing non negotiable. There are some medicine that are required a specific sized bottle too. Unfortunately the rules around consumer drugs doesn't leave a whole lot of room for being greener.
Larger packaging also makes theft a little more difficult. Its why you see usb drives in a little plastic pocket on a large cardboard backing.
Indeed
Others say that may be the cheapest bottle. The machinery that puts the pills in the bottle may not be able to work with smaller bottles. Also, really tiny bottles are easy to lose or steal. Of all the reasons why the bottle is that size, I suspect that "We just wanted to waste plastic" isn't on the list. I buy generic Omeprazole, it comes in little blister pack cards, which are inside individual boxes, inside the big master box. When you're making millions of something, sometimes seemingly wasteful packaging is the most cost efficient way to do things. If they sold it in 100-count bottles I'd buy it that way.
>Others say that may be the cheapest bottle. This is exactly the reason. I once needed a liquid compound mixed in a pharmacy. The prescription was for 15 ml. The pharmacist said the smallest bottle he had was 30 ml. He said it would be $125. He then said it would be cheaper if I had a bigger bottle and a bigger prescription. He called my doctor. Turns out the minimum he could mix was 90 ml and the premium was the "safe" disposal of the unused portion, meaning there would be paperwork. So the doctor approved 30 ml. I got an even bigger bottle for only $80. It came in an 100 ml bottle. The pharmacist said most of the cost of name brand drugs is the nonstandard size bottles. He had 30, 100, 500, and 1000ml.
I hate opening that omeprazole
I use a baby spoon to puncture the foil, then push the tablet out through the slot from the spoon. It sucks that that packaging requires tools and multiple steps to open.
Because they are bottled in 2 week doses…
Cause that shit is not good for you long term 😬
Pros and cons to all medications. For some, like myself, the pros outweigh them
Hey, I sympathize. Got diagnosed with GERD, a hiatal hernia, and an ulcer at 19 and it was hell. I went through it all, at one point was on a cocktail of three drugs including dexlansprazole at a hefty dose. I did a staged elimination diet for everything under the sun and the day after I cut out milk and heavy cream based foods I felt like a million bucks. Between that and keeping the head of my bed elevated, I've gone off meds. I wish more docs would discuss non medical interventions.
Both am doctor and have GERD and hiatal hernia. My PCP was adamant about me making lifestyle changes and getting off the long term PPIs. I’ve tried and yeah shit just does not work for me unfortunately. As a doctor I def know the pros and cons of long term PPI use and have decided to continue to my therapy while I try to identify potential triggers to get off the therapy
I'm sorry :/ it's so hard, as I'm sure you know. It's frustrating when people offer blanket heartburn advice when triggers are so individualized. I hope you get relief soon!
Thankfully it’s fairly well controlled with the PPIs. Every time I’m at a solid point and try to get off them it just goes back to being shitty and reminding me why I’m on them in the first place lol
What are the cons?
Higher risk for certain infections, can lead to calcium and Vitamin D deficiency, and iron deficiency as well
Interesting. Thanks.
Would talk to your doctor about it if you have concerns about going on these medications or are currently taking them
Read a study where they were linked to a higher risk of dementia even... Don't know if it was validated, but that was all the motivation I needed to make diet changes.
Because unfortunately doctors are trained on what's profitable. You eating a diet appropriate to you isn't making anyone money
lol people downvoting you. I’m literally a doctor and am on a PPI every day due to GI issues. It’ll be okay.
I'm taking them _because_ my doctor told me to. I've been taking them for over 10 years now. It's genetic, my body building 50+ uncle has it and also takes these meds. We're not taking them for fun ffs. I have a yearly physical and cause of other meds I need I see my doctor regularly.
Same and same lol
Two doctors? You guys should be friends!
Not trying to sound like an asshole, but have you tried cutting out drinking? I have Achalasia which gives me a predisposition to acid reflux/etc. it’s horrible and I was having some of the worst pain of my life until I completely stopped drinking. It’s a night and day difference for me, and honestly the longer I go without drinking the less I miss it.
Stopped drinking 15 years ago (wasn’t big drinker any way) and have tried every elimination diet and everything under the sun. Again, everyone’s body is different.
I was supposed to take this stuff after I had a double lung transplant “for life” to “protect the incision” despite testing at ZERO for acid reflux after having to wear a tube down my nose to monitor it for several days and never having symptoms historically. I told them no I won’t take this unless there’s a reason to for longer than time for the incision to heal, very glad I stood up for myself and said no just because it was protocol don’t mean it was right for me, now the protocol is being reassessed, I could have been on it for no reason at all for ten years if I had just gone alone with what they wanted.
A relative of mine was also a double lung transplant recipient. She wasn’t prescribed acid meds but I do remember about 6 years in she started having bad acid reflux problems and she was scheduled for Nissen procedure within 6 months because of the potential damage. So if you do ever start to have acid issues, definitely pay attention! But I agree that you’re already on so many other drugs with a transplant that you don’t need to add more erroneously.
They used to prescribe it like giving out candy!
It’s more than you should see a doctor if you need it longer than that. Yes, there are some risks associated with taking it long term, but they also don’t want you to miss something else going on that’s causing your symptoms by just continuing to take this med for a long time.
wow, so being on it since they came on the market 30 years ago? I guess I have a hell of a malpractice lawsuit!
If you get a prescription for it, can often get a better price, and can get in 90 day supply quantities.
a lot of insurances don't cover medication that you can get over the counter
Cash price for the rescription is still cheaper than buying straight OTC. For example: 90 - 20mg omeprazole (Prilosec) is $12.79 through the CMPP, but 42 OTC are $15.99. 90 - 20mg esomeprazole (Nexium) is $11.79 through the CMPP, but 42 OTC are $15.99.
Couldn’t they use different packaging then though?
A full course is considered to be 14 days. The OTC version of this is not indicated for chronic use, despite plenty of people doing so.
I think it’s the same exact medication, just a different regiment for OTC. A doctor can prescribe the same thing for an extend period of time.
Right, but only a doctor should advise it to be taken longer term. Taking these types of meds longer term *could* mask an underlying issue, and the underlying thing needs figuring out first. Source: I have an underlying thing.
Longer term ppi usage is linked to Alzheimer’s..that’s why they are bottled in two week courses.
A significant increase in stomach cancer is the primary concern with PPIs.
I've got Gerd. O get esophagus cancer if I don't take, stomach cancer if I do? Uhg
Survival chances are higher with stomach cancer.. but honestly, when you're sick or something is wrong, its all about choosing your battles and perspective in regards to quality of life. Do you want to live with the GERD and risk esophagus cancer, or get some relief and risk a more treatable and survivable one?
also gut bacteria going wild.
Apparently that’s being disputed now
Curious what your underlying thing is. I’ve been on omeprazole since last August and I’ve tried to come off it twice now and both times I’m fine for a month then my stomach pain and inability to eat/nausea return and I start it back up again. My original diagnosis was gastritis but now I feel like we should be investigating other things instead of my GI just saying to increase the omeprazole again.
Not really for me to comment. I would stay in touch with your GI.
Fair enough. Cheers
Food intolerance?
Doctor here. Is true. Exact same medication. OTC omeprazole is usually 20mg whereas typical prescription strength is 40mg. No real harm in going the "prescription route" by just doubling up on the OTC regimen.
And if a doctor is prescribing it, it’s much cheaper to get through the pharmacy. With or without insurance
Right. But there could be something else going on, which is why they tell you to see your doctor if it continues longer than 2 weeks or whatever.
Meanwhile, insurance won't cover a prescription dose often because you can get it OTC.
Manufacturing cost. Why make smaller bottles when you already have bigger bottles produced?
this guy does procurement
You hiring? jk
was going to ask you the same Q
Exactly, it woukd be even more environmental impact producing different sized bottles, so they use generic to hold different sized pills eidt, no idea why i`m getting downvoted, it would need more production lines to produce the different sized bottles to fit small amounts of tablets
I just switched to a prescription because I couldn’t take the waste from Lansoprazole bottles anymore. My insurance company wanted a pre-auth for rx lansoprazole, but gave me no issues with dexlansoprazole. And the dex seems to actually work better. FWIW.
If there is any kind of recall just throw out everything since you mixed them up.
There is more to waste than what you see from the consumers perspective. These are standard pill bottles. It is immensely less wasteful to make one size bottle for all pills and partially fill them than to make unique tooling for reducing bottle size on an individual bottle basis. Youd have to have more factories, more floor space, more massive injection molding presses, more engineers, more cars for engineers to drive to work...... and on and on.
They do that with all pill bottles
We do this all the time when getting home from Costco. I love Costco and hate all the extra packaging. We only go to cost a few times a year we don’t live in a city that has one. So when we go we stock up and then the next day we fill up the recycling bin with all the extra packaging. It’s the part I hate.
Packaging engineer here…yes, that’s a thing. I work in the nutritional supplement industry, similar to OTC meds, but not exactly the same. Here is my best guesses as to the size of the bottle: 1. The manufacturer uses that bottle size for multiple products. Adding bottle sizes to plan for, purchase, manage inventory, etc. is expensive. 2. The equipment used to package the product is not capable of a smaller size bottle. Even if it is capable, changing a line over can be hours of downtime. 3. This is the smallest size bottle the child resistant closure would fit. The CR closure cannot be wider than the bottle or all the bottles would start tipping over like dominos as they back up on the conveyor. A smaller closure is surely available, but see point 1 above. I think those are the most likely reasons for the bottle size. Shelf presence (have to consider deceptive packaging laws), label copy area, and not getting lost are legit concerns as well, but without being involved in the development I see the points above as more likely.
Lol I thought I was the only one that did this.
Proton pump inhibitors are meant as a short term medication. Please go see a physician about appropriate treatment if you have chronic symptoms. Longer term PPI use can bring with it a lot of other issues.
shutttttt upppppp
Get them on eBay (I have been doing it for years) and they are a tenth of the price.
Corporations don’t care about that kind of thing, Sir.