Nexium and Prilosec are two medications that are commonly used for symptoms of heartburn and GERD, which stands for gastroesophageal reflux disease and affects around 20% of all people in the United States.
While acid reflux or heartburn, sometimes called GERD, may affect people after certain foods or occasionally, GERD is a chronic digestive condition that causes a lot of pain. If left untreated, it can cause health complications.
In this article, we’ll compare these two common heartburn medications, go over which works better, and how to safely use these medicines.
What Is Nexium?
Esomeprazole is the generic name for Nexium. It is a proton pump inhibitor (PPI) that is used for treating heartburn and acid reflux.
Common side effects for Nexium include:
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What Is Prilosec?
Prilosec, the brand name for omeprazole, is also a proton pump inhibitor (PPI). It is used to treat heartburn and acid reflux, too.
Common side effects of Prilosec are:
Nexium vs Prilosec
Both Prilosec and Nexium have similar-sounding generic names because they are made from the same chemicals with slightly different arrangements.
They both work to reduce the symptoms of GERD by blocking acid in the stomach.
This prevents the backflow of stomach acid through the esophageal sphincter and up the esophagus to the back of the throat, which is what causes the painful burning symptoms associated with acid reflux or heartburn.
Both drugs are approved by the U.S. Food and Drug Administration (FDA) for treating the following conditions:
Gastroesophageal reflux disease (GERD)
Zollinger-Ellison syndrome
Prilosec is also FDA-approved to treat:
Duodenal ulcers and stomach ulcers
Esophagitis
Nexium and Prilosec are both available as prescriptions or over-the-counter.
Even if you choose an OTC option, you should still check with a medical provider before you use either Nexium or Prilosec, since they can interact with other medications.
Comparisons | Nexium | Prilosec |
Type of drug | Proton pump inhibitor | Proton pump inhibitor |
Brand or generic | Both | Both |
Prescription forms | Delayed-release capsules, suspension, injection, packets | Delayed-release capsules, suspension |
Over-the-counter forms | Capsules, mini capsules, tablets | Delayed-release tablets |
Insurance coverage | Yes, as a generic prescription | Yes, as a generic prescription |
Medicare coverage | Yes, as a generic prescription | Yes, as a generic prescription |
Typical copay | $14 | $0-$20 |
Standard dosage | 20-40 mg, one or two times per day | 20-40 mg, one or two times per day |
Effectiveness
When comparing Nexium to Prilosec, clinical trials found that Nexium tended to outperform Prilosec and other PPIs.
Nexium was able to offer the best acid control as well as faster symptom relief.
Even so, both medicines are effective and one may work better for another based on individual health factors.
Which Is Better
Nexium and Prilosec are both similar drugs, and while Nexium performed better in some aspects of research, they are both considered to be effective treatments for GERD and acid reflux.
A healthcare provider will recommend the medication that works best for your health history, current medical needs, and in consideration of any other medications you take.
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Warnings and Interactions
Nexium and Prilosec are similar drugs, so they have similar warnings and interactions.
Some potentially serious health conditions that can occur with PPI use can include:
Clostridium difficile diarrhea
Bone fractures, especially in the spine, hip, and wrist
Kidney problems or disorders
Cutaneous lupus erythematosus
Systemic lupus erythematosus
Vitamin B12 deficiency after long-term use
Serious magnesium deficiency after long-term use
Both drugs have the potential to increase false-positive test results for neuroendocrine tumors.
Nexium and Prilosec use is not recommended for pregnant and breastfeeding persons. They should check with healthcare providers before the use of PPIs.
People who have osteoporosis or are at high risk for developing it should not take Prilosec or Nexium, since it can increase the risk for bone fractures.
Possible drug interactions include:
Nexium: Atazanavir, calcium carbonate, clopidogrel, dapsone, indinavir, iron, itraconazole, ketoconazole, mycophenolate, nelfinavir, vitamin B12, methotrexate, tacrolimus, warfarin, cilostazol, clozapine, any CYP2C19 drugs, diazepam, digoxin, penicillins, saquinavir
Prilosec: Ampicillin, calcium carbonate, vitamin B12, cycloSPORINE, diazepam, digoxin, disulfiram, flurazepam, gefitinib, indinavir, iron salts, ketoconazole, phenytoin, triazolam, warfarin, citalopram, methotrexate, plavix, St. John’s wort
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