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:
What Is Prilosec?
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
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.
|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|
|Standard dosage||20-40 mg, one or two times per day||20-40 mg, one or two times per day|
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
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.
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
How K Health Can Help
Now you can treat acid reflux online using K Health for just $29 per month.
Just three easy steps:
- Answer a few simple questions.
- Meet your provider.
- Get the care you need.
Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Definition and facts for GER and GERD. (2020).
Proton pump inhibitors (PPI). (2022).
Esomeprazole 40 mg provides more effective intragastric acid control than lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg in patients with gastro-oesophageal reflux symptoms. (2004).
Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis. (2009).
A review of esomeprazole in the treatment of gastroesophageal reflux disease (GERD). (2007).
Nexium (esomeprazole magnesium). (2021).
Prilosec (omeprazole). (2012).