Table of ContentsView AllTable of ContentsWhat Is Nexium?What Is Prilosec?Dosage ComparisonReview of EfficacySide Effects & SafetyPrecautionsInteractionsOther Ways to Manage GERDFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is Nexium?
What Is Prilosec?
Dosage Comparison
Review of Efficacy
Side Effects & Safety
Precautions
Interactions
Other Ways to Manage GERD
Frequently Asked Questions
Many Americans risk developing digestive disorders due to unhealthy eating or lifestyle practices, such asexcessive alcohol consumptionorsmoking.
Among these risks is a digestive disorder calledgastroesophageal reflux disease (GERD). GERD occurs when stomach acid flows back into the mouth through the esophagus (food tube) instead of traveling to the stomach.
Fortunately, effective treatment options exist for GERD and its symptoms, which includeheartburn,acid reflux, and stomachulcers.
While Nexium and Prilosec are chemically related, making them relatively similar, they carry some distinct differences, such as their active ingredients and dosing requirements.
This article will provide an in-depth analysis of Nexium and Prilosec, comparing and contrasting their indications, dosing requirements, potential side effects, and more.
Bloomberg / Getty Images
The Food and Drug Administration (FDA) approved OTC Nexium (Nexium 24HR) as a short-term treatment option for frequentindigestionor heartburn.
In comparison, prescription Nexium is FDA-approved for a longer list of uses, including the following:
Sometimes, healthcare providers prescribe medications for uses that are not FDA-approved. This is called off-label prescribing.
Nexium is prescribed off-label for issues that include but are not limited to:
How Does Nexium Work?
You may see it as Nexium (brand), including OTC formulations such as Nexium 24HR or esomeprazole (generic).
Nexium is administered in various ways, including tablets, capsules, and granules.
The pharmacy commonly dispenses Nexium for adults (those 18 and older) as generic esomeprazole delayed-release (DR) capsules, a medication designed to last longer in the body so that fewer doses are needed.
As with OTC Nexium, OTC Prilosec is also used for short-term treatment of frequentindigestion or heartburntwo or more times per week.
Prescription Prilosec is dispensed in pharmacies primarily as generic omeprazole, as many brand-name forms are no longer available.
However, healthcare providers often refer to Prilosec and omeprazole interchangeably, so this article will also refer to both names.
Prescription omeprazole is FDA-approved for the following uses:
Sometimes, omeprazole is prescribed off-label for specific uses, including but not limited to:
How Does Prilosec Work?
You may see it as Prilosec (brand), including OTC formulations such as Prilosec OTC or omeprazole (generic).
It is available in tablets, capsules, and orally disintegrating tablets. Pharmacies commonly dispense prescription omeprazole for adults as generic omeprazole capsules.
The following offers general dosing guidelines for Nexium vs. Prilosec. Remember, however, that your exact dosage may vary based on various factors, including preexisting conditions, allergies, and height and weight, among others. Moreover, dosing may differ based on the drug’s mode of administration.
Always talk with a healthcare provider before using Nexium or Prilosec.
Nexium
General dosing guidelines for Nexium are as follows:
Prilosec
General dosing guidelines for Prilosec are as follows:
The dose for children and adolescents depends on medical conditions, age, and weight.
Comparing Efficacy
It’s no coincidence that the active ingredients found in Nexium and Prilosec sound almost alike. These drugs are chemically very similar and act similarly on the body.
Regarding efficacy, some studies found that Nexium may be more effective than Prilosec. For example, a review of studies found that Nexium was more effective in decreasing acid production and that its effects lasted longer than Prilosec.
One study found Nexium significantly more effective than omeprazole in people with GERD and erosive esophagitis.
Another study compared Nexium with four other PPIs, including omeprazole, and found that Nexium was most effective in controlling GERD symptoms.
It’s important to note that either Nexium or omeprazole can be effective. Always consult your healthcare provider for personalized medical advice.
Because of their similar chemical structure and drug class, Nexium and Prilosec have similar side effects.
Nexium: Common Side Effects
Common side effects of Nexium in adults and children include:
Prilosec: Common Side Effects
Common side effects of Prilosec in adults and children include:
Nexium vs. Prilosec: Severe Side Effects
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.
Serious side effects and their symptoms associated with Nexium and Prilosec include the following:
Because of the risk of severe side effects, the prescribing information recommends PPIs be prescribed at the lowest effective dose and for the shortest time possible.
PPIs, like Nexium or Prilosec, are not appropriate for everyone. Before you take Nexium or Prilosec, please tell your healthcare provider about your medical conditions, medical history, and family history.
You should not take Nexium or Prilosec if you are allergic to esomeprazole, omeprazole, or any inactive ingredients in Nexium or Prilosec.
Other people who should not take Nexium or Prilosec include individuals taking Edurant (rilpivirine) medication.
Nexium vs. Prilosec: Potential Interactions
Tell your healthcare provider about all your medicines, including Rx, OTC, and vitamins or supplements.
While taking Nexium or Prilosec, do not start any new medications without approval from your healthcare provider. Some drug interactions include:
This is not a complete list of drug interactions. Other drug interactions may occur with Nexium or Prilosec. Consult your healthcare provider for more information about drug interactions and how they may affect you.
What Are Other Ways to Help Manage GERD?
Some lifestyle changes you can make to help with GERD symptoms include:
Consulting a registered dietitian can be helpful so you can work together to create aneating planthat can help minimize symptoms.
Summary
GERD is agastrointestinal (GI) disorderthat affects around 20% of adults in North America.
Nexium (esomeprazole) and Prilosec (omeprazole) are PPI medications that help decrease stomach acid production, reducing symptoms of GERD and other stomach and intestinal conditions.
Although they have many similarities, such as side effects and drug interactions, they have some differences, too, such as specific indications for use and dosages for certain conditions.
You can always consult your healthcare provider for these two medications.
Either drug should be stored at room temperature (between 68 and 77 degrees F). Keep away from direct light, heat, and moisture.Do not store it in the bathroom. Keep out of reach and out of sight of children and pets.Learn MoreWhy Drugs Are Temperature-Sensitive
Either drug should be stored at room temperature (between 68 and 77 degrees F). Keep away from direct light, heat, and moisture.Do not store it in the bathroom. Keep out of reach and out of sight of children and pets.
Either drug should be stored at room temperature (between 68 and 77 degrees F). Keep away from direct light, heat, and moisture.
Do not store it in the bathroom. Keep out of reach and out of sight of children and pets.
Learn MoreWhy Drugs Are Temperature-Sensitive
The cost of the prescription formulations depends on your insurance plan. However, the price should be reasonable since both medications have generic forms.
OTC Nexium and Prilosec are also reasonably priced, especially when you choose the generic version.
Some studies have found that long-term use of a PPI can increase the risk of gastric cancer.However, to avoid side effects and bad reactions, including risk of bone fractures, kidney problems, and skin problems, healthcare providers prescribe PPIs at the lowest effective dose for the shortest time possible.As always, consult your healthcare provider for medical advice.Learn MoreOmeprazole: Cancer Risk and Alternatives
Some studies have found that long-term use of a PPI can increase the risk of gastric cancer.However, to avoid side effects and bad reactions, including risk of bone fractures, kidney problems, and skin problems, healthcare providers prescribe PPIs at the lowest effective dose for the shortest time possible.As always, consult your healthcare provider for medical advice.
Some studies have found that long-term use of a PPI can increase the risk of gastric cancer.
However, to avoid side effects and bad reactions, including risk of bone fractures, kidney problems, and skin problems, healthcare providers prescribe PPIs at the lowest effective dose for the shortest time possible.
As always, consult your healthcare provider for medical advice.
Learn MoreOmeprazole: Cancer Risk and Alternatives
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Clarrett DM, Hachem C.Gastroesophageal reflux disease (GERD).Mo Med. 2018;115(3):214-218.Label:Nexium- esomeprazole magnesium capsule, delayed release.DailyMed.Label: Prilosec- omeprazole magnesium granule, delayed release.Kendall MJ.Review article: esomeprazole–the first proton pump inhibitor to be developed as an isomer.Aliment Pharmacol Ther. 2003;17 Suppl 1:1-4. doi:10.1046/j.1365-2036.17.s1.1.xDailyMed.Label: Nexium 24HR- esomeprazole magnesium capsule, delayed release Nexium 24HR Clearminis- esomeprazole magnesium capsule, delayed release.Medline Plus.Proton pump inhibitors.Prescribers’ Digital Reference:Esomeprazole - drug summary.Franciosi JP, Mougey EB, Dellon ES, et al.Proton pump inhibitor therapy for eosinophilic esophagitis: History, mechanisms, efficacy, and future directions.J Asthma Allergy. 2022;15:281-302. doi:10.2147/JAA.S274524MedlinePlus.Esomeprazole.DailyMed.Label: Prilosec OTC- omeprazole magnesium tablet, delayed release.Prescribers’ Digital Reference.Omeprazole - drug summary.Kendall MJ.Review article: esomeprazole–the first proton pump inhibitor to be developed as an isomer.Aliment Pharmacol Ther. 2003;17 Suppl 1:1-4. doi:10.1046/j.1365-2036.17.s1.1.xRichter JE, Kahrilas PJ, Johanson J, et al.Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial.Am J Gastroenterol. 2001;96(3):656-665. doi:10.1111/j.1572-0241.2001.3600_b.xRöhss K, Lind T, Wilder-Smith C.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.Eur J Clin Pharmacol. 2004;60(8):531-539. doi:10.1007/s00228-004-0804-6MedlinePlus.Omeprazole.U.S. National Library of Medicine.Omeprazole capsule, delayed release.U.S. National Library of Medicine.Esomeprazole magnesium capsule, delayed release.National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Eating, Diet, & Nutrition for GER & GERD.Poly TN, Lin MC, Syed-Abdul S, Huang CW, Yang HC, Li YJ.Proton pump inhibitor use and risk of gastric cancer: Current evidence from epidemiological studies and critical appraisal.Cancers (Basel). 2022;14(13):3052. doi:10.3390/cancers14133052Cheung KS, Leung WK.Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence.Therap Adv Gastroenterol. 2019;12:1756284819834511. doi:10.1177/1756284819834511
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Clarrett DM, Hachem C.Gastroesophageal reflux disease (GERD).Mo Med. 2018;115(3):214-218.Label:Nexium- esomeprazole magnesium capsule, delayed release.DailyMed.Label: Prilosec- omeprazole magnesium granule, delayed release.Kendall MJ.Review article: esomeprazole–the first proton pump inhibitor to be developed as an isomer.Aliment Pharmacol Ther. 2003;17 Suppl 1:1-4. doi:10.1046/j.1365-2036.17.s1.1.xDailyMed.Label: Nexium 24HR- esomeprazole magnesium capsule, delayed release Nexium 24HR Clearminis- esomeprazole magnesium capsule, delayed release.Medline Plus.Proton pump inhibitors.Prescribers’ Digital Reference:Esomeprazole - drug summary.Franciosi JP, Mougey EB, Dellon ES, et al.Proton pump inhibitor therapy for eosinophilic esophagitis: History, mechanisms, efficacy, and future directions.J Asthma Allergy. 2022;15:281-302. doi:10.2147/JAA.S274524MedlinePlus.Esomeprazole.DailyMed.Label: Prilosec OTC- omeprazole magnesium tablet, delayed release.Prescribers’ Digital Reference.Omeprazole - drug summary.Kendall MJ.Review article: esomeprazole–the first proton pump inhibitor to be developed as an isomer.Aliment Pharmacol Ther. 2003;17 Suppl 1:1-4. doi:10.1046/j.1365-2036.17.s1.1.xRichter JE, Kahrilas PJ, Johanson J, et al.Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial.Am J Gastroenterol. 2001;96(3):656-665. doi:10.1111/j.1572-0241.2001.3600_b.xRöhss K, Lind T, Wilder-Smith C.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.Eur J Clin Pharmacol. 2004;60(8):531-539. doi:10.1007/s00228-004-0804-6MedlinePlus.Omeprazole.U.S. National Library of Medicine.Omeprazole capsule, delayed release.U.S. National Library of Medicine.Esomeprazole magnesium capsule, delayed release.National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Eating, Diet, & Nutrition for GER & GERD.Poly TN, Lin MC, Syed-Abdul S, Huang CW, Yang HC, Li YJ.Proton pump inhibitor use and risk of gastric cancer: Current evidence from epidemiological studies and critical appraisal.Cancers (Basel). 2022;14(13):3052. doi:10.3390/cancers14133052Cheung KS, Leung WK.Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence.Therap Adv Gastroenterol. 2019;12:1756284819834511. doi:10.1177/1756284819834511
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Clarrett DM, Hachem C.Gastroesophageal reflux disease (GERD).Mo Med. 2018;115(3):214-218.Label:Nexium- esomeprazole magnesium capsule, delayed release.DailyMed.Label: Prilosec- omeprazole magnesium granule, delayed release.Kendall MJ.Review article: esomeprazole–the first proton pump inhibitor to be developed as an isomer.Aliment Pharmacol Ther. 2003;17 Suppl 1:1-4. doi:10.1046/j.1365-2036.17.s1.1.xDailyMed.Label: Nexium 24HR- esomeprazole magnesium capsule, delayed release Nexium 24HR Clearminis- esomeprazole magnesium capsule, delayed release.Medline Plus.Proton pump inhibitors.Prescribers’ Digital Reference:Esomeprazole - drug summary.Franciosi JP, Mougey EB, Dellon ES, et al.Proton pump inhibitor therapy for eosinophilic esophagitis: History, mechanisms, efficacy, and future directions.J Asthma Allergy. 2022;15:281-302. doi:10.2147/JAA.S274524MedlinePlus.Esomeprazole.DailyMed.Label: Prilosec OTC- omeprazole magnesium tablet, delayed release.Prescribers’ Digital Reference.Omeprazole - drug summary.Kendall MJ.Review article: esomeprazole–the first proton pump inhibitor to be developed as an isomer.Aliment Pharmacol Ther. 2003;17 Suppl 1:1-4. doi:10.1046/j.1365-2036.17.s1.1.xRichter JE, Kahrilas PJ, Johanson J, et al.Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial.Am J Gastroenterol. 2001;96(3):656-665. doi:10.1111/j.1572-0241.2001.3600_b.xRöhss K, Lind T, Wilder-Smith C.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.Eur J Clin Pharmacol. 2004;60(8):531-539. doi:10.1007/s00228-004-0804-6MedlinePlus.Omeprazole.U.S. National Library of Medicine.Omeprazole capsule, delayed release.U.S. National Library of Medicine.Esomeprazole magnesium capsule, delayed release.National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Eating, Diet, & Nutrition for GER & GERD.Poly TN, Lin MC, Syed-Abdul S, Huang CW, Yang HC, Li YJ.Proton pump inhibitor use and risk of gastric cancer: Current evidence from epidemiological studies and critical appraisal.Cancers (Basel). 2022;14(13):3052. doi:10.3390/cancers14133052Cheung KS, Leung WK.Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence.Therap Adv Gastroenterol. 2019;12:1756284819834511. doi:10.1177/1756284819834511
Clarrett DM, Hachem C.Gastroesophageal reflux disease (GERD).Mo Med. 2018;115(3):214-218.
Label:Nexium- esomeprazole magnesium capsule, delayed release.
DailyMed.Label: Prilosec- omeprazole magnesium granule, delayed release.
Kendall MJ.Review article: esomeprazole–the first proton pump inhibitor to be developed as an isomer.Aliment Pharmacol Ther. 2003;17 Suppl 1:1-4. doi:10.1046/j.1365-2036.17.s1.1.x
DailyMed.Label: Nexium 24HR- esomeprazole magnesium capsule, delayed release Nexium 24HR Clearminis- esomeprazole magnesium capsule, delayed release.
Medline Plus.Proton pump inhibitors.
Prescribers’ Digital Reference:Esomeprazole - drug summary.
Franciosi JP, Mougey EB, Dellon ES, et al.Proton pump inhibitor therapy for eosinophilic esophagitis: History, mechanisms, efficacy, and future directions.J Asthma Allergy. 2022;15:281-302. doi:10.2147/JAA.S274524
MedlinePlus.Esomeprazole.
DailyMed.Label: Prilosec OTC- omeprazole magnesium tablet, delayed release.
Prescribers’ Digital Reference.Omeprazole - drug summary.
Richter JE, Kahrilas PJ, Johanson J, et al.Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial.Am J Gastroenterol. 2001;96(3):656-665. doi:10.1111/j.1572-0241.2001.3600_b.x
Röhss K, Lind T, Wilder-Smith C.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.Eur J Clin Pharmacol. 2004;60(8):531-539. doi:10.1007/s00228-004-0804-6
MedlinePlus.Omeprazole.
U.S. National Library of Medicine.Omeprazole capsule, delayed release.
U.S. National Library of Medicine.Esomeprazole magnesium capsule, delayed release.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).Eating, Diet, & Nutrition for GER & GERD.
Poly TN, Lin MC, Syed-Abdul S, Huang CW, Yang HC, Li YJ.Proton pump inhibitor use and risk of gastric cancer: Current evidence from epidemiological studies and critical appraisal.Cancers (Basel). 2022;14(13):3052. doi:10.3390/cancers14133052
Cheung KS, Leung WK.Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence.Therap Adv Gastroenterol. 2019;12:1756284819834511. doi:10.1177/1756284819834511
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