Esomeprazole vs. Lansoprazole for Heartburn and Gastric Ulcer: Important Differences and Potential Risks.

Esomeprazole

(Nexium)

Lansoprazole

(Prevacid)

Summary for Esomeprazole

Prescription or over-the-counter

Esomeprazole (Nexium) is a medication used to treat conditions that are caused by too much stomach acid, such as heartburn or acid reflux. It's available both with a prescription and over the counter (OTC). Take esomeprazole (Nexium) an hour before a meal so that it can start working before you eat. It can take a couple days for you to feel its full effects, so consider taking other quick-acting antacids in the meantime until the medication effect kicks in.

Indications for Esomeprazole

For adults only:

Heartburn — OTC only
Lower the risk of stomach ulcer due to nonsteroidal anti-inflammatory drugs (NSAID)
Lower the risk of duodenal ulcer caused by Helicobacter pylori (H. pylori) infection
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)

For adults and children:

Gastroesophageal reflux disease (GERD)
Inflamed esophagus due to GERD

Pros and Cons for Esomeprazole

Pros

Can continue to use with antacids, such as calcium carbonate
Provides longer-lasting relief than some other heartburn medications
Available as over-the-counter and lower-cost generic options
Granules or pellets inside the capsules can be mixed with water or applesauce, so convenient for people with difficulty swallowing pills

Cons

Takes 1 to 4 days for the medication to fully kick in, so not the best choice for immediate heartburn relief
Significant interaction with clopidogrel (Plavix), which can raise the risk of blood clot
Long-term use might weaken bones and raise the risk of bone fracture
Can lower magnesium and vitamin B12 levels

Common Side Effects for Esomeprazole

Headache (4-8%)
Belly pain (3-4%)
Diarrhea (2-4%)
Nausea (2%)
Passing gas (more than 1%)
Constipation (more than 1%)
Dry mouth (more than 1%)

Warnings for Esomeprazole

Risk of hiding symptoms of a more serious problem
Sudden kidney problems
Severe infectious diarrhea
Bone fractures
Skin reactions
Lupus
Low vitamin B12 and magnesium levels
Interaction with other medications

Summary for Lansoprazole

Prescription or over-the-counter

Lansoprazole (Prevacid) a proton-pump inhibitor (PPI). It treats heartburn, gastroesophageal reflux disease (GERD), and other similar conditions by lowering the amount of acid produced in the stomach. Lansoprazole (Prevacid) is available over the counter (OTC) for adults only, while providers can prescribe lansoprazole (Prevacid) for children and adults. Lansoprazole (Prevacid) is taken by mouth, typically once daily for most conditions. Although there aren't many noticeable side effects on a day-to-day basis, long-term use of lansoprazole (Prevacid) can raise certain risks like bone fractures.

Indications for Lansoprazole

For adults only:

Frequent heartburn (2 or more days a week) - OTC only
Stomach or duodenal ulcer
Lower the risk of duodenal ulcer caused by Helicobacter pylori (H. pylori) infection
Lower the risk of stomach ulcer due to nonsteroidal anti-inflammatory drugs (NSAID)
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)

For adults and children:

Pros and Cons for Lansoprazole

Pros

Can continue to use with antacids, such as calcium carbonate
Available as over-the-counter and lower-cost generic options
Capsules can be opened and sprinkled over soft foods (e.g., applesauce, yogurt)
Typically few to no noticeable day-to-day side effects

Cons

Takes about 3 days for the medication to fully kick in, so not the best choice for immediate heartburn relief
Might cause or worsen lupus
Long-term use might weaken bones and raise the risk of bone fracture
Can lower magnesium and vitamin B12 levels

Common Side Effects for Lansoprazole

Diarrhea (4%)
Belly pain (2%)

Warnings for Lansoprazole

Risk of hiding symptoms of a more serious problem
Sudden kidney problems
Severe infectious diarrhea
Bone fractures
Skin reactions
Lupus
Low vitamin B12 and magnesium levels
Interaction with other medications
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only