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Esomeprazole vs. Pepcid

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Esomeprazole

(Nexium)

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Famotidine

(Pepcid)

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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 Pepcid

Prescription or over-the-counter

Famotidine (Pepcid) is a type of acid reducer called a histamine-2 (H2) antagonist. It helps treat problems caused by too much stomach acid. Over-the-counter famotidine (Pepcid or Pepcid AC) can help with heartburn in people who are 12 and up. Prescription-only famotidine is for people with more ongoing stomach acid problems and stomach or gut ulcers. This medication is taken by mouth once or twice a day. It usually starts to work within an hour and lasts several hours. Side effects include headache, dizziness, and constipation.

Indications for Pepcid

Pros and Cons for Pepcid

Pros

Cons

Common Side Effects for Pepcid

Warnings for Pepcid

  • Confusion and other side effects related to the nervous system in some people
  • Masking of possible stomach cancer

Prices with our coupons for Esomeprazole vs. Pepcid

Price Card Drug Icon
Esomeprazole30 capsules / 40mg
$13.25$22.11
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Price Card Drug Icon
Famotidine60 tablets / 20mg
$12.25$15.46
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