Nexium vs. Tums for Heartburn: Important Differences and Potential Risks.

Key takeaways

Esomeprazole (Nexium) and calcium carbonate (Tums) are both used to treat heartburn, but they work in different ways and have different uses. Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production and is available both over-the-counter and by prescription. It is used for conditions like GERD, stomach ulcers, and Zollinger-Ellison syndrome. It takes a few days to feel its full effects and is taken before meals. On the other hand, calcium carbonate is an antacid that neutralizes stomach acid and provides quick relief within minutes. It is available over-the-counter and is also used to treat indigestion and sour stomach. Esomeprazole can have more serious side effects like bone fractures and low magnesium levels with long-term use, while calcium carbonate's main side effect is constipation. Additionally, calcium carbonate can be used as a calcium supplement, whereas esomeprazole cannot.

Esomeprazole

(Nexium)

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calcium carbonate

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Summary for Nexium

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 Nexium

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 Nexium

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 Nexium

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 Nexium

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 Tums

Over-the-counter

Calcium carbonate is an antacid. It's mainly used to relieve symptoms of acid reflux, such as heartburn and indigestion, for adults and children. Sometimes, providers might prescribe it as a supplement to prevent calcium deficiency. Calcium carbonate is available over the counter in several different formulations, including chewable tablets and oral solutions. Side effects from calcium carbonate are rare, but some people have reported constipation.

Indications for Tums

Heartburn
Indigestion
Sour or upset stomach

Pros and Cons for Tums

Pros

Works within minutes to treat heartburn symptoms
Chewable tablets come in many different flavors for better taste
Available as a lower-cost generic
Available over the counter

Cons

Shouldn't be used for longer than 2 weeks without speaking to a healthcare provider
Not the best option if you have high levels of calcium in your body
Can raise the risk of kidney stones in some people
Might need to take multiple tablets several times throughout the day