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Prevacid vs. Nexium

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

Key takeaways

Lansoprazole (Prevacid) and esomeprazole (Nexium) are both proton pump inhibitors (PPIs) used to treat conditions caused by too much stomach acid, such as gastroesophageal reflux disease (GERD) and ulcers. But they have several differences. Lansoprazole and esomeprazole are available in both over-the-counter (OTC) and prescription forms. Lansoprazole can be taken by adults and children, while esomeprazole is also suitable for both but has a specific liquid suspension form for those who can't swallow pills. Both medications can take a few days to start working fully, but esomeprazole may take up to 4 days, whereas lansoprazole typically takes about 3 days. Esomeprazole has a significant interaction with clopidogrel (Plavix), which can raise the risk of blood clots, a concern not highlighted for lansoprazole. Both medications can lower magnesium and vitamin B12 levels and may increase the risk of bone fractures with long-term use.

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What Is A Proton Pump Inhibitor? How To Compare PPIs For Acid Reflux

Lansoprazole

(Prevacid)

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Esomeprazole

(Nexium)

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Summary for Prevacid

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 Prevacid

For adults only:

For adults and children:

Pros and Cons for Prevacid

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

Common Side Effects for Prevacid

  • Diarrhea (4%)
  • Belly pain (2%)

Warnings for Prevacid

  • 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

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

Prices with our coupons for Prevacid vs. Nexium

Price Card Drug Icon
Lansoprazole30 capsules / 30mg
$12.53$35.13
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Esomeprazole30 capsules / 40mg
$13.25$19.78
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