Prilosec OTC vs. Prevacid for Heartburn and Gastric Ulcer: Important Differences and Potential Risks.

Key takeaways

Omeprazole (Prilosec) and Lansoprazole (Prevacid) are both proton pump inhibitors (PPIs) used to treat conditions like heartburn and gastroesophageal reflux disease (GERD). While both medications are available over-the-counter (OTC) and by prescription, they differ in their dosing strengths and some specific uses. Omeprazole (Prilosec) is available in 10 mg, 20 mg, and 40 mg prescription strengths, while Lansoprazole (Prevacid) comes in 15 mg and 30 mg strengths. Omeprazole (Prilosec) is typically taken once daily, 30 minutes before breakfast, whereas Lansoprazole (Prevacid) is also taken once daily but can be taken before any meal. Both medications can cause similar side effects like headache and stomach pain, and may take a few days to start working fully, making them less suitable for immediate relief. Additionally, long-term use of both medications can lead to risks like bone fractures and low vitamin B12 levels. Always consult your healthcare provider to determine which medication is best for your specific needs.

Omeprazole

(Prilosec)

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Lansoprazole

(Prevacid)

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Summary for Prilosec OTC

Prescription or over-the-counter

Omeprazole (Prilosec) is a proton pump inhibitor (PPI). Over-the-counter (OTC) omeprazole (Prilosec) can ease heartburn, while the prescription version can treat gastroesophageal reflux disease (GERD) and other conditions involving too much stomach acid. Omeprazole (Prilosec) is taken by mouth, typically once daily 30 minutes before breakfast. Some of the more common side effects of omeprazole (Prilosec) include headache, stomach pain, and nausea. It's available as both brand name and generic medications.

Indications for Prilosec OTC

For adults only:

Heartburn — OTC only
Stomach or duodenal ulcer
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 Prilosec OTC

Pros

Typically few to no noticeable day-to-day side effects
Provides longer-lasting relief than some other heartburn medications
Can use for adults, as well as children with certain medical conditions
Available as over-the-counter and lower-cost generic options

Cons

Interacts with many medications, such as digoxin (Lanoxin) and clopidogrel (Plavix)
Won't provide immediate heartburn relief
Usually taken 30 to 60 minutes before eating a meal for best results
Not recommended for long-term treatment, except for certain conditions, because of risk of serious side effects

Common Side Effects for Prilosec OTC

Adults

Headache (7%)
Belly pain (5%)
Nausea (4%)
Diarrhea (4%)
Vomiting (3%)
Passing gas (3%)

Children — similar to the above, with the addition of:

Respiratory system problems (up to 75%)
Fever (up to 33%)
Ear infection (up to 22%)

Warnings for Prilosec OTC

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
Inaccurate lab work

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:

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 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

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 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