Protonix vs. Prevacid for Heartburn and GERD: Important Differences and Potential Risks.

Key takeaways

Pantoprazole (Protonix) and Lansoprazole (Prevacid) are both proton pump inhibitors (PPIs) used to treat conditions like GERD and excessive stomach acid. Pantoprazole (Protonix) is available only by prescription, while Lansoprazole (Prevacid) can be bought over-the-counter (OTC) or by prescription. Pantoprazole (Protonix) can be taken orally or through an intravenous injection, whereas Lansoprazole (Prevacid) is only taken orally. Lansoprazole (Prevacid) is available in both capsule and orally disintegrating tablet forms, which can be helpful if you have trouble swallowing pills. Both medications can cause side effects like diarrhea, stomach pain, and headache. Additionally, both medications can interact with other drugs, including with Edurant (rilpivirine), which is used to treat HIV.

Pantoprazole

(Protonix)

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Lansoprazole

(Prevacid)

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Summary for Protonix

Prescription only

Pantoprazole (Protonix) is a proton-pump inhibitor (PPI). It's used to treat symptoms of gastroesophageal reflux disease (GERD) in adults and children. It's also used to treat other conditions involving too much stomach acid, such as erosive esophagitis, in adults only. Pantoprazole (Protonix) is taken by mouth, typically once daily for most conditions. Some of the more common side effects of this medication include headache and diarrhea. Pantoprazole (Protonix) isn't available over-the-counter (OTC).

Indications for Protonix

Short-term treatment of gastroesophageal reflux disease (GERD)
Erosive esophagitis
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)

Pros and Cons for Protonix

Pros

Can continue to use with antacids, such as calcium carbonate
Available as a lower-cost generic medication
Oral tablets can be taken without regard to food
Available in oral granules and suspension for people with trouble swallowing

Cons

Long-term use might weaken bones and raise the risk of bone fractures
Might cause or worsen lupus
Interacts with warfarin (Coumadin), which can raise the risk of bleeding
Not available over-the-counter

Common Side Effects for Protonix

Headache (12%)
Diarrhea (9%)
Nausea (7%)
Belly pain (6%)

Please note: Side effect percentages are listed for adults with GERD.

Warnings for Protonix

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