Tagamet HB vs. Prevacid for Heartburn and Gastric Ulcer: Important Differences and Potential Risks.

Key takeaways

Cimetidine (Tagamet HB) and lansoprazole (Prevacid) are both used to treat conditions related to excess stomach acid, but they belong to different drug classes and work in different ways. Cimetidine is a histamine H2 receptor antagonist (H2RA) that blocks acid production in the stomach, while lansoprazole is a proton pump inhibitor (PPI) that stops acid from being pumped into the stomach. Cimetidine is available both over-the-counter (OTC) and by prescription, and it can be used for heartburn, gastroesophageal reflux disease (GERD), and ulcers. Lansoprazole is also available OTC and by prescription, but it is typically used for more frequent heartburn, GERD, and ulcers. Lansoprazole can also lower the risk of ulcers caused by Helicobacter pylori (H. pylori) infection or nonsteroidal anti-inflammatory drugs (NSAIDs). Cimetidine can be taken multiple times a day, whereas lansoprazole is usually taken once daily. Cimetidine has more drug interactions compared to lansoprazole, which can make it less suitable for people taking multiple medications. Long-term use of lansoprazole can lead to risks like bone fractures and low magnesium levels, which are less likely with cimetidine.

Cimetidine

(Tagamet HB)

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Lansoprazole

(Prevacid)

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Summary for Tagamet HB

Prescription or over-the-counter

Cimetidine (Tagamet HB) is a histamine H2 receptor antagonist (H2RA) that lowers how much acid is made in the stomach. The over-the-counter (OTC) version relieves and prevents heartburn in people 12 years and older. Higher strengths of cimetidine are prescription only and are used to treat acid reflux, stomach and gut ulcers, and other stomach acid problems in people 16 years and older. Cimetidine (Tagamet HB) is taken by mouth one to four times a day, depending on what stomach problem you have. This medication has few side effects, which can include headache, dizziness, and diarrhea.

Indications for Tagamet HB

Heartburn related to indigestion and sour stomach - OTC only
Erosive gastroesophageal reflux disease (GERD) - prescription only
Gastric and duodenal ulcers - prescription only
Conditions that cause too much stomach acid (such as Zollinger-Ellison syndrome) - prescription only

Pros and Cons for Tagamet HB

Pros

Available as an OTC product for heartburn only
Available as a tablets and an oral solution

Cons

Interacts with many medications, including warfarin (Coumadin) and propranolol
Might not work as well as you continue taking the medication (when taken long-term)

Common Side Effects for Tagamet HB

Diarrhea
Headache
Dizziness
Sleepiness

Warnings for Tagamet HB

Speak with provider if symptoms don't go away or come back
Confusion
Drug interactions

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