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Zegerid vs. Nexium

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

Key takeaways

Zegerid (omeprazole/sodium bicarbonate) and Nexium (esomeprazole) are both medications used to treat conditions caused by too much stomach acid, but they have some key differences. Zegerid combines omeprazole, a proton pump inhibitor (PPI), with sodium bicarbonate, an antacid that protects omeprazole from stomach acid. Nexium, on the other hand, contains only esomeprazole, a PPI. Zegerid and Nexium are both available in prescription and over-the-counter forms. Zegerid is taken once daily, typically on an empty stomach, and is available as capsules and a liquid. Nexium is taken an hour before meals and comes in capsules, tablets, and a liquid. Zegerid contains sodium, which may not be suitable for those on a low-sodium diet. Both medications can cause side effects like headaches, stomach pain, and diarrhea, and long-term use of either can lead to bone fractures and low magnesium and vitamin B12 levels.

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Esomeprazole Vs. Omeprazole: Which Is Best For GERD?

Zegerid

(omeprazole / sodium bicarbonate)

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Esomeprazole

(Nexium)

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Summary for Zegerid

Prescription or over-the-counter

Zegerid (omeprazole / sodium bicarbonate) is a combination medication used to treat conditions related to having too much stomach acid. This medication is typically taken by mouth once daily. But don't take it longer than what your provider recommends. Doing so raises your risk for side effects, such as bone fractures or low magnesium levels. Zegerid (omeprazole / sodium bicarbonate) is available as a powder that can be made into a liquid suspension for people who have trouble swallowing pills.

Indications for Zegerid

Prescription-strength Zegerid (omeprazole / sodium bicarbonate) capsules and suspension:

  • Stomach ulcer
  • Duodenal (first part of small intestine) ulcer
  • Heartburn and other symptoms related gastroesophageal reflux disease (GERD)
  • Erosive esophagitis (inflammation of the esophagus) due to GERD
  • Lower the risk of stomach bleeding in hospitalized people (suspension only)

OTC Zegerid (omeprazole / sodium bicarbonate) capsules:

  • Frequent heartburn

Konvomep (omeprazole / sodium bicarbonate) suspension:

  • Stomach ulcer
  • Lower the risk of stomach bleeding in hospitalized people

Pros and Cons for Zegerid

Pros

  • Available over the counter
  • Packet form is a good option if you have trouble swallowing pills
  • Typically taken once daily
  • Available as lower-cost generics
  • Longer-lasting relief than some other medications for heartburn

Cons

  • Takes 1 to 4 days to ease heartburn
  • Has sodium, so not a good option for people on sodium-restricted diets
  • Typically has to be taken on an empty stomach before meals for best results
  • Can interact with other medications
  • Long-term use can weaken your bones and cause low vitamin B12 and magnesium

Common Side Effects for Zegerid

  • Headache (3-7%)
  • Stomach pain (2-5%)
  • Diarrhea (3-4%)
  • Nausea (2-4%)
  • Gas (3%)
  • Vomiting (2-3%)

Please note: These side effects were reported in clinical trials by people who took omeprazole only. The side effects you experience from Zegerid (omeprazole / sodium bicarbonate) might differ.

Warnings for Zegerid

  • Follow up with provider needed
  • Kidney damage
  • Severe skin reactions
  • High sodium content
  • Acid and base out of balance (Milk-alkali syndrome)
  • Severe diarrhea
  • Bone fractures
  • Lupus
  • Interactions with other medications
  • Low vitamin B12 and magnesium levels
  • Small growths in the stomach

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 Zegerid vs. Nexium

Price Card Drug Icon
Omeprazole/Sodium Bicarbonate90 capsules / 40mg/1100mg
$71.68-
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Esomeprazole30 capsules / 40mg
$13.25$20.91
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