· Learn how Nexium and Prilosec, two proton pump inhibitors (PPIs), work, compare their effectiveness, side effects, and interactions. Find out when to use them for GERD, ulcers, and other conditions. · Learn how Nexium and Prilosec, two common PPIs for GERD, differ in active ingredients, dosing, uses, and side effects.
Understanding the Context
Compare and contrast the two medications and find out which one may be better for you. Two of the most commonly prescribed proton pump inhibitors (PPIs) are omeprazole (Prilosec) and esomeprazole (Nexium). Both are now available as over-the-counter (OTC) drugs.Heartburn is difficult enough. Making sense of your medication choices for gastroesophageal reflux disease (GERD) can make it even more challenging.See full list on healthline.comProton pumps are enzymes found in the parietal cells of your stomach.
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Key Insights
They make hydrochloric acid, the main ingredient of stomach acid.Your body needs stomach acid for digestion. However, when the muscle between your stomach and esophagus doesn’t close properly, this acid can end up in your esophagus. This causes the burning feeling in your chest and throat that’s associated with GERD.Stomach acid in your esophagus can also cause:•asthma•coughing•pneumoniaSee full list on healthline.comPPIs like Nexium and Prilosec are used to treat gastric acid-related conditions, including:•GERD•heartburn•esophagitis, which is inflammation or erosion of the esophagus•stomach and duodenal ulcers, which are caused by Helicobacter pylori (H. pylori) infection or nonsteroidal anti-inflammatory drugs (NSAIDs)•Zollinger-Ellison syndrome, which is a disease in which tumors cause the production of excessive stomach acidSee full list on healthline.comOmeprazole (Prilosec) and esomeprazole (Nexium) are similar drugs. However, there are minor differences in their chemical makeup.Prilosec contains two isomers of the drug omeprazole, while Nexium only contains one isomer.Isomer is a term for a molecule that includes the same chemicals but is arranged in a different way.
Important Details
So, you could say that omeprazole and esomeprazole are made of the same building blocks but are put together differently.While the differences in isomers might seem minor, they can result in differences in how drugs work. For example, the isomer that’s in Nexium is processed more slowly in your body than Prilosec. This means that there are higher levels of the drug in your bloodstream, and esomeprazole may decrease acid production for a longer period of time.It may also work slightly faster to treat your symptoms compared with omeprazole. Esomeprazole is also broken down differently by your liver, so it may lead to fewer drug interactions than omeprazole.See full list on healthline.comMost people don’t have side effects from PPIs.
Final Thoughts
Infrequently, people may experience:•diarrhea•nausea•vomiting•headacheThese side effects may be more likely with esomeprazole than omeprazole.See full list on healthline.comRisk factorsCertain risk factors may affect how your body tolerates PPIs, including: •being of Asian descent, as your body may take longer to process PPIs, and you may need a different dosage •having liver disease •having had low magnesium levels •being pregnant or planning to become pregnant •breastfeedingDrug interactionsAlways tell your doctor about all the drugs, herbs, and vitamins you take. Prilosec and Nexium can interact with other medications you might be taking. The Food and Drug Administration (FDA) has issued a warning that the drug in Prilosec reduces the effectiveness of the blood thinner clopidogrel (Plavix). You shouldn’t take the two drugs together. Other PPIs aren’t included in the warning because they haven’t been tested for this action. These drugs should not be taken with either Nexium or Prilosec: •clopidogrel •delavirdine •nelfinavir •rifampin •rilpivirine •risedronate •St.
John’s wortOther drugs can interact with Nexium or Prilosec but may still be taken with either drug. Tell your doctor if you take any of these drugs so they can evaluate your risk: •amphetamine •aripiprazole •atazanavir •bisphosphonates •bosentan •carvedilol •cilostazol •citalopram •clozapine •cyclosporine •dextroamphetamine •escitalopram •antifungal drugs •fosphenytoin •iron •hydrocodone •mesalamine •methotrexate •methylphenidate •phenytoin •raltegravir •saquinavir •tacrolimus •warfarin or other vitamin K antagonists •voriconazoleSee full list on healthline.comGenerally, you can choose the PPI that’s readily available and costs less. But keep in mind that PPIs treat only the symptoms of GERD and other disorders. They don’t treat the cause and are only indicated for short-term use unless your doctor determines otherwise.Lifestyle changes should be your first step in controlling GERD and heartburn. You may want to try: •weight management•avoiding big meals right before you sleep•quitting or refraining from tobacco use, if you use itOver time, long-term GERD can lead to esophageal cancer. Although few people with GERD get esophageal cancer, it’s important to be aware of the risk.See full list on healthline.comMar 24, 2025 · Esomeprazole (Nexium) and omeprazole (Prilosec, Prilosec OTC) belong to a group of medications called proton pump inhibitors (PPIs). They’re both effective medications for gastroesophageal reflux disease (GERD). Esomeprazole may have stronger acid-lowering effects compared with omeprazole. · Prilosec and Nexium are both used to treat acid-related digestive conditions, but Nexium is more potent and effective than Prilosec. Learn about their uses, side effects, interactions, and safety during pregnancy and breastfeeding. Nexium and Prilosec are both proton pump inhibitors used to treat heartburn and ulcers, but Nexium isprescription and more effective. Learn about their active ingredients, side effects, dosage, pregnancy safety, and availability. What is the difference between Prilosec and Nexium?Esomeprazole -- the newer, more advanced of the two -- is an isomer of omeprazole. This means it's got all the same types and numbers of atoms in the molecule, they're just stuck together in a different way, so Prilosec and Nexium are nearly identical on a chemical level. That slight structural change makes a difference, though.What are Nexium and Prilosec used for?Nexium and Prilosec are used to reduce the acid in the stomach that causes frequent heartburn and conditions associated with it. Nexium is mainly used as a treatment for GERD (Gastro esophageal reflux disease) and Zollinger-Ellison Syndrome, which produces tumors that secrete excess stomach acid.Are Prilosec and Nexium a proton pump inhibitor?Prilosec and Nexium are proton pump inhibitors or proton pump antagonists. Proton pumps are the mechanisms that squirt out components of hydrochloric acid (hydrogen and chloride ions) into the stomach from the gastric glands to be used for digestion.Are Nexium and Prilosec heartburn medications?Nexium and Prilosec are heartburn medications — more specifically Proton Pump Inhibitors (PPI) — manufactured by AstraZeneca Pharmaceuticals. Nexium, whose active ingredient is Esomeprazole, is prescription medicine that is principally used to treat GERD and Zollinger-Ellison Syndrome. · Prilosec (omeprazole) and Nexium (esomeprazole) are related proton pump inhibitors (PPIs) that lower stomach acid, but they have distinct chemical structures and potentially different effects on efficacy and drug interactions. · Prilosec and Nexium are both used to treat acid-related digestive conditions, but Nexium is more potent and effective than Prilosec. Learn about their uses, side effects, interactions, and safety during pregnancy and breastfeeding. Nexium and Prilosec are both proton pump inhibitors used to treat heartburn and ulcers, but Nexium isprescription and more effective. Learn about their active ingredients, side effects, dosage, pregnancy safety, and availability. · Prilosec (omeprazole) and Nexium (esomeprazole) are related proton pump inhibitors (PPIs) that lower stomach acid, but they have distinct chemical structures and potentially different effects on efficacy and drug interactions. · Esomeprazole (Nexium) and omeprazole (Prilosec, Prilosec OTC) belong to a group of medications called proton pump inhibitors (PPIs). They’re both effective medications for gastroesophageal reflux disease (GERD). Esomeprazole may have stronger acid-lowering effects compared with omeprazole.
