Compare Nexium vs. Omeprazole

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

Nexium
(esomeprazole)

Prilosec
(omeprazole)

Treats heartburn and stomach ulcers. Nexium (Esomeprazole) gives you long-lasting heartburn relief. But this purple pill ain't cheap! The generic forms of alternative drugs work just as well, and are usually less expensive.Treats heartburn and stomach ulcers. Prilosec (Omeprazole) gives you long-lasting heartburn relief. Choose the cheapest proton pump inhibitor because they all work equally well for heartburn.
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Coupons for Nexium
Best available price for 30 (40mg) capsules of nexium
Coupons for Omeprazole
Best available price for 30 (20mg) capsules of omeprazole
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
5.45Nexium
Reviews for Nexium
75%
of people (All ages) say Nexium is worth it
59%
say it works well
11%
say it's a big hassle
1239 reviews
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it
Reviews for Omeprazole
80%
-5% worse vs. Nexium
59%
Same vs. Nexium
8%
-3% worse vs. Nexium
1167 reviews
Have you used Prilosec (omeprazole)?
Worth itNot sureNot worth it
Side effects
NexiumOmeprazole
  • Diarrhea 3%
  • Headache 2%
  • Drowsiness 2%
  • Change in taste 7%
  • Abdominal pain 4%
  • Nausea 2%
  • Irritability 5%
  • Vomiting 5%
More Nexium side effects »
  • Upper respiratory infection 75%
  • Fever 33%
  • Headache 7%
  • Abdominal pain 5%
  • Nausea 4%
  • Diarrhea 4%
  • Accidental injuries 4%
  • Passing gas 3%
  • Vomiting 3%
More Omeprazole side effects »
How it works
NexiumOmeprazole
Nexium (Esomeprazole) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach, treats heartburn, and heals ulcers.Prilosec (Omeprazole) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach, treats heartburn, and heals ulcers.
Type of medication
NexiumOmeprazole
Prescription or OTCPrescription or OTC
Available as
NexiumOmeprazole
  • Extended release
  • Extended release
Used for
NexiumOmeprazole
Risk factors for serious side effects
NexiumOmeprazole
  • Helicobacter pylori infection
  • Autoimmune disease
  • Being hospitalized
  • Antibiotic use
  • Osteoporosis
Detailed Nexium (esomeprazole) risks & warnings »
  • Helicobacter pylori infection
  • Autoimmune disease
  • Being hospitalized
  • Antibiotic use
  • Osteoporosis
Detailed Prilosec (omeprazole) risks & warnings »
Pregnancy

Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Interactions
NexiumOmeprazole
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Nexium.
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Nexium.
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Omeprazole.
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Omeprazole.
Food
NexiumOmeprazole
  • Take 1 hour before a meal.
  • Take 1 hour before a meal.
Upsides and benefits
NexiumOmeprazole
  • Most people can take Nexium without any noticeable day-to-day side effects.
  • Nexium lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once or twice a day.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
  • In studies it was better than a placebo (sugar pill) and as good as other proton pump inhibitors at treating heartburn.
  • Available as both a generic and over-the-counter option, so it's pretty affordable.
  • Most people can take Omeprazole without any noticeable day-to-day side effects.
  • Omeprazole lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once or twice a day.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
  • In studies it was better than a placebo (sugar pill) and as good as other proton pump inhibitors at treating heartburn.
  • Available as both a generic and over-the-counter option, so it's pretty affordable.
Downsides and risks
NexiumOmeprazole
  • Doesn't start working as fast as some other antacids like Tums, Rolaids, or Maalox.
  • Like with other proton pump inhibitors, long-term use can cause weak or broken bones.
  • Can cause low levels of magnesium in the blood. You might need to take a magnesium supplement if you use Nexium long-term.
  • Can be expensive—especially the purple brand-name pill. Other alternatives are usually cheaper than Nexium and work just as well.
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Nexium.
  • Doesn't start working as fast as some other antacids like Tums, Rolaids, or Maalox.
  • Like with other proton pump inhibitors, long-term use can cause weak or broken bones.
  • Can cause low levels of magnesium in the blood. You might need to take a magnesium supplement if you use Omeprazole long-term.
  • Although the generic is affordable, other medications might still be cheaper than Omeprazole.
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Omeprazole.
Tips from our pharmacists for people taking the medication
NexiumOmeprazole
  • Take 1 hour before a meal.
  • Don't chew or crush capsules; swallow them whole.
  • If you have trouble swallowing you can carefully open the capsules and sprinkle the inside pellets onto applesauce. Swallow the applesauce without chewing or crushing the pellets.
  • When using Nexium long-term, take a calcium citrate with vitamin D supplement daily to prevent bone loss. Be sure it's calcium citrate because it works the best when using a proton pump inhibitor.
  • Get a blood test for your magnesium level once a year; you may need a magnesium supplement while using Nexium.
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Nexium.
  • Take 1 hour before a meal.
  • Don't chew or crush capsules; swallow them whole.
  • If you have trouble swallowing you can carefully open the capsules and sprinkle the inside pellets onto applesauce. Swallow the applesauce without chewing or crushing the pellets.
  • When using Omeprazole long-term, take a calcium citrate with vitamin D supplement daily to prevent bone loss. Be sure it's calcium citrate because it works the best when using a proton pump inhibitor.
  • Get a blood test for your magnesium level once a year; you may need a magnesium supplement while using Omeprazole.
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Omeprazole.
Learn more
More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it
More about OmeprazoleSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Prilosec (omeprazole)?
Worth itNot sureNot worth it