Compare Nexium vs. pantoprazole

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

Nexium
(esomeprazole)

Protonix
(pantoprazole)

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 excess release of stomach acid. Protonix (pantoprazole) is usually only taken once a day for long-lasting heartburn relief, but it can increase your risk of bone fractures if you've used it for a long time.
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Prices and coupon for 30 (40mg) capsules of esomeprazole
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Prices and coupon for 30 (40mg) tablets of pantoprazole
Reviews & ratings
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5.45Nexium
Reviews for Nexium (esomeprazole)
75%
of people (All ages) say Nexium (esomeprazole) 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 Protonix (pantoprazole)
68%
-7% worse vs. Nexium (esomeprazole)
51%
-8% worse vs. Nexium (esomeprazole)
13%
-2% worse vs. Nexium (esomeprazole)
584 reviews
Have you used Protonix (pantoprazole)?
Worth itNot sureNot worth it
Side effects
Nexiumpantoprazole
  • Diarrhea 3%
  • Headache 2%
  • Drowsiness 2%
  • Change in taste 7%
  • Abdominal pain 4%
  • Nausea 2%
  • Irritability 5%
  • Vomiting 5%
More Nexium side effects »
  • Headache 3%
  • Diarrhea 4%
  • Vomiting 2%
  • Dizziness 2%
  • Joint pain 2%
More pantoprazole side effects »
How it works
Nexiumpantoprazole
Nexium (Esomeprazole) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach, treats heartburn, and heals ulcers.Protonix (pantoprazole) is a proton pump inhibitor. It lowers the amount of acid in your stomach which treats heartburn.
Type of medication
Nexiumpantoprazole
Prescription or OTC
Prescription only
Available as
Nexiumpantoprazole
  • Extended release
  • Pill
  • Packet
Used for
Nexiumpantoprazole
Risk factors for serious side effects
Nexiumpantoprazole
    • Helicobacter pylori infection
    • Autoimmune disease
    • Being hospitalized
    • Antibiotic use
    • Osteoporosis
    • Age 50 or older
    • Using high medication doses
    • Long-term therapy (1 year or more)
    • Smoking
    • Use of other medications that weaken bones
      Detailed Nexium (esomeprazole) risks & warnings »
      • Using multiple daily doses and/or for 1 year or longer
      • People age 65 or older
      • High risk of bone fractures
      • People who are being treated in the hospital
        • People with lupus
        • Taking Protonix (pantoprazole) for more than 3 years
        • Diuretics (water pills)
        • Digoxin
        Detailed Protonix (pantoprazole) risks & warnings »
        Pregnancy

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

        Interactions
        Nexiumpantoprazole
        • 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.
        No interactions related info.
        Food
        Nexiumpantoprazole
        • Take 1 hour before a meal.
        • Unlike other proton pump inhibitors, it can be taken with or without food and have the same effectiveness.
        Kidneys and liver
        Nexiumpantoprazole
        No kidneys and liver related info.
        • Protonix (pantoprazole) can very rarely damage your kidneys. This can happen at any time. Talk to your doctor right away if you are urinating less or have blood in the urine.
        Pain
        Nexiumpantoprazole
        No pain related info.
        • Talk to your doctor if you get watery diarrhea, fever, or stomach pain that don't go away after taking Protonix (pantoprazole), which can happen even 2 months after stopping the medicine.
        Upsides and benefits
        Nexiumpantoprazole
        • 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 Protonix (pantoprazole) without any noticeable day-to-day side effects.
        • Protonix (pantoprazole) 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 with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
        • Unlike other proton pump inhibitors, it can be taken with or without food and have the same effectiveness.
        • Can be used in children age 5 or older.
        Downsides and risks
        Nexiumpantoprazole
        • 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.
        • Needs to be taken every single day for a certain period of time to be effective.
        • Like with other proton pump inhibitors, long-term use can cause weak or broken bones.
        • Only available as a prescription medicine, not over the counter.
        • Can lower the magnesium level in your body so you may need to take a supplement for it.
        Tips from our pharmacists for people taking the medication
        Nexiumpantoprazole
        • 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 the tablet form of Protonix (pantoprazole) with or without food.
        • The medicine should be swallowed whole and not to to be chewed or crushed.
        • Protonix (pantoprazole) takes some time to kick in, about 2.5 hours after taking it.
        • The oral suspension form needs to be prepared and then taken 30 minutes before a meal. The contents of the packet for the suspension shouldn't be crushed or chewed and be taken in apple juice or applesauce only as stated in the instructions.
        • Talk to your doctor if you get watery diarrhea, fever, or stomach pain that don't go away after taking Protonix (pantoprazole), which can happen even 2 months after stopping the medicine.
        • Using this medicine for a long period of time can increase your risk of getting weaker bones. Talk to your doctor if you are worried about this possible long-term side effect.
        Learn more
        More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert
        Have you used Nexium (esomeprazole)?
        Worth itNot sureNot worth it
        More about pantoprazoleSide effectsReviews & ratingsAlternativesFDA package insert
        Have you used Protonix (pantoprazole)?
        Worth itNot sureNot worth it