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 has some risks if used long term.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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Best available price for 30 (40mg) tablets of pantoprazole
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 pantoprazole
68%
+7% better vs. Nexium
51%
+8% better vs. Nexium
13%
+2% better vs. Nexium
584 reviews
Have you used Protonix (pantoprazole)?
Worth itNot sureNot worth it
Side effects
Nexiumpantoprazole

The Nexium FDA package insert doesn’t have numbers about how common side effects are.

More about 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 treats heartburn and heals ulcers by lowering the amount of acid in your stomach.Protonix (pantoprazole) is a proton pump inhibitor. It lowers the amount of acid in your stomach which treats heartburn.
Type of medication
Nexiumpantoprazole
Over-the-counterPrescription only
Available as
Nexiumpantoprazole
  • Pill
  • Injection
  • Packet
  • Pill
  • Packet
Used for
Nexiumpantoprazole
  • GERD
  • H Pylori Bacterial Infection
Risk factors for serious side effects
Nexiumpantoprazole
  • Being treated at a hospital
  • High dose Nexium (esomeprazole)
  • Long-term treatment with Nexium (esomeprazole)
  • Low bone mineral density
  • Aged 65 years or older
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
Detailed Protonix (pantoprazole) risks & warnings »
Pregnancy
Interactions
Nexiumpantoprazole
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
No interactions related info.
Food
Nexiumpantoprazole
No food related info.
  • Unlike other proton pump inhibitors, it can be taken with or without food and have the same effectiveness.
Kidneys and liver
Nexiumpantoprazole
  • Nexium (esomeprazole) can cause acute kidney damage that can occur at any time during treatment. If you notice blood in the urine, changes in urine output, swelling of the body, weight gain, fever, or confusion, stop taking Nexium (esomeprazole) and speak to your doctor immediately.
  • 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 (esomeprazole) without any noticeable day-to-day side effects.
  • Nexium (esomeprazole) lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once a day.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need quicker relief.
  • Nexium (esomeprazole) is inexpensive, with over-the-counter and generic options.
  • Coupons are available for the brand name - speak to your doctor or pharmacist.
  • The packet form is a good option if you have trouble swallowing pills.They can be mixed with water for easier swallowing.
  • 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 right away like antacids (Tums, Rolaids, or Maalox).
  • It can take several days or weeks to start feeling benefits.
  • May not be the best choice for patients 65 years of age and older due to risk of bone fractures and severe diarrhea.
  • 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 Nexium (esomeprazole) with a full glass of water 1 hour before eating.
  • Starts working in as little as an hour.
  • It can take 1 to 4 days to take full effect.
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
  • Do not take Nexium (esomeprazole) for more than 14 days, unless directed by your doctor. Speak to your doctor if your symptoms don't go away after 2 weeks.
  • Nexium (esomeprazole) capsules can be opened and sprinkled on 1 tablespoon of applesauce, cottage cheese, or yogurt. Swallow immediately after.
  • 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