Compare Nexium vs. Pepcid

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

Nexium
(esomeprazole)

Pepcid
(Famotidine)

Treats heartburn and stomach ulcers. Nexium (esomeprazole) gives you long-lasting heartburn relief but has some risks if used long term.Relieves heartburn. Pepcid (Famotidine) works well for heartburn but may not last as long or start working as quickly as other antacids.
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 Pepcid
75%
Same vs. Nexium
41%
+18% better vs. Nexium
8%
-3% worse vs. Nexium
853 reviews
Have you used Pepcid (Famotidine)?
Worth itNot sureNot worth it
Side effects
NexiumPepcid

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

More about Nexium side effects »
  • Diarrhea 2%
  • Headache 5%
More Pepcid side effects »
How it works
NexiumPepcid
Nexium (esomeprazole) is a proton pump inhibitor (PPI). It treats heartburn and heals ulcers by lowering the amount of acid in your stomach.Pepcid (Famotidine) is a type of antacid called an H2 blocker. It blocks the chemical histamine, which lowers acid production in your stomach. This treats heartburn and helps ulcers heal.
Type of medication
NexiumPepcid
Over-the-counterLower-cost generic availablePrescription or OTCLower-cost generic available
Available as
NexiumPepcid
  • Pill
  • Injection
  • Packet
  • Pill
  • Chewable tablet
  • Liquid
Used for
NexiumPepcid
  • GERD
  • H Pylori Bacterial Infection
Risk factors for serious side effects
NexiumPepcid
  • 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 »
  • Current kidney disease
Detailed Pepcid (Famotidine) 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
NexiumPepcid
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
  • Few drug interactions.
Kidneys and liver
NexiumPepcid
  • 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.
  • Because Pepcid (Famotidine) is processed by the kidney it can cause some worrisome side effects for people with kidney problems. These include confusion, delirium, and a dangerous irregular heartbeat known as QT prolongation. If you have kidney problems, you may need a different dose to prevent this increased risk for side effects.
  • Can cause more serious side effects for people with kidney disease. Ask your doctor to give you a lower dose or choose a different option.
Upsides and benefits
NexiumPepcid
  • 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 Famotidine without any noticeable day-to-day side effects.
  • Famotidine lasts longer than many other antacids like Maalox and 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.
  • Available as both a generic and over-the-counter option, so it's pretty affordable.
  • Few drug interactions.
Downsides and risks
NexiumPepcid
  • 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.
  • Other antacids like Maalox, Tums, or Rolaids often start to work more quickly than Famotidine.
  • Medication like omeprazole (proton pump inhibitors) works better at healing and preventing stomach ulcers than medication like Famotidine (H2 blockers).
  • Can cause more serious side effects for people with kidney disease. Ask your doctor to give you a lower dose or choose a different option.
Tips from our pharmacists for people taking the medication
NexiumPepcid
  • 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.
  • Short-term treatment of ulcers and acid reflux.
Learn more
More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it
More about PepcidSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Pepcid (Famotidine)?
Worth itNot sureNot worth it