Compare Nexium vs. Zantac

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

Nexium
(esomeprazole)

Zantac 75
(ranitidine)

Treats heartburn and stomach ulcers. Nexium (esomeprazole) gives you long-lasting heartburn relief but has some risks if used long term.Relieves heartburn and stomach ulcers. Zantac 75 (ranitidine) is an effective and inexpensive medicine for hearburn with few side effects, but may interfere with other drugs.
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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 Zantac
72%
+3% better vs. Nexium
44%
+15% better vs. Nexium
7%
-4% worse vs. Nexium
1062 reviews
Have you used Zantac 75 (ranitidine)?
Worth itNot sureNot worth it
Side effects
NexiumZantac

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

More about Nexium side effects »

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

More about Zantac side effects »
How it works
NexiumZantac
Nexium (esomeprazole) is a proton pump inhibitor (PPI). It treats heartburn and heals ulcers by lowering the amount of acid in your stomach.Zantac 75 (ranitidine) reduces the production of acid by blocking a chemical from acting on the acid-producing cells in your stomach.
Type of medication
NexiumZantac
Over-the-counterPrescription or OTC
Available as
NexiumZantac
  • Pill
  • Injection
  • Packet
  • Pill
  • Oral solution
  • Oral syrup
  • Injection
Used for
NexiumZantac
  • GERD
  • H Pylori Bacterial Infection
Risk factors for serious side effects
NexiumZantac
  • 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 »
  • Aged 60 years or older
  • Kidney conditions
  • Liver conditions
  • Acute Porphyria
  • Asthma
Detailed Zantac 75 (ranitidine) risks & warnings »
Pregnancy
Interactions
NexiumZantac
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
  • Zantac 75 (ranitidine) can interact with certain prescription and over-the-counter medications. Let your doctor or pharmacist know about the medicines you are currently taking.
Alcohol
NexiumZantac
No alcohol related info.
  • The syrup product may contain up to 7.5% of alcohol.
Kidneys and liver
NexiumZantac
  • 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.
No kidneys and liver related info.
Upsides and benefits
NexiumZantac
  • 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.
  • Zantac 75 (ranitidine) works well to relieve heartburn symtoms and is quite tolerable.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
  • If you have trouble swallowing pills you may find the liquid product a good option.
  • Inexpensive with over-the-counter and generic options.
  • Coupons are available for the brand product - speak to your doctor or pharmacist.
Downsides and risks
NexiumZantac
  • 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.
  • Zantac 75 (ranitidine) doesn't work as quickly as some other acid reducers. Speak to your doctor or pharmacist if you need quicker relief.
  • Zantac 75 (ranitidine) does not last as long as some other acid reducers. Speak to your doctor or pharmacist if you need longer relief.
  • May not be as effective in healing the esophagus when it is inflammed or torn, known as erosive esophagitis. Your doctor will assess which medication is best for you.
  • Can lower your vitamin B12 levels if you use Zantac 75 (ranitidine) for a long time. Your doctor can order lab tests to monitor your vitamin B12 levels.
Tips from our pharmacists for people taking the medication
NexiumZantac
  • 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.
  • To prevent a heartburn attack, take Zantac 75 (ranitidine) 30 minutes before eating.
  • Works within 30 to 60 minutes. Relief lasts up to 12 hours.
  • Do not use Zantac 75 (ranitidine) for more than 14 days. Talk to your doctor if your symptoms do not improve after 2 weeks of using the over-the-counter product, as this may indicate a more serious problem.
  • The syrup product may contain up to 7.5% of alcohol.
  • Speak to your doctor or pharmacist about lifestyle and dietary changes that can help prevent heartburn.
Learn more
More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it
More about ZantacSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Zantac 75 (ranitidine)?
Worth itNot sureNot worth it